Employer Nomination Scheme (Subclass 186) Questionnaire

CLIENT FILE NUMBER

If you have been given a client file number by your Migration Agent, record it here:

SCHEME & APPLICATION DETAILS

Complete the following details about the scheme, the nominating business, and the nominated person.

Scheme Details

Scheme Type * Visa Application Stream *

Business / Organisation Details

Legal Name of Business / Organisation *

Does the business / organisation have a trading name different from its legal name?

Yes No

Trading Name

Transitional Visa Arrangements

TRT stream: The nominee must have held a TSS (subclass 482) or subclass 457 visa sponsored by this employer and worked in the nominated occupation for at least 3 years.

Does the nominee currently hold or have they previously held a Subclass 457 visa? *

Yes No

Does the nominee currently hold or have they previously held a Subclass 482 visa? *

Yes No

Nominated Person Details

Give details of the nominee and their relevant visa history.

Family Name * Given Names *

Sex *

Female Male Other

Date of Birth *

457 Transitional Visa Details

Give details of the nominee's subclass 457 visa application.

Reference number type * Reference number *

482 Transitional Visa Details

Give details of the nominee's subclass 482 visa application.

Reference number type * Reference number *

Transitional Nomination Details

Transitional Nomination Reference Number Type Reference Number

Previous Applications

Is the business currently an approved Standard Business Sponsor?

Yes No

Has the business previously lodged a different application for this nominated person?

Yes No

Previous Application Reference Number Type Reference Number

Labour Agreement Details

Labour Agreement Reference Number Type Reference Number

Business Registration Details

Is the business registered with the Australian Taxation Office (ATO)?

Yes No

Is the business registered with ASIC or listed on the ASX?

Yes No

Is the business not required to have an ABN?

Yes No

Work Location Postcode

Add all registration identifiers for the business (ABN, ACN, state/territory registration numbers etc.).

Business Type

ABN

Business ID / ACN

Date of Change

ABN in Trust?

Add

Yes No

POSITION DETAILS

Provide details of the position for which you are seeking to nominate a person.

Job / Position Title * ANZSCO Code *

ANZSCO Occupation Name Occupation (as it appears in the form)

Caveat Details

Caveat Reason

Caveat Details

Add

BUSINESS / TRADING / INDUSTRY DETAILS

Is your business a Trusted Trader?

Yes No

Has the business been operating for 12 months or more?

More than 12 months Less than 12 months

Date Business Was Established *

Number of Years Operating

Business Structure * Business Structure Details (if Other)

Description of Business Activities *

Has the business structure changed in the last 12 months?

Yes No

Provide details of the structure change

Was the Department notified of the restructure?

Yes No

Is the business a franchise?

Yes No

Franchise Details

Franchise Name

Location

End Date

Add

Is the business a trustee for a trust?

Yes No

Trust Details

Trust Name

Trust ABN

Add

Owners / Directors / Principals / Partners

List all owners, directors, principals, and partners of the business.

Type

Name (Family, Given)

Position

Change Type

Effective Date

Add

Industry Details

Industry Type * Industry Details (if not listed above)

Is the business a member of an industry association?

Yes No

Industry Association Name(s)

Financial Details

Annual Turnover (AUD) * Turnover Range

Gross Annual Payroll (AUD) * Projected Annual Payroll after Nomination (AUD)

Is there any adverse information about the business that should be disclosed? (e.g. legal proceedings, insolvency, regulatory issues)

Yes No

Adverse Information Details

CONTACT PERSON & BUSINESS ADDRESSES

Contact Person Details

Contact Family Name * Contact Given Names *

Position / Title * Business Phone

Mobile Email *

Confirm the Department may contact the business via this email address?

Yes No

Head Office Address (Physical)

Country

Address Line 1 *

Address Line 2 (optional)

Suburb *

State *

Postcode *

Is the postal address the same as the head office address?

Yes No

Postal Address

Country

Address Line 1

Address Line 2

Suburb

State

Postcode

AUTHORISED RECIPIENT

Do you authorise someone to receive all correspondence about this application on behalf of the business?

No Yes — Migration Agent Yes — Legal Practitioner Yes — Another Person

Email address for correspondence

Migration Agent Details

MARN Organisation

Family Name Given Names

Business Phone Mobile

Email Country

Address

Suburb

State

Postcode

Legal Practitioner Details

LPN Organisation

Family Name Given Names

Business Phone Mobile

Email Country

Address

Suburb

State

Postcode

Authorised Person Details

Family Name Given Names

Business Phone Mobile

Email Country

Address

Suburb

State

Postcode

NOMINATED POSITION DETAILS

Address Where Nominated Person Will Be Employed

Address Line 1 *

Address Line 2 (optional)

Suburb *

State *

Postcode

Will the position be at a fixed address?

Yes No

Please explain where the nominee will be employed

Is regional certification required? (RSMS stream only)

Yes No / Not applicable

Certifying Body Certification Date

Visa Stream Scheme Type

SALARY ARRANGEMENTS FOR NOMINATED POSITION

Guaranteed Annual Earnings (AUD) * Hours Per Week *

Monetary Salary Components

List all monetary components that make up the guaranteed earnings (e.g. base salary, allowances, overtime).

