Australian Migration Services

Subsidiary of Multinational Holdings group of companies

First Name: Family Name: (As in your passport): Email: Telephone: Date of Birth: Date 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month January February March April May June July August September October November December Year 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 Your English language ability? : Excellent Very Good Good Poor Very Poor Marital Status: Single Married Separated Divorced Which of the following statements best describes your intentions? I owned one or more businesses and am considering establishing or purchasing a business in Australia. I am an investor and willing to invest over AUD 750,000 in Australia. Are you ready to participate in a day to day management of a business or investment activity in Australia? No Depends upon other factors Yes What is the combined net assets own by your family and business AUD$2,250,000 or greater At least AUD$1,125,000 At least AUD$500,000 At least AUD$250,000 Less than AUD$250,000 What was the turnover of your business(es) in any 2 years of last 4 years ? At least AUD$500,000 or greater At least AUD$300,000 or greater Less than AUD$300,000 What was the approximate net value of your business assets in any 2 years of last 4 years? AUD $200,000 or Greater Less than AUD $200,000 Type of your business Sole proprietor of a business Active partner in a partnership Shareholder in a public listed company with at least 10% ownership interest Shareholder in a public listed company with less than 10% ownership interest None of the above applies What is the total net value of your assets available for transfer to Australia within next 2 years? Over AUD$2.5 million Between AUD$1.5 and 2.5 million Between AUD$500,000 and 1.5 million Less than AUD$500,000