COMPANIES NOW

Phone: (02) 9986 0248

Fax:     (02) 9997 1844

Proposed Company Details
Company Order Form
Date:
Name:
Phone:
Email:
Fax:
Firm:
Address:
 

We draw your attention to the new section 222A of the Corporations Law. A company must first receive written Consent from a person before appointing them as a Director and/or Secretary. Noncompliance with this section carries a maximum penalty of a gaol term. A Consent to Act form is supplied in our register under tabbed section Register of directors. Companies Now and the director's of the company supplied will not be held responsible for obtaining the above.

PLEASE INDICATE YOUR CHOICE:
EMAIL ONLY VERSION $527:    COMPANY REGISTER $660:
COMMON SEAL (OPTIONAL) Yes No $27.50 each inc GST
Preferred Company Name
Company Name (2nd Choice)
Is this a registered business name:   Yes No Business Registration NO:
Registered Office Address:
Occupier of Registered Office:
Principal Place of Business:
COMPANY OFFICERS & SHAREHOLDERS (If shareholder a company please provide ACN or Country of Registration)
1/  
Surname Given Names
ADDRESS:
Date of birth: TOWN OF BIRTH: STATE/COUNTRY:
   Director        SECRETARY        CHAIRMAN        PUBLIC OFFICER
Number of shares:     Class Ord or
If shares are held on behalf of a Trust, Super Fund, Company or another person please provide the full name on the following line
2/  
Surname Given Names
ADDRESS:
Date of birth: TOWN OF BIRTH: STATE/COUNTRY:
   Director        SECRETARY        CHAIRMAN        PUBLIC OFFICER
Number of shares:     Class Ord or
If shares are held on behalf of a Trust, Super Fund, Company or another person please provide the full name on the following line
3/  
Surname Given Names
ADDRESS:
Date of birth: TOWN OF BIRTH: STATE/COUNTRY:
   Director        SECRETARY        CHAIRMAN        PUBLIC OFFICER
Number of shares:     Class Ord or
If shares are held on behalf of a Trust, Super Fund, Company or another person please provide the full name on the following line
4/  
Surname Given Names
ADDRESS:
Date of birth: TOWN OF BIRTH: STATE/COUNTRY:
   Director        SECRETARY        CHAIRMAN        PUBLIC OFFICER
Number of shares:     Class Ord or
If shares are held on behalf of a Trust, Super Fund, Company or another person please provide the full name on the following line
5/  
Surname Given Names
ADDRESS:
Date of birth: TOWN OF BIRTH: STATE/COUNTRY:
   Director        SECRETARY        CHAIRMAN        PUBLIC OFFICER
Number of shares:     Class Ord or
If shares are held on behalf of a Trust, Super Fund, Company or another person please provide the full name on the following line
Declaration: (Must be signed for order to be processed)
I declare that I hold the necessary consents of all the partys listed on this order form.
Signed Date:

Payment must be made before processing order (If ordering common seal please add to totals)

Payment Details: Bank Deposit of $660 to be made to account: Westpac BSB No: 032095 Account No: 175116

Or Please debit the following card by the amount of $674.52 OR $538.60 (2.2% surcharge for credit card)

TYPE OF CARD:
Visa:    MasterCard:    BankCard:
CARD NUMBER:   
EXPIRY DATE:
NAME ON CARD:
I am the person authorized to charge this account and give permission for the assigned amount to be debited  
I declare this statement to be true       DATED:  

Please return this application to Fax (02) 9997 1844 or Phone (02) 9986 0248 for enquiries