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The more we know about you, the better we can serve
you.
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| Name
|
|
| Date Of Birth |
dd/mm/yyyy
|
| Nationality |
|
| Sex |
|
| Marital
Status |
|
| Occupation |
|
| Company
Name |
|
| Monthly Income
|
Salary
|
|
Rental Receivable
Pension
Dividend
|
| Education |
|
| Residential
Address |
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| Contact
No. |
Home
phone |
-
|
| |
Mobile
phone |
-
|
| |
Office
phone |
-
|
| |
Facsimile |
-
|
| E-mail
Address |
|
|
COMPANY BUSINESS TURNOVER IN THE LAST 2 YEARS AND PERCENTAGE OWBERSHIP : |
|
Year 1 |
In year
(ie : 2005) |
| |
Ownership %
|
| |
Business Turnover [ Please specify ]
|
|
Business Assets [ Please specify ]
|
|
Year 2 |
In year
(ie : 2006) |
| |
Ownership %
|
| |
Business Turnover [ Please specify ]
|
|
Business Assets [ Please specify ]
|
| Net Personal Assets
: |
(A)
|
| [ Please specify ]
|
(B)
|
|
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(C)
|
|
|
(D)
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|
|
(E)
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KINDLY FILL IN YOUR SPOUSE & CHILDREN'S DETAILS : |
| Spouse Name
|
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| Spouse Date Of Birth |
dd/mm/yyyy
|
| Spouse Nationality |
|
| Spouse Occupation |
|
| Spouse Income |
|
| Spouse Net Personal Assets |
[ Please specify ] |
| Spouse Education |
|
| Number of Children
|
|
| 1st Children Name
|
|
| Date Of Birth |
dd/mm/yyyy
|
| Age |
|
| Occupation |
|
| 2nd Children Name
|
|
| Date Of Birth |
dd/mm/yyyy
|
| Age |
|
| Occupation |
|
| 3rd Children Name
|
|
| Date Of Birth |
dd/mm/yyyy
|
| Age |
|
| Occupation |
|
| 4th Children Name
|
|
| Date Of Birth |
dd/mm/yyyy
|
| Age |
|
| Occupation |
|
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KINDLY FILL IN HEALTH CONDITION FOR ALL APPLICANTS : |
| Main Applicant's
Health Condition |
|
| Spouse's
Health Condition |
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| All Children's
Health Condition |
1st :
|
|
2nd :
|
|
3rd :
|
|
4th :
|
| Do you have
any relatives in Australia? |
YES / NO
|
| If YES,
where in Australia? |
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| Any Comment? |
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