UGLHRF1005.13
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PROOF OF ENTITLEMENT TO WORK IN AUSTRALIA
Please complete using BLOCK LETTERS:

All sections - * Mandatory fields

Sign and date the form; Return to Interviewer
Details of Applicant
Surname*
Given Names*
If
you
have
not
produced
identification
documentation, please complete the section below,
to allow UGL to check your entitlement to work in
Australia.
Details of Position Applying for
Authority to obtain details of work rights status form
DIAC
Position Title*
I authorise the Department of Immigration and Citizenship
(DIAC) to release the details of my work rights status (that is,
my entitlement to work legally in Australia) to UGL.
Business Segment*
Group
Engineering
O&M
DTZ
I understand that these details are held by DIAC on
departmental files and computer systems. I also understand
that UGL will use this information for the purposes of
establishing my legal entitlement to work in Australia, and for
no other purpose.
Location*
Residency Status*
Print Name
Australian Citizen
Australian Permanent Resident
Aboriginal/Torres Strait Islander
Passport Number
New Zealand Citizen who entered Australia on a valid
NZ Passport
Non-Citizen holding a valid visa with work rights
Country of Issue
Permission Number (DIAC Approved Position
Nomination Number)
Date of Birth
Visa Class and Subclass
Signature
Use Drop Down Menu
Student Visa
417 Working Holiday Visa
457 Visa
457 Regional Area Visa
Date
485 Temporary Graduate Visa
Other Resident Visa (eg Spouse or Bridging)
Supervisor / Manager
Date Issued
Original evidence of work rights sighted and
copied to file
Duration of Visa
Years
Months
Evidence of Work Rights*
(no other documents are acceptable as proof of work rights)
One of the following Original Documents must be sighted
Australian Birth Certificate
No evidence of work rights
Check of Visa Class – fax this form to DIAC on
1800 505 550. If all details match DIAC’s
records, the person’s work rights status will be
faxed to you within one working day – please
include your contact details for response
Australian Citizenship Certificate
Australian Passport
Aboriginal/Torres Strait Islander Community
Identification
Certificate of Evidence of Resident Status
Valid Visa with Work Rights
Print Name
HR Manager
Signature
Date