Name:
Service Address:
This address will appear on the public record and can be the Companies Registered office address
Residential Address:
This address will not appear on the public record
Date of Birth:..........
Nationality:....
Occupation:.............
Number of Shares being Taken:
Electronic Filing Details (Required)
First 3 letters of town of birth.:
Last 3 digits of Telephone No:.
First 3 letters of Eye Colour: ...................
_________________________________________________________________________________________
Director/Shareholder Details
............................Designation:
........................................Title:
Name:
Service Address:
This address will appear on the public record and can be the Companies Registered office address
Residential Address:
This address will not appear on the public record
Date of Birth:..........
Nationality:....
Occupation:.............
Number of Shares being Taken:
Electronic Filing Details (Required)
First 3 letters of town of birth.:
Last 3 digits of Telephone No:.
First 3 letters of Eye Colour: ...................
____________________________________________________________________________________________
Secretary Details
Title:...........
Name:.........
Service Address:
This address will appear on the public record and can be the Companies Registered office address
Electronic Filing Details (Required)
Date of Birth:........................
First 3 letters of town of birth.:
Last 3 digits of Telephone No:.
First 3 letters of Eye Colour: ...................
Number of Shares being Taken:(if any)...
____________________________________________________________________________________________
Corporate Body as Director/Shareholder/Secretary
Designation
Full Company Name:...
Companys Registered Office Address:
Place of Registration
Company No.
Number of Shares being Taken:
Authorised Representative
Title:...........
Full Name:.........
Electronic Filing Details (Required)
First 3 letters of town of birth.:
Last 3 digits of Telephone No:.
First 3 letters of Eye Colour: ...................