NSW Sponsorship Application
State/Territory Sponsored Investor visa (subclass 893)

Before completing this form, please carefully read the NSW sponsorship requirements and Department of Immigration and Border Protection criteria for the Business Investor (subclass 893) visa. Sponsorship by NSW does not guarantee a successful visa outcome.

Applications should be supported by appropriate evidence (see Part 5 – Checklist) against each criterion.

Part 1 – Details of authorised representative (if applicable)

1.1 Migration agent / authorised representative details
Title / Name
Business name / MARN (if applicable)
Telephone / Email
Address

Part 2 – Details of main applicant

2.1 Personal details
Title / Last name / First name
Date of birth / Passport number
Country of birth / Country of passport
No. of secondary applicants / Primary applicant at provisional
(165) stage
Sponsor at provisional stage / Date of provisional visa grant
Date of provisional visa expiry / Days in Australia in last 4 years
Main language spoken / Prefer language assistance / Yes No
Telephone / Email
Address / Postcode
See Part 5 - Checklist – Item 1 & 2 for evidence required
2.2 Current net assets (AUD)
Cash and cash equivalent (e.g. term deposit)
Financial products (e.g. stocks, bonds, funds)
Real property
Business assets
Other (please specify)
Total
See Part 5 - Checklist – Item 3 for evidence required

Part 3 – Investment See Part 5 - Checklist – Item 4 for evidence required

3.1 Continuous designated investment for at least 4 years
Investment in NSW Waratah Bonds / AUD$
Date on which continuous investment commenced
3.2 Other investments in NSW (if applicable)
Description of investment(s)
Date on which investment commenced
Amount invested / AUD$

Part 4 – Declaration

4.1 Privacy statement

The personal information you provide on this form is subject to the Privacy & Personal Information Protection Act 1998. It is being collected by NSW Department of Industry and will be used for purposes related to NSW sponsorship for a business visa.

NSW Department of Industry will not disclose your personal information to anybody else unless authorised by law. The provision of this information is required for the purposes of assessing your eligibility for NSW sponsorship for a business visa. If you choose not to provide the requested information we may not be able to process your application.

You have the right to request access to, and correct details of, your personal information held by us. Further information regarding privacy can be obtained from our website at www.industry.nsw.gov.au/legal/privacy.

4.2 Applicant’s declaration

I solemnly and sincerely declare the following:

·  I understand that a NSW sponsorship decision will be made on the basis of the information provided in my application. To the best of my knowledge, all information provided in this application is complete, true and accurate, and I believe I satisfy all relevant NSW requirements and the Commonwealth visa criteria.

·  I acknowledge that it is my own commercial decision to make investments in NSW, and my sole responsibility to obtain independent legal and financial advice in relation to any risk. I have not relied on any information or advice from the NSW Government in relation to my investment. I understand and acknowledge that the NSW Government does not accept any liability for any loss I may sustain as a result of my investment activities.

·  I authorise NSW Department of Industry to share the information provided in this application with the Department of Immigration and Border Protection (DIBP) and other parties for purposes of verifying and processing my application.

·  I intend to continue to maintain business and/or investment activities inNSW if granted a subclass 893 visa.

·  Neither I or my spouseorde facto partner(if any) has a history of involvement in business or investment activities that are of a nature that is not generally acceptablein Australia.

·  I understand the limitations of state sponsorship and that the Commonwealth of Australia has the sole responsibility for granting visas to enter or stay in Australia. I acknowledge that NSW sponsorship does not imply that my subsequent visa application will be approved by the Commonwealth of Australia. I understand that if sponsored by NSW, the sponsorship would apply to this application only, and does not guarantee that NSW will approve any subsequent applications for state sponsorship.

·  If granted a subclass 893 visa by DIBP, I will:

o  advise NSW Department of Industry of my visa grant and my contact details within 28 days; and

o  respond to NSW Department of Industry surveys, market research or requests for updated information on my business and investment activities.

Applicant’s signature ______

Applicant’s name Date

4.3 Declaration by migration agent / authorised representative

I have explained all of the NSW sponsorship requirements and conditions to the applicant, and believe that the applicant understands the information, including the privacy statement and the applicant’s declaration above.

To the best of my knowledge, I believe that the information provided in this application is complete, true and accurate.

Signature ______

Name Date

Part 5 – Checklist

Criteria / Supporting documents
Item 1: Identity / Passport bio-data page
Passport of main applicant at provisional stage if different
Other, please specify
Item 2: Provisional (165)
nomination and visa grant / Evidence of provisional visa grant
Evidence of release (signed Form 949) from previous state/territory sponsor (if not NSW)
Evidence of residence in Australia for 2 of the last 4 years
Item 3: Assets / Bank statements
Share certificates
Certificate of property title and property valuation documents
Loan statements
Financial statements/reports
Other, please specify
Item 4: Investments / Letter from NSW Treasury
Evidence of the progress you have made to implement the business or investment activity outlined in your NSW 165 sponsorship application
Other, please specify
Item 5: Payment of application fee
(AUD $1270) / Online payment receipt/Australian bank cheque/Australian money order

Part 6 – Lodgement

Please return the completed form and the supporting documentation to NSW Business & Skilled Migration

through one of the following methods:

Email (preferred):

Please begin the subject line with: 893 sponsorship application_[Applicant’s name]

Post:

Business & Skilled Migration

NSW Department of Industry

GPO Box 5477

Sydney NSW 2001

Australia

Courier:

Business & Skilled Migration

NSW Department of Industry

L48 MLC Centre

19 Martin Place

Sydney NSW 2000

Australia

Before lodging the application please note the following:

·  All supporting documents must be certified copies, or if the application is being lodged by

email, colour scanned copies.

·  Please do not send original documents as we are unable to return them to you.

·  Documents in a language other than English must be accompanied by a certified English

translation.

If you have any questions about completing or returning this form, please contact us at or on (+61) 2 9934 0704.

Document last updated on 2 September 2015 Page 1 of 4