COMPANY REGISTRATION ORDER FORM

Note: This form is for printing, if you want to fill out an electronic form, please download the PDF version.

Date:

First Name: / Last Name:
Firm:
Phone: / Fax:
Email:
Delivery Add:

PROPOSED COMPANY DETAILS

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.

Delivery Options:

Company Register $670 - The Company Register is express posted to you in a quality bound Company Register with identifying dividers for easy reference and filing of compliance documents.

Email Version $600 - The Company Register will be delivered to you via email in PDF format.

Other Company Options (untick if not required):

Bank Account Kit +$22 inc. GST

A Bank Account Kit contains all the information you need in a package to take to any bank.

Common Seal $39.00 each inc GST (Optional):

If you would like to receive a common seal.

Preferred Company Name (Please print neatly in BLOCK CAPITAL LETTERS, one character per box including punctuation)

Company Name 2nd choice (Please print neatly in BLOCK CAPITAL LETTERS, one character per box including punctuation)

Is this a registered business name?: / Yes / No / Business Registration NO:
Do you need a domain name? (It’s Free) / Yes / No
If yes, enter your preferred FREE domain name: / Prefer a .com.au for just $20 a year
Registered Office Address:
Name of Occupier or Registered Office:
State of Incorporation:
Principal Place of Business:
Is this a superannuation trustee company? / Yes / No

COMPANY OFFICERS & SHAREHOLDERS

Fields marked with * are mandatory.

All names must be full legal names as per Birth Certificate/Drivers Licence, no initials. Directors and Secretaries MUST also include all former given and family names s117 Corporations Act 2001 (Cth). Members are only required to provide current given and family names.

The First Officer will default as Chairman of the Company unless otherwise specified.

Under the Income Tax Assessment Act 1936 (Cth), a company must appoint a Public Officer within three months after the company commences to carry on business or derive an income in Australia.

If more than 10 officers required please Contact us at 1300 658 934 or email

Please return this application to FAX 02 9997 1844 or phone 1300 658 934 for inquiries

COMPANY REGISTRATION ORDER FORM (CONTINUED)

Company Of cers

Of cers are the Directors & Secretaries of the company. Of cers are individuals.

Of cer 1
Family Name: / Full Legal Names:
Residential Address: / Australian / Not Australian
Unit/Suite, Floor, Building: / Street Number & Name (No P.O. Boxes)*:
Suburb/City*: / State/Region*:
Postcode/Zip*: / Country*:
Date of Birth *: / Country of Birth*:
Town/City of Birth*: / State of Birth*:
Position: / DIRECTOR / SECRETARY / CHAIRMAN / PUBLIC OFFICER / SHAREHOLDER
Officer 2
Family Name: / Full Legal Names:
Residential Address: / Australian / Not Australian
Unit/Suite, Floor, Building: / Street Number & Name (No P.O. Boxes)*:
Suburb/City*: / State/Region*:
Postcode/Zip*: / Country*:
Date of Birth *: / Country of Birth*:
Town/City of Birth*: / State of Birth*:
Position: / DIRECTOR / SECRETARY / CHAIRMAN / PUBLIC OFFICER / SHAREHOLDER
Officer 3
Family Name: / Full Legal Names:
Residential Address: / Australian / Not Australian
Unit/Suite, Floor, Building: / Street Number & Name (No P.O. Boxes)*:
Suburb/City*: / State/Region*:
Postcode/Zip*: / Country*:
Date of Birth *: / Country of Birth*:
Town/City of Birth*: / State of Birth*:
Position: / DIRECTOR / SECRETARY / CHAIRMAN / PUBLIC OFFICER / SHAREHOLDER
Officer 4
Family Name: / Full Legal Names:
Residential Address: / Australian / Not Australian
Unit/Suite, Floor, Building: / Street Number & Name (No P.O. Boxes)*:
Suburb/City*: / State/Region*:
Postcode/Zip*: / Country*:
Date of Birth *: / Country of Birth*:
Town/City of Birth*: / State of Birth*:
Position: / DIRECTOR / SECRETARY / CHAIRMAN / PUBLIC OFFICER / SHAREHOLDER

Please return this application to FAX 02 9997 1844 or phone 1300 658 934 for inquiries

COMPANY REGISTRATION ORDER FORM (CONTINUED)

