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Visa nomination
Q1.0 Visa Applying for / Significant Investor stream (subclass 188)
Q1.1 SkillSelect EOI Number
Agent/Representative Details
Q2.0 Is a representative or migration agent acting on your behalf to complete this application? / Yes No (Go to Q3.0)
Appointment of an Agent formmust be sent with this application form.
Q2.1 Type of representative / MARA Registered Migration Agent
(Go to Q2.1.1)
Fee for Service Representative (Go to
Q2.1.2)
Lawyer (registered to practice in
Australia) (Go to Q2.2)
Q2.1.1 Please provide the MARA registration number
Q2.1.2 If the agent operates in a country which requires registration or licensing, does the agent hold the required registration or licensing? / Yes No
Q2.2 Title
Q2.3 Family name
Q2.4 Given name(s)
Q2.5 Agency business name
Q2.6 Mailing Address
Q2.7 Mailing address (continued)
Q2.8 City/town/suburb
Q2.9 Postal code
Q2.10 State/province
Q2.11 Country
Q2.12 Telephone number
Q2.13 Email address
Q2.14 Who will be lodging the formal visa application with the Department of Home Affairs? / The same representative (Go to Q3.0)
A different representative (Go to Q2.14.1)
Q2.14.1 Title
Q2.14.2 Family name
Q2.14.3 Given name(s)
Q2.14.4 Agency business name
Q2.14.5 Mailing Address
Q2.14.6 Mailing address (continued)
Q2.14.7 City/town/suburb
Q2.14.8 Postal code
Q2.14.9 State/province
Q2.14.10 Country
Q2.14.11 Telephone number
Q2.14.12 Email address
Applicant's Details
Q3.0 Title
Q3.1 Family name
Q3.2 Given name(s)
Q3.3 Date of birth
Q3.4 Country of birth
Q3.5 Nationality
Q3.6 Residential address
Q3.7 Residential address (continued)
Q3.8 City/town/suburb
Q3.9 Postal code
Q3.10 State/Province
Q3.11 Country
Q3.12 Telephone number
Q3.13 Applicant's email address
Please note that this email address should remain active for the duration of the visa, if nominated. If this changes, the Victorian Government should be informed immediately.
Others to be included in this application
Q4.0 Do you have a spouse or partner
Q4.1Will your spouse or partner be included in the visa application? / Yes No (Go to Q4.2)
Yes No
If you responded ‘Yes’ to question 4.1,please provide your spouse/partner’s details
Family Name / Given Name / Date of Birth
Q4.2Do you have any dependents?
Q4.3 Will your dependents be included in the visa application? / Yes No (Go to Q5.0)
Yes No (Go to Q5.0)
If you responded ‘Yes’ to question 4.3,please provide your dependents’ details
Family Name / Given Name / Date of Birth / Relationship
Q4.4Do you have any children studying in Australia? / Yes No (Go to Q5.0)
If you responded ‘Yes’ to question 4.4,please provide details of your child's study
State/Territory of study / Visa expiry date / Indicate primary, secondary or tertiary education
Associations with Victoria
Q5.0 Why have you chosen to migrate to Victoria? / Investment opportunities in Victoria
Business opportunities in Victoria
Priority processing of visa state nomination
Quality of education
Reputation as world’s most liveable city
Family in Victoria
Friends in Victoria
Children studying in Victoria
Health Services
Clean environment
Opportunities for family
Safety
Economic prospects
Political stability
Proximity to Asia
Chinese-Victorian bilateral relations
Victoria’s Multiculturalism
Other, please specify:
Q5.1 Have you visited Victoria? / Yes No (Go to Q5.3)
Q5.2 What was your reason for visiting Victoria? / Holiday
Work
Study
Business
Other
Q5.2.1 Please provide more detail about this visit
Q5.3 Have you visited any other Australian States or Territories? / Yes No (Go to Q6.0)
Q5.4 What was your reason for visiting? / Holiday
Work
Study
Business
Other
Q5.4.1 Please provide more detail about this visit identifying any family or friends living in Australia
Business and settlement
Q6.0 The Victorian Government may engage with you regarding your business activity in Victoria. Would you require a translator to undertake this discussion? / Yes No (Go to Q6.1)
Q6.0.1 Please indicate the language for which you require a translator. / Arabic
Hindi
Japanese
Mandarin Chinese
Spanish
Vietnamese
Other (please specify)______
Q6.1 Provide a close approximation of the assets and liabilities held by you and your spouse
Assets / (A$) / Liabilities / (A$)
Family home / Home mortgage(s)
Investment property/ies / Investment loan(s)
Business/es / Business loan(s)
Cash/Shares/Stocks etc. / Personal loan(s)
Superannuation / Credit card(s)
Other assets / Other debt
Total / Total
Q6.2 Do you currently operate a business? / Yes No (Go to Q7.0)
Q6.3 Provide the following information about your primary business:
Name of business
Turnover for the last 12 months (A$)
Date established
Estimated value of the business (A$)
Your position / title
Number of full time jobs
Your ownership percentage of the business
Country / State/Province
Provide a brief description of your business and activities undertaken
Select the industry sector which best describes your primary business / Agriculture, Forestry and Fishing
Mining
Manufacturing
Electricity, Gas, Water and Waste Services
Construction
Wholesale Trade
Retail Trade