Salary Component

Description

Other Details

Amount (AUD)

Add

Will the nominee receive any non-monetary benefits (e.g. accommodation, use of vehicle, meals)?

Yes No

Non-Monetary Benefits

Component

Details

Value (AUD)

Add

Will the business be responsible for paying the nominee's salary directly?

Yes No

Please provide details of who will pay the nominee's salary

Is the nominee required to pay any amount back to the employer?

Yes No

Details

Will any deductions be made from the nominee's earnings?

Yes No

Details of Deductions

Will Australian terms and conditions of employment apply?

Yes No

Please explain what terms and conditions will apply

SALARY ARRANGEMENTS FOR AN EQUIVALENT AUSTRALIAN WORKER

Provide details of the market salary rate for an equivalent Australian worker performing the same duties in the same location.

Market Salary Rate — Annual (AUD) * Hours Per Week

Monetary Components of Market Salary Rate

Salary Component

Description

Other Details

Amount (AUD)

Add

Does an equivalent Australian worker receive non-monetary benefits?

Yes No

Non-Monetary Components of Market Salary Rate

Component

Details

Value (AUD)

Add

Does the business employ Australian workers in the same or similar position?

Yes No

Employment Arrangement (e.g. Award, Enterprise Agreement) Name / Reference of Arrangement

Classification Under Arrangement Any Other Relevant Details

Do the same Australian terms and conditions of employment apply to the nominee?

Yes No

Explain the differences

Do you declare that the market salary rate reflects the salary that would genuinely be paid to an equivalent Australian worker?

Yes No

Evidence of Market Salary Rate

Provide details of the evidence used to determine the market salary rate (e.g. pay slips, survey, industry data).

Type of Evidence

Details

Add

Additional details about how the market salary rate was determined

WORKFORCE DETAILS

Number of Australian Citizens / Permanent Residents Employed * Number of Foreign National Employees

Number of Professionals Employed (Australian workers) Number of Tradespersons Employed (Australian workers)

NOMINATED PERSON DETAILS

Provide details of the person being nominated for the position.

Personal Details

Family Name * Given Names *

Sex *

Female Male Other / Unspecified

Date of Birth *

Passport Details

Is a passport available?

Yes No

Passport Number * Country of Issue *

Nationality Place of Issue

Issue Date Expiry Date

Place of Birth

Town / City

State / Province

Country of Birth

Residential Address

Country of Residence

Address Line 1

Address Line 2 (optional)

Suburb / City

State / Province

Postcode

ENS / RSMS DECLARATIONS & CERTIFICATIONS

Please confirm the following declarations by selecting Yes or No for each item.

The Applicant Declares That They:

Have the authority to nominate the person for the position and to sign this application on behalf of the business

Yes No

The position is a genuine full-time position

Yes No

Understand that the nomination may be cancelled if the nominator does not comply with their obligations

Yes No

Will comply with all obligations as a nominator under the Migration Act 1958

Yes No

The Applicant Certifies That:

The business has the financial capacity to meet all conditions of the nomination, including paying the nominee's salary

Yes No

The business will employ the nominee for at least two years (if applicable to the stream)

Yes No Not Applicable

The position requires the nominee to hold any licences, registrations or memberships required by law to perform the occupation

Yes No

The business will comply with all employment contract obligations and relevant Australian workplace laws

Yes No

Paying for Visa Sponsorship

I confirm that no payment has been or will be sought or accepted from the nominated person in return for this nomination or for the granting of a visa

Yes — no payment has been sought No (please provide details below)

Please provide details

FINAL DECLARATIONS

Please read each declaration carefully and indicate your agreement by ticking the checkbox. All declarations must be accepted before submission.

I have read and understood this questionnaire and I declare that all the information I have provided is complete, correct and up to date. All information provided in this questionnaire and any supporting documents is complete and correct to the best of my knowledge. I understand that providing false or misleading information to the Department of Home Affairs is a serious offence and may result in the nomination being refused or cancelled, and that the business may be subject to sanctions. I understand that a nomination may be cancelled after it has been approved if the nominator fails to comply with the conditions of the nomination or the requirements of the Migration Act 1958. I understand that approval of this nomination does not automatically confer a right of entry to Australia on the nominated person and that the nominee must separately satisfy the criteria for the grant of the visa. I understand that I must notify the Department of any change in circumstances that may affect this nomination, including if the position is no longer available or the nominated person's employment ceases. I have read the privacy notice on this form and I understand that the Department of Home Affairs will use the personal information collected in this form for the purpose of assessing this nomination. I understand how the Department will use and disclose my personal information in accordance with the Privacy Act 1988 and the Australian Privacy Principles.

FINISH

Have you completed all the required questions?

Yes No

Is all the information you have provided in this Questionnaire true, complete and correct?

Yes No

Date Completed

SUBMIT YOUR QUESTIONNAIRE

Please review all your answers above before submitting. Once submitted, a confirmation email will be sent to you.