Fillable Neis Application Form 2018 (Australian National University)

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Neis Application Form 2018 (Australian National University)

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The Neis Application Form 2018 (Australian National University) form is 3 pages long and contains:

  • 1 signature
  • 47 check-boxes
  • 30 other fields

Country of origin: AUSTRALIA
File type: PDF

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Applicant’s Full Legal Name
Street Address
City Post Code
Email Address
Phone Number Date of Birth
Centrelink Reference Number Job Seeker ID
Provide a brief description of
the proposed Business
NEIS APPLICATION:
PART A - Contact Details
All elds must be completed by the Job Seeker and completed in detail.
PART B - REGISTRATION INFORMATION
You do not need to be receiving any Centrelink income to be eligible.
Jobactive provider/Disability
Support Provider
Benet Type Amount P/F $
PART C - PARTICIPANT ELIGIBILITY
Are you over the age of 18? Y N
Are you prohibited by law from working in Australia?
Y N
Attendance in training is compulsory, will you be available to participate in the 7
week training activity
Y N
Will you be able to work full time in your business? Y N
Have you ever declared bankruptcy? Y N
Do you agree to hold and maintain the controlling interest in the business for the
duration of your NEIS Participant Agreement?
Y N
Will you be operating business with another NEIS Client? Y N
If yes; What is the name of your NEIS business partner?
Are you Aboriginal and/or Torres Strait Islander? Y N
Have you previously received NEIS allowance? Y N
If yes was it for a same/similar business as the proposed business in this application? Y N
Approximate date you nished your previous NEIS arrangement (DD/MM/YYYY)
PART D - BUSINESS ELIGIBILITY
To be eligible for NEIS Assistance, the proposed business must meet eligibility criteria. Please indicate below that
your business meets the following requirements.
Is not currently operating on a commercial basis Y N
Is an independent business structure Y N
Will be established, located and operated solely in Australia Y N
THE PROPOSED BUSINESS
Do you require to borrow money to commence your business?
Y N
If yes, how much is required and how do you plan to raise the nance?
Do you have the required skills and qualications to operate this business? Y N
What skills and qualications do you have to bring to your business?
Are you/your partner medically capable of working in the business Y N
Do you have any medical conditions which may aect your business? Y N
Please provide information on any medical conditions that may aect your business
Have you discussed with Centrelink whether participating in NEIS may aect
your ongoing entitlement to income support, i.e. DSP, Carer Payment,
Parenting Payment Single?
Y N
Have you discussed with Centrelink whether participating in NEIS may aect your
ongoing entitlement to a current Health Care Card or Pension Card?
Y N
From what location will you run your business?
Do you require Council approval to operate from this location? Y N
If yes, at what stage is your approval process up to?
Do you require any licences to operate this type of business
(e.g. Contractors, Trade, Agent)?
Y N
If yes, do you have the Licence? Y N
If no, at what stage are you at obtaining it?
Do you have a vehicle and a current Drivers Licence? Y N
PART E - YOUR DECLARATION
Information provided in the application is used to check your eligibilty for NEIS.
I certify that the information that I have supplied on this form is correct to the best of my knowledge and I
acknowledge that false information may lead to refusal, suspension or termination of NEIS Assistance.
Note - by placing a tick in the following box you agree to the above declaration.
NEIS Applicant 1 Signature
Ëmail completed form to: neis@businesscentre.com.au
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Neis Application Form 2018 (Australian National University)

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Completed 9 August 2021

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