Create Form (old)

To express an interest in being listed on the Significant Investor Services Directory, please complete this form.

If you are unable to complete this form online, you can register using an alternative Word (.DOC) version. Download the Expression of Interest for Listing a Service form (DOC, 140KB).

Fields marked with * are required fields.

Part A: Service Offering

Investment option

If an investment provider, please select below which option(s) the business can facilitate for Significant Investors.

Primary service offering*

Please indicate the primary service that the business can provide to Significant Investors.

Business services

Please select which other services the business can provide to Significant Investors.

Professional Services

Financial Services

Part B: Business Listing Details*


To reduce the risk of spam, email addresses will not be visible on your listing. Directory users will be able to contact the business via an online enquiry form.

http://
Enter your website address without 'http://', e.g. www.website.com.au

Please outline below the services and products offered by the business that are relevant to Significant Investors.

Part C: Other business information

Fund Managers: Does the business have investment management staff based in Victoria?

Financial Advisors: Does the business have licensed financial advisors based in Victoria?

Service Providers: If Significant Investors engage the services of the business:

Will their portfolios be managed from within Victoria?

Will their portfolios be investing in Victorian assets?

Professional associations and registration / licensing bodies:
Please indicate if the business is registered with, or a member of, any of the professional associations and registration / licensing bodies listed below. If applicable, please attach an electronic copy of the current corporate registration of the business.

Note: You will be able to upload any relevant electronic documents after you have submitted this form.


Is the applicant properly licenced and fully compliant with all necessary licensing requirements to provide investment advice, products and services to Significant Investors?



Part D: Applicant’s Contact Details*

Information provided in Part D will not be displayed as part of the Directory and will only be used by Department of State Development, Business and Innovation representatives to contact you regarding the listing.

Part E: Newsletters

I would like to subscribe to the following Department of State Development, Business and Innovation newsletters:

Part F: Consent*

Terms of inclusion in Victoria’s Significant Investor Services Directory

You declare that the information provided on this Expression of Interest for Listing a Business is true and correct.

By participating in and submitting information to Victoria’s Significant Investor Services Directory (Directory), you agree to the Department of State Development, Business and Innovation (Department) publishing, reproducing and making available to the public, the Victorian Government and/or any business associate, the information provided for purposes relating to the Directory including use:

  • 1. in any printed material relating to the Directory;
  • 2. on the Live In Victoria website (www.liveinvictoria.vic.gov.au); and
  • 3. on the Department’s website and otherwise in connection with the Directory.

You acknowledge that inclusion in the Directory is subject to the Department’s approval and at the discretion of the Department. The Department also reserves the right to edit, in its sole discretion, the information you provide before publication of the Directory. The Department reserves the right, in its sole discretion, to remove information or an entire business listing from the Directory at any time.

You acknowledge that inclusion in the Directory does not guarantee that work will be generated for any organisation or person listed.

The information contained in this Directory is provided for general information purposes only. The Victorian Government does not endorse or recommend any organisation or person listed or referred to in the Directory and gives no representation or warranty (express or implied) as to their services, standards or status. Inclusion of details for an organisation or person in the Directory does not imply or indicate that they have sponsorship, endorsement, approval of or affiliation with the Victorian Government and therefore must not promote any such association.

The Department will take steps to ensure the information in the Directory is accurate, however, the Victorian Government makes no representation, warranty or claim of any kind, express or implied, about the completeness, accuracy, reliability or suitability, with respect to the information.

Privacy Statement

In completing this form, you are providing the Victorian Government with personal information such as your name, contact details and position title. Your personal information is being collected so the Department can contact you when assessing your business's eligibility for inclusion in the Victorian Significant Investor Services Directory.

The terms and conditions you are consenting to describe the way in which the Department will use and share your personal information. In otherwise collecting, using, sharing and storing your personal information, the Department will manage it in accordance with the Information Privacy Principles in the Information Privacy Act 2000. If the purpose for which we have collected your information or the use we intend to put your personal information deviates from the usage and sharing described in the terms and conditions, the Department will contact you on the details given to seek your consent to the extended use of your personal information. For more information on how the Department manages your personal information and on how to access your personal information, go to http://www.liveinvictoria.vic.gov.au/about-us/privacy.