 | 01 Personal Details |  |
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| Title |
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| Other Title: |
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| Given Name(s) |
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| Family Name |
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| Email |
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| Address |
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| Telephone |
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| Date of birth |
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| How would you rate your level of English? |
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| What is your preferred method of us contacting you? |
| | Email Telephone |
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02 Career & Personal History |
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Do you have at least 3 years experience in managing one or more
qualifying businesses
| Qualifying business = an enterprise that |
| (a) | is operated for the purpose of making a profit through the provision of goods, services, or goods and services (other than the provision of rental property) to the public, and; |
| (b) | is not operated primarily or substantially for the purpose of speculative or passive investment. |
or
eligible investment
| Eligible investment in relation to a person means: |
| (a) | an ownership interest in a business, or |
| (b) | a loan to a business, or |
| (c) | cash on deposit, or |
| (d) | stocks and bonds, or |
| (e) | real estate, or |
| (f) | gold or silver bullion |
? |
| | Yes No |
| For at least one of the last 5 fiscal years have you (or you and your spouse) managed a qualifying business where you have owned at least 10%? |
| | Yes No |
| For at least one of the last 5 fiscal years have you (or you and your spouse) managed a business or investment portfolio with a value of: |
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| For the last 2 fiscal years you and your spouse had combined net assets of: |
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You are willing to invest the following amount in a
Designated investment
| Designated investment |
| (a) | primary-issue govt. securities with a maturity of no less than 4 years from the date of purchase |
| (b) | limited to investments of:
- AUD$750,000 if you are applying under the State/Territory Sponsored investor category
- AUD$1,500,000 if you are applying under the Investor category, with interest paid every 6 months
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| (c) | Non-transferable and non-redeemable (that is the security cannot be sold to another investor or sold back to the issuing authority before maturity). |
| (d) | Repayment of principal on maturity is guaranteed by the State/Territory government issuing the security. |
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| Do you have a realistic commitment to establish / participate in a business in Australia and to maintain both substantial ownership and direct and continuous management in that business? |
| | Yes No |
| Are you prepared to be sponsored by a State or Territory government? |
| | Yes No |