Client Details
Mr Mrs Ms Miss Other: / Gender: Male Female Other
Family name: / Given name(s):
Date of birth: //
(DD/MM/YYYY)
Proposed Business for Victorian Visa Nomination/SponsorshipInformation
Provide a brief summary of the proposed business activity and how it will be of value to Victoria:
Which product category does your proposed export product(s) fit into,Select all that apply:
Dairy products
Beef products
Beauty care
Fashion
Nutrition
Frozen food
Alcohol
Fruits and vegetables
Processed foods
Other, Explain: ______
Identify or describe the goods or services to be exported: ______
How will the goods be exported? Select all that apply:
Business to business - Attach a list of proposed clients
Business to client - Attach market research of client base
Which platform will you be distributing through? Select all that apply:
Warehouse
Australia Post
Consolidation Agent
Air Freight
Shipping Container
Other, Explain: ______
Explain your tasks and duties in managing the day-to-day operations of the business:
What is the intended percentage (%) dollar add you intend to put on your products in-market?
What is the projected value of the export activity over the first 24 months of your visa: $A
Detail the projected Victorian jobs created or retained from the activity:
Projected number of Victorian jobs created: ______Description of positions: ______
Projected number of Victorian jobs retained: ______Description of positions: ______
Whereis the proposed location of the business? Suburb/City: ______
Identify any local economic benefits the business will create: : ______
Is the export product’s origin fromVictoria?
Yes
No
Explain: : ______
/ Is the export product value-added in Victoria?
Yes
No
Explain: : ______
Will you be exporting a trademark product already available in the Australian or international marketplace?
Yes → You are required to attach evidence that you will not engage in ‘grey market’ or ‘parallel exporting’. Evidence your consultation with the trademark owner of the product, for example, attach partnership agreements, provide meeting dates and personnel consulted. Please note an agreement with the manufacturer is required.
No
Indicate the markets the business intends to export to: / China
Germany
India
Indonesia
Japan
Malaysia
Republic of South Korea
United Kingdom
United Arab Emirates
United States of America
Other – explain
Provide any additional information you think important to support your application: : ______
______

Business Overview

I ______(the applicant), Date: //

(Print name) (DD/MM/YY)

  1. The applicant has read (or has had read to them) the contents of their application and confirms that the information contained therein is true and correct.
  2. The Victorian Government may share information relating to the application and the applicant’s business/investment activities in Victoria with the Department of Home Affairs.
  3. The Victorian Government reserves the right to make direct contact with the applicant in relation to this application or related matters. This may include contact from the Commissioner of a Victorian Government Business Office (VGBO) to discuss potential assistance in relation to business/investment activity in Victoria.
  4. The Victorian Government has no legal authority to deal with visa matters and will not advocate to the Department of Home Affairs or the Migration Review Tribunal on behalf of the applicant.
  5. The Victorian Government does not endorse any investment made, or any business activity undertaken, by the applicant nor does it accept liability for any financial loss, cost or expense incurred as a result of any business decision, business activities or investments made by any person in any way connected with this application, or otherwise.

Signature of applicant: ______Date: //
(Applicant only to sign) (DD/MM/YY)

Migration Agent / Representative

I have discussed the above conditions with my client and am satisfied he/she fully understands their obligations.

Migration Agent/Representative Signature: ______Date: // (DD/MM/YY)

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