1263 Working Holiday Visa: Employment Verification
Form
Working Holiday visa:
Employment verifi cation
1263
THIS IS NOT AN APPLICATION FORM
About this form
Eligible regional Australia postcodes
Important – Please read this information carefully before
Regional areas
Postcodes
you complete your Employment verification. Once you have
completed your Employment verification we strongly advise
New South Wales
2311 to 2312
(most areas except the greater
that you keep a copy for your records.
2328 to 2411
Sydney area, Newcastle, the
2420 to 2490
Central Coast and Wollongong)
2536 to 2551
Who should use this form?
2575 to 2594
2618 to 2739
This form is for people who are in Australia as holders of a
2787 to 2898
Working Holiday visa and who wish to apply for a second
Working Holiday visa.
Northern Territory
Entire Territory
This form is to record details of employment in a specified
Queensland
4124 to 4125
field or industry in regional Australia.
(most areas except the greater
4133
Brisbane area and the Gold Coast) 4211
Other evidence of specified work may include original or
4270 to 4272
certified copies of payslips, group certificates, payment
4275
summaries, tax returns and employer references. Providing
4280
this evidence with this form will enable your application to be
4285
assessed more quickly.
4287
4307 to 4499
The completed form should be retained and may be
4510
requested by the Department of Immigration and Citizenship
4512
(the department) after you lodge your application
4515 to 4519
electronically to verify your specified work. If lodging a paper
4522 to 4899
application, please attach this form.
South Australia
Entire State
To be eligible for a second Working Holiday visa, the applicant
must have undertaken work for a minimum of 3 months
Tasmania
Entire State
(88 days in total) in a specified field or industry* in a
Victoria
3139
designated area of regional Australia**.
(most areas except the
3211 to 3334
greater Melbourne area)
Specified work is any type of work in the list below:
3340 to 3424
3430 to 3649
• plant and animal cultivation:
3658 to 3749
– cultivating or propagating plants, fungi or their products
3753, 3756, 3758, 3762, 3764
3778 to 3781
or parts;
3783, 3797, 3799
– general maintenance crop work;
3810 to 3909
3921 to 3925
– harvesting and/or packing fruit and vegetable crops;
3945 to 3974
– immediate processing of animal products including
3979
shearing, butchery in an abattoir, packing and tanning;
3981 to 3996
Note: Secondary processing of animal products, such as
small goods processing and retail butchery is not eligible.
Western Australia
6041 to 6044
(most areas except Perth and
6083 to 6084
– immediate processing of plant products;
surrounding areas)
6121 to 6126
– maintaining animals for the purpose of selling them or
6200 to 6799
their bodily produce, including natural increase;
(Information about harvest work opportunities in regional
– manufacturing dairy produce from raw material;
Australia can be found at the Harvest Trail website at
– pruning and trimming vines and trees.
www.jobsearch.gov.au/harvesttrail)
Some vacancies on the Harvest Trail website may not be in the
above eligible postcodes.
* For further information please see ‘Specified work’
www.immi.gov.au/visitors/working-holiday/417/
eligibility-second.htm
** ‘Regional Australia’ is restricted to areas within the postcodes
listed in the opposite table.
© COMMONWEALTH OF AUSTRALIA, 2009
1263 (Design date 11/09) - Page 1
• fishing and pearling:
– conducting operations relating directly to taking or
catching fish and other aquatic species;
– conducting operations relating directly to taking or
culturing pearls or pearl shell.
• tree farming and felling:
– felling trees in a plantation or forest;
– planting or tending trees in a plantation or forest that are
intended to be felled;
– transporting trees or parts of trees that were felled in
a plantation or forest to the place where they are first
to be milled or processed or from which they are to be
transported to the place where they are to be milled or
processed.
• mining:
– coal mining;
– construction material engineering
– exploration;
– metal ore mining;
– mining support services;
– oil and gas extraction;
– other non-metallic mineral mining and quarrying.
• construction:
– building completion services;
– building installation services;
– building structure services;
– heavy and civil engineering construction;
– land development and site preparation services;
– non-residential building construction;
– residential building construction;
– other construction services.
Specified work:
• does not need to be paid work.
Example: Work undertaken as a volunteer or through
the Willing Workers on Organic Farms (WWOOF) scheme
may also qualify if the work you undertook falls with the
specified work definition above.
