Free Retirement Visa Assessment Please fill in this questionnaire as fully as possible, omitting the questions that are not relevant to your situation. Your details will be kept confidential.Note: Questions marked with an asterisk ( * ) are compulsory NamesSalutation:Mr.Mrs.Miss.Ms.Dr.Given Names:Family name:Current address:Contact detailsTelephone:Facsimile:E-mailDate of birth:Gender:MaleFemaleCountry of Passport:Country of residence:Marital status:Married or in de facto relationshipSingleNet assets of you and your spouse/partner in $AUD: Will you be able to transfer to Australia $750000 or $550000 and deposit it in government bonds??YesNoPlease answer the following if you have previously held or applied for an Australian visaWhat type of Visa? Please give details if your Australian visa was cancelled?Please give details if your Australian visa was refused?Is there any further information you want to add, or do you have any questions you want to ask us?How did you hear about us? Submit Newsletter