Accommodation and Food Services
Transport, Postal and Warehousing
Information Media Telecommunications
Financial and Insurance Services
Rental, Hiring and Real Estate Services
Professional, Scientific Technical Services
Administrative and Support Services
Public Administration and Safety
Education and Training
Health Care and Social Assistance
Arts and Recreation Services
Other Services
Q6.5 Do you currently operate another business? / Yes No(Go to Q6.7)
Q6.6 Provide the following information about your secondary business:
Name of business
Turnover for the last 12 months (A$)
Date established
Estimated value of the business (A$)
Your position / title
Number of full time jobs
Your ownership percentage of the business
Country / State/Province
Provide a brief description of your business and activities undertaken
Select the industry sector which best describes your secondary business / Agriculture, Forestry and Fishing
Mining
Manufacturing
Electricity, Gas, Water and Waste Services
Construction
Wholesale Trade
Retail Trade
Accommodation and Food Services
Transport, Postal and Warehousing
Information Media Telecommunications
Financial and Insurance Services
Rental, Hiring and Real Estate Services
Professional, Scientific Technical
Services
Administrative and Support Services
Public Administration and Safety
Education and Training
Health Care and Social Assistance
Arts and Recreation Services
Other Services
Q6.7 Do you intend to maintain your overseasfinancial interests? For example, business and investments? / Yes No
Complying Investments
Under the new Significant Investor visa framework, from 1 July 2015, applicants are required to make compulsory investments of at least A$5million into complying funds (see
The complying funds consist of:
  • a minimum of A$500,000 investment into Venture Capital and Growth Private Equity (VCPE). This amount can be invested any time after the visa application is made and no later than 12 months after the visa is granted.
  • a minimum of A$1.5 million investment into emerging companies
  • the balancing investment to make up at least A$5 million in complying funds.
It is understood that some applicants will invest in a combined, single complying fund, whilst others will allocate investments into multiple funds. Please note that detailed evidence of the complying fund(s) invested in will be required for the 888C stage of the visa.
Q7.0 Specify your managing institution that provides investment advice on the complying investments? / Company:
Contact name:
Phone:
Email:
Q7.1
Balancing Investment and Emerging Companies
Name and contact details
of Fund / Type of investment / Economic benefit to Victoria
(only one example is required)
FundManager:
Address:
Contact name:
Position:
Phone:
Email: / Type of Investment
Balancing investment
Emerging companies
Amount to be invested
$ ______/ Fund maintains office in Victoria
(please provide office address)
Address: ______
______
Investment includes Victorian investment (please provide further details)
Fund Manager:
Address:
Contact name:
Position:
Phone:
Email: / Type of investment
Balancing investment
Emerging companies
Amount to be invested
$______
Fund Manager:
Address:
Contact name:
Position:
Phone:
Email: / Type of investment
Balancing investment
Emerging companies
Amount to be invested
$ ______
Fund Manager:
Address:
Contact name:
Position:
Phone:
Email: / Type of investment
Balancing investment
Emerging companies
Amount to be invested
$ ______
Venture Capital and Growth Private Equity
Q7.2 What is the amount to be invested in a venture capital fund? $______
Q7.3 Have you chosen a venture capital fund?(You are not required to have chosen your venture capital fund to qualify for nomination)
Yes (please provide details of the fund and outline the economic benefit to Victoria)
No (please notify the Victorian Government when you have chosen your venture capital fund)
Name and contact details
of Fund / Amount to be invested / Economic benefit to Victoria
(only one example is required)
Fund Manager:
Address:
Contact name:
Position:
Phone:
Email: / $______/ Fund maintains office in Victoria
(please provide office address)
Address: ______
______
Investment includes Victorian investment (please provide further details)
Fund Manager:
Address:
Contact name:
Position:
Phone:
Email: / $______
Additional Investment
Q8.0 Have you made, or do you intend to make, an additional investment/s into Victoria? / Yes No
Q8.1 Indicate the amount of additional investment / $______
Q8.2 Briefly describe the investment made / proposed investment, for example, purchased land for hotel development in Melbourne, establishing a food processing business in Moorabbin, made further investment in managed fund etc.
Attachments

Your Victorian Government state nomination application requires the attachment of appropriate documentary evidence:

•A signed and scanned Nomination Conditions form

•A signed and scanned Appointment of an Agent form (if applicable)

•Additional attachment (if relevant).

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Significant Investor streamApplication form1 of 9