independent-executive-application-may.docVIP

PAGE 8 PAGE 6 457 Independent Executive – Designed 05/10 Payment Reference No. _______________ APPLICATION FOR WESTERN AUSTRALIAN GOVERNMENT ENDORSEMENT BUSINESS VISA 457 INDEPENDENT EXECUTIVE (Further Application Onshore) Name:  FORMTEXT
????? Attached is my Application for Endorsement, including (?):  FORMCHECKBOX
 Copy of passport bio-data page  FORMCHECKBOX
 Evidence of ownership  FORMCHECKBOX
 Copy of ABN registration  FORMCHECKBOX
 Copies of Business Activity Statements  FORMCHECKBOX
 Copies of financial statements  FORMCHECKBOX
 Evidence of identity for employees Declaration I declare that All of the information contained in my application is correct; and I have assessed myself against the Department of Immigration and Citizenship’s 457 Independent Executive visa criteria and believe I meet all the requirements. _______________________ (Name of Applicant) ______________________________ (Signature of Applicant) Dated (dd/mm/yyyy):  FORMTEXT
????? Migration Agent Declaration (if applicable) As the appointed migration agent for the above named applicant I declare that To the best of my knowledge the information contained in the application is correct; I have assessed the applicant against the Department of Immigration and Citizenship’s 457 Independent Executive visa criteria and believe he/she meets all the requirements; and The applicant has read and understands the content of this application. _______________________ (Name of Migration Agent) ______________________________ (Signature of Migration Agent) Dated (dd/mm/yyyy):  FORMTEXT
????? Please send your application to: State Migration Centre Small Business Development Corporation GPO Box C111 PERTH WESTERN AUSTRALIA 6839 Telephone: (+618) 9220 0222 Facsimile: (+618) 9221 1132 Email: businessmigration@smallbusiness.wa.gov.au WESTERN AUSTRALIAN GOVERNMENT ENDORSEMENT APPLICATION FORM Family Name:  FORMTEXT
????? Given Name