NOTE: All fields are required. Incomplete forms will delay processing,
so please make sure you have entered all information needed.

1. Contact details of the Applicant:
    
   First Name:
   Last Name:
    
   Residential Street Address:
   (NOTE: Must be a street address, not a PO Box number)
   
    
   Postal Address:
   
    
   Phone Number:
   NOTE: Please include the area code, e.g. 09-123-4567
   
    
   Fax Number (essential):
   (so forms can be signed by directors and shareholders and faxed back)
   NOTE: Please include the area code, e.g. 09-123-4567
   
    
   Email Address (essential):
   (required for correspondence and payment purposes)
   NOTE: Please DOUBLE-CHECK that you have entered your email address correctly!
   
     
2. First preferred name of Company:
   
    
   Second preferred name of Company:
   
    
3. Full name, occupation and residential street address of each director of the company:
   
   (NOTE: Add more fields as needed, or leave the field 2 empty if
   only one director):
   ( 1 ) Full Name: Occupation: Residential Address: ( 2 ) Full Name: Occupation: Residential Address:
    
4. Full name, occupation and residential street address of each shareholder of the company:
    
   (NOTE: Add more fields as needed, or leave the field 2 empty if
   only one shareholder. Leave blank if directors are to hold all the shares):
   ( 1 ) Full Name: Occupation: Residential Address: ( 2 ) Full Name: Occupation: Residential Address:
    
5. How many shares in the company in total:
   (Basic company is usually set up with 100 shares. More shares can be issued by the company at a later stage):
   
    
6. Number of shares to be held by each director:
   (NOTE: Enter the number of shares for each director. Add more fields as needed)
   Director 1: Director 2:
    
7. Number of shares to be held by each shareholder:
   (NOTE: Enter the number of shares for each shareholder. Add more fields as needed. Leave blank if directors are to hold all the shares)
   Shareholder 1: Shareholder 2:
    
     
8. Is your application urgent?
   Yes        No
    
9. What is to be the registered office of the Company? (Usually place of operation of the business)
   (NOTE: Must be a street address, not a PO Box number)
   
    
10. What is to be the address for service?
    (where legal or statutory documents or items can be delivered)
    (NOTE: Must be a street address, not a PO Box number)
    
     
11. Details required for constitution
    (Optional - will be quoted upon receipt of information. If you do not require a constitution, please leave blank.)
     
    Are directors to be removed or appointed by shareholders, by majority vote, or by special resolution (75% vote) or by a larger percentage of votes? Specify.
    
    
    What is the quorum (number) of shareholders you require to be present for a shareholders meeting?
    
    What is the quorum of directors you require to be present for a directors' meeting?
      
12. Would you require our services in the future, such as an on-going business advice once you have set up your company?
    Yes        No
     
13. Where did you hear about us?
    
     
14. If you have any additional comments or questions,
    please enter them here:
    
     

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