• does not need to be undertaken as a direct employee
Example: Work in the list above as a contractor is eligible.
• must be listed above
Example: Working as a nanny for a farmer would not be
eligible.
1263 (Design date 11/09) - Page 2
© COMMONWEALTH OF AUSTRALIA, 2009
Your personal details
1
DAY
MONTH
YEAR
Your full name as it appears on your passport
3
Your date of birth
4
Your passport number
2
Other names you are known by, if any
(including aliases, previous married names, names other than on your
passport)
Your employment details
5
Details of employment in specified industries in regional Australia
You must keep a record of all dates worked. You will require this information when lodging your Working Holiday visa application electronically.
If you have worked for the same employer on more than one occasion, you should record each period of employment separately or attach a separate
document containing these details.
If you have more employer details than will fit in the spaces below, attach a separate document containing these details.
You should attach evidence of your specified work (see page 1). This will allow your application to be assessed more quickly.
A I confirm the following work has been undertaken
Employee’s full name
Type of work
Actual number of days worked
DAY
MONTH
YEAR
DAY
MONTH
YEAR
Start date
End date
Postcode where work was completed
Business name and address
Employer’s telephone number
Employer’s full name
( )
Employer’s ABN
Signature
of employer
POSTCODE
Name of contact for work verification
E-mail address (if available)
Contact person’s telephone number
(eg. payroll officer/direct supervisor)
( )
@
B Employee’s full name
Type of work
Actual number of days worked
DAY
MONTH
YEAR
DAY
MONTH
YEAR
Start date
End date
Postcode where work was completed
Business name and address
Employer’s telephone number
Employer’s full name
( )
Employer’s ABN
Signature
of employer
POSTCODE
Name of contact for work verification
E-mail address (if available)
Contact person’s telephone number
(eg. payroll officer/direct supervisor)
( )
@
C Employee’s full name
Type of work
Actual number of days worked
DAY
MONTH
YEAR
DAY
MONTH
YEAR
Start date
End date
Postcode where work was completed
Business name and address
Employer’s telephone number
Employer’s full name
( )
Employer’s ABN
Signature
of employer
POSTCODE
Name of contact for work verification
E-mail address (if available)
Contact person’s telephone number
(eg. payroll officer/direct supervisor)
( )
@
© COMMONWEALTH OF AUSTRALIA, 2009
1263 (Design date 11/09) - Page 3
D Employee’s full name
Type of work
Actual number of days worked
DAY
MONTH
YEAR
DAY
MONTH
YEAR
Start date
End date
Postcode where work was completed
Business name and address
Employer’s telephone number
Employer’s full name
( )
Employer’s ABN
Signature
of employer
POSTCODE
Name of contact for work verification
E-mail address (if available)
Contact person’s telephone number
(eg. payroll officer/direct supervisor)
( )
@
E Employee’s full name
Type of work
Actual number of days worked
DAY
MONTH
YEAR
DAY
MONTH
YEAR
Start date
End date
Postcode where work was completed
Business name and address
Employer’s telephone number
Employer’s full name
( )
Employer’s ABN
Signature
of employer
POSTCODE
Name of contact for work verification
E-mail address (if available)
Contact person’s telephone number
(eg. payroll officer/direct supervisor)
( )
@
Your contact details
Your declaration
6
Your e-mail address
WARNING: Giving false or misleading information is a serious offence.
10 I declare that the information I have supplied on this form is complete,
correct and up-to-date in every detail.
7
Current residential address
(If applying in Australia, please give your current address in Australia)
Your
Note: A post office box address is not acceptable as a residential
signature
address. Failure to give a residential address will result in your
application being invalid.
DAY
MONTH
YEAR
Date
We strongly advise that you keep a copy of your Employment
POSTCODE
verification and all attachments for your records.
8
Address for correspondence
(This may be required by the department to communicate with you
about your application. If the same as your residential address, write
‘AS ABOVE’)
POSTCODE
9
Your telephone numbers
Mobile
COUNTRY CODE
AREA CODE
NUMBER
Office hours
( ) ( )
After hours
( ) ( )
1263 (Design date 11/09) - Page 4
© COMMONWEALTH OF AUSTRALIA, 2009
Document Outline
