Alice Anderson Fund One Off

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This is a preview of the Alice Anderson Fund One-Off Application Form form. When you’re ready to apply, click Fill Out Now to begin.
 

Section 1: Investor Information and Eligibility

* indicates a required field.

Investing Entity Information

The ABN provided will be used to look up the following information.
Click Lookup above to check that you have entered the ABN correctly.
Information from the Australian Business Register
ABN
Entity name
ABN status
Entity type
Goods & Services Tax (GST)
DGR Endorsed
ATO Charity TypeMore information
ACNC Registration
Tax Concessions
Main business location
Must be an ABN. 
Must be an Australian phone number. 
Must be an email address. 
Address Line 1, Suburb/Town, State/Province, Postcode, and Country are required. 
Have you entered into a contract with LaunchVic previously? * Required

Investor Eligibility

Are you * Required
Response required.
Clear the selected value for Are you
Please provide evidence of status in the next question
Attach a file: Select stored file
    If you are an individual investor, please provide evidence of sophisticated investor status. If you are a Managed investment scheme, please provide details of the AFSL license holder under which you operate.
    Do you declare that all investors in this deal are completely independent from the founders? * Required
    Eligible applying investors must prove they are completely independent from the investee i.e., a founder or related parties to the founder are not eligible to apply. If related parties are involved in the investment round, the Alice Anderson Fund will not co-invest on the related party funding amount. Related Parties include spouse, child, parent, grandparent, brother, sister, uncle, aunt, nephew, niece, lineal descendent or adopted child. If a relationship exists where services are provided in lieu of equity this is also considered to be a related party. Any funding provided by a public fund or grant also must be declared. The Alice Anderson Fund will not co-invest on the funding provided by related parties or by public funds or grants..