Officer 5
Family Name: / Full Legal Names:
Residential Address: / Australian / Not Australian
Unit/Suite, Floor, Building: / Street Number & Name (No P.O. Boxes)*:
Suburb/City*: / State/Region*:
Postcode/Zip*: / Country*:
Date of Birth *: / Country of Birth*:
Town/City of Birth*: / State of Birth*:
Position: / DIRECTOR / SECRETARY / CHAIRMAN / PUBLIC OFFICER / SHAREHOLDER
Officer 6
Family Name: / Full Legal Names:
Residential Address: / Australian / Not Australian
Unit/Suite, Floor, Building: / Street Number & Name (No P.O. Boxes)*:
Suburb/City*: / State/Region*:
Postcode/Zip*: / Country*:
Date of Birth *: / Country of Birth*:
Town/City of Birth*: / State of Birth*:
Position: / DIRECTOR / SECRETARY / CHAIRMAN / PUBLIC OFFICER / SHAREHOLDER
Officer 7
Family Name: / Full Legal Names:
Residential Address: / Australian / Not Australian
Unit/Suite, Floor, Building: / Street Number & Name (No P.O. Boxes)*:
Suburb/City*: / State/Region*:
Postcode/Zip*: / Country*:
Date of Birth *: / Country of Birth*:
Town/City of Birth*: / State of Birth*:
Position: / DIRECTOR / SECRETARY / CHAIRMAN / PUBLIC OFFICER / SHAREHOLDER
Officer 8
Family Name: / Full Legal Names:
Residential Address: / Australian / Not Australian
Unit/Suite, Floor, Building: / Street Number & Name (No P.O. Boxes)*:
Suburb/City*: / State/Region*:
Postcode/Zip*: / Country*:
Date of Birth *: / Country of Birth*:
Town/City of Birth*: / State of Birth*:
Position: / DIRECTOR / SECRETARY / CHAIRMAN / PUBLIC OFFICER / SHAREHOLDER

Please return this application to FAX 02 9997 1844 or phone 1300 658 934 for inquiries

COMPANY REGISTRATION ORDER FORM (CONTINUED)

Officer 9
Family Name: / Full Legal Names:
Residential Address: / Australian / Not Australian
Unit/Suite, Floor, Building: / Street Number & Name (No P.O. Boxes)*:
Suburb/City*: / State/Region*:
Postcode/Zip*: / Country*:
Date of Birth *: / Country of Birth*:
Town/City of Birth*: / State of Birth*:
Position: / DIRECTOR / SECRETARY / CHAIRMAN / PUBLIC OFFICER / SHAREHOLDER
Officer 10
Family Name: / Full Legal Names:
Residential Address: / Australian / Not Australian
Unit/Suite, Floor, Building: / Street Number & Name (No P.O. Boxes)*:
Suburb/City*: / State/Region*:
Postcode/Zip*: / Country*:
Date of Birth *: / Country of Birth*:
Town/City of Birth*: / State of Birth*:
Position: / DIRECTOR / SECRETARY / CHAIRMAN / PUBLIC OFFICER / SHAREHOLDER

Company Shareholders

More than one title can be chosen if applicable.

Shareholder 1
Family Name: / Full Legal Names:
Care Of: / Country*:
Unit/Suite, Floor, Building: / Street Number & Name (No P.O. Boxes) *:
Suburb/City *: / State/Region *:
Postcode/Zip *: / Date of Birth:
Country of Birth: / Town/City of Birth:
State of Birth:
Members' Primary Share Class:
Number of Shares *: / Shares Ordinary:
Are the Shares Beneficially held ? / Yes - held for the benefit of self / No* - held for the benefit of other

*If you selected No to the above question, please input the beneficial owner: Share values are $1.00 each unless otherwise requested

Please return this application to FAX 02 9997 1844 or phone 1300 658 934 for inquiries

COMPANY REGISTRATION ORDER FORM (CONTINUED)

Shareholder 2
Family Name: / Full Legal Names:
Care Of: / Country*:
Unit/Suite, Floor, Building: / Street Number & Name (No P.O. Boxes) *:
Suburb/City *: / State/Region *:
Postcode/Zip *: / Date of Birth:
Country of Birth: / Town/City of Birth:
State of Birth:
Members' Primary Share Class:
Number of Shares *: / Shares Ordinary:
Are the Shares Beneficially held ? / Yes - held for the benefit of self / No* - held for the benefit of other
*If you selected No to the above question, please input the beneficial owner:
Share values are $1.00 each unless otherwise requested
Shareholder 3
Family Name: / Full Legal Names:
Care Of: / Country*:
Unit/Suite, Floor, Building: / Street Number & Name (No P.O. Boxes) *:
Suburb/City *: / State/Region *:
Postcode/Zip *: / Date of Birth:
Country of Birth: / Town/City of Birth:
State of Birth:
Members' Primary Share Class:
Number of Shares *: / Shares Ordinary:
Are the Shares Beneficially held ? / Yes - held for the benefit of self / No* - held for the benefit of other
*If you selected No to the above question, please input the beneficial owner:
Share values are $1.00 each unless otherwise requested
Shareholder 4
Family Name: / Full Legal Names:
Care Of: / Country*:
Unit/Suite, Floor, Building: / Street Number & Name (No P.O. Boxes) *:
Suburb/City *: / State/Region *:
Postcode/Zip *: / Date of Birth:
Country of Birth: / Town/City of Birth:
State of Birth:
Members' Primary Share Class:
Number of Shares *: / Shares Ordinary:
Are the Shares Beneficially held ? / Yes