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1/5/2015

Victorian Government skilled nomination application form - Live in Victoria

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Victorian Government skilled nomination application form


Thank You
Thank you for submitting your visa nomination application.
We will respond to you by email within 2 weeks to confirm receipt of your application and advise your reference number. Progress of your application will take
up to 12 weeks.
Please print the following summary of your submitted application.

Visa nomination request


Application for *
Skilled Nominated (190) visa

Step 1 - Personal details


Q1.1 Family name (on passport) *
Eapen
Q1.2 Given name(s) (on passport) *
Jithin
Q1.3 Gender *
Male
Q1.4 Date of birth (on passport) *
1988-10-26
Q1.5 Have you lodged an Expression of Interest (EOI) application with the Department of Immigration and Border Protection *
Yes
If you answered Yes to question 1.5 please provide

Q1.5.1 Please provide your EOI reference number


E0004532971
Q1.6 Please provide your DIBP points mark e.g. 60
60
Q1.7 Country of birth (on passport) *
India
Q1.8 Nationality (on passport) *
Indian

Step 2 - Occupation details


Q2.1 Do you have an offer of employment or can you provide confirmation of current employment from an employer in Victoria? *
No
Q2.2 Occupation you will be nominating on your Department of Immigration and Border Protection (DIBP) application *
Developer Programmer 261312

Step 3 - Nomination details


Q3 Have you made an application to/or been nominated by any other Australian state or territory *
No

Step 4 - Contact details


Q4.1 Address *
B-45 ,Aastha Residency
Q4.2 Address (continued)
Hathital
Q4.3 City/town/suburb *
Jabalpur
Q4.4 Postal code
482001
Q4.5 State/province
Madhya Pradesh
Q4.6 Country *
India
Q4.7 Email address e.g. skilled.migrantname@liv.vic.gov.au *
jithin.eapen@yahoo.com
Q4.8 Confirm email address e.g. skilled.migrantname@liv.vic.gov.au *

https://www.liveinvictoria.vic.gov.au/manageyouraccount/skilled-visa-nomination

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1/5/2015

Victorian Government skilled nomination application form - Live in Victoria

jithin.eapen@yahoo.com
Q4.9 Telephone Number *
918867538984

Step 5 - Representative details


Q5 Is a representative acting on your behalf? Please note that all correspondence will be with your agent *
No

Step 6 - Spouse details


Q6 If you have a spouse, will they be immigrating with you? *
No

Step 7 - Dependant details


Q7 If you have dependants, will they be immigrating with you? *
No

Step 8 - Skills assessment / English language details


Q8.1 Have you completed your Department of Immigration and Border Protection (DIBP) Skills Assessment? *
Yes
Q8.1: If you answered Yes to question 8.1 please answer questions 8.1.1 to 8.1.3.

Q8.1.1 Name of assessing body. Example: TRA


ACS Australian Computer Society
Q8.1.2 Date of assessment
2014-06-02
Q8.1.3 Nominated occupation
Developer Programmer 261312
Q8.2 Are you providing an English language test with this application? *
Yes
Q8.2: If you answered Yes to question 8.2 please answer questions 8.2.1 and 8.2.2

Q8.2.1 Date of test


2014-12-06
Listening
73
Reading
72
Writing
71
Speaking
77
Overall Score
71

Step 9 - Education details


Q9.1 Have you ever studied in Australia for a period of 12 months or longer? *
No
Q9.2 Have you obtained higher education academic qualifications outside of Australia? *
No
Q9.3 Have you graduated with a PhD? *
No

Step 10 - Financial details


Q10 Total estimated amount of financial resources you have, including all of your assets (in A$) e.g. 100000 *
85000

Step 11 - Living in Victoria


Q11.1 Have you, your spouse, or any of your dependants ever lived in Australia i.e. resided for more than 3 months or worked? *
No
Q11.2 Have you, your spouse, or any of your dependants ever visited Australia i.e. travelled? *
No
Q11.3 Do you, your spouse, or any of your dependants have relatives and/or friends currently living in Victoria or elsewhere in Australia?
*
Yes

https://www.liveinvictoria.vic.gov.au/manageyouraccount/skilled-visa-nomination

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Victorian Government skilled nomination application form - Live in Victoria

Q11.3.1 If you have responded 'Yes' to question Q11.3 please complete the following details:
Name
Location City/Town/Suburb

Relationship
State/Territory

Relative / friend 1
Soby Varghese
Sydney

Cousin
New South Wales

Q11.4 Please indicate your planned settlement location *


Metropolitan Melbourne

Step 12 - Attachments
Please attach your declaration *
Signed-Declaration_Victoria3.pdf, type application/pdf, 1.9 MB
Please attach your detailed resume *
CV-EAPEN-Jithin.docx, type application/vnd.openxmlformats-officedocument.wordprocessingml.document, 34.3 KB
Please attach your skill(s) assessment *
ACS-confirmation2.pdf, type application/pdf, 177.3 KB
Please attach your English language test transcript. *
PTE-Exam-Report.pdf, type application/pdf, 121.6 KB

Following the Victorian State Election on 29 November 2014, changes may be made to this website to reflect the election outcome. In the
interim, website content may not reflect the election outcome.

State Government of Victoria


Last Updated : 05 November 2014

https://www.liveinvictoria.vic.gov.au/manageyouraccount/skilled-visa-nomination

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