Name of fund Form 1413D & letter from my Fund Manager attached Managing institution Fund Manager name Fund Manager phone Fund Manager email Amount invested A$ From: To: Dates held Name of fund Balancing Investment Managing institution Form 1413D & letter from Fund Manager name my Fund Manager attached Fund Manager phone Fund Manager email For evidence required, please see Part 7 - 3.3 Additional investment in NSW (if applicable) (Note: It is not a requirement for you to make any additional investments. This is for our information only) Type of investment Amount of total investment A$ I intend on making additional investments in NSW. Please describe your intended additional investments and include which sector you consider to be attractive for a future investment (approx. 150 words): 3.4 Additional business activity in NSW (if applicable) (Note: It is not a requirement for you undertake additional business activity. This is for our information only) Type of investment Amount of total investment A$ I intend on undertaking additional business activity in NSW? Please describe your intended additional business activity (approx. 150 words): Part 4 Applicants nominated by another state/territory before 1 September 2014 –
Form 1413D & letter from my Fund Manager attached Name of fund Managing institution Fund Manager name Fund Manager phone Fund Manager email Balancing Investment Form 1413D & letter from my Fund Manager attached Amount invested A$ Dates held From: To: Name of fund Managing institution Fund Manager name Fund Manager phone Fund Manager email For evidence required, please see Part 7 - 3.3 Additional investment in NSW (if applicable) (Note: It is not a requirement for you to make any additional investments. This is for our information only) Type of investment Amount of total investment A$ I intend on making additional investments in NSW. Please describe your intended additional investments and include which sector you consider to be attractive for a future investment (approx. 150 words): 3.4 Additional business activity in NSW (if applicable) (Note: It is not a requirement for you undertake additional business activity. This is for our information only) Type of investment Amount of total investment A$ I intend on undertaking additional business activity in NSW? Please describe your intended additional business activity (approx. 150 words): Part 4 – Applicants nominated by another state/territory before 1 September 2014
888C-Significant-Investor-nomination-application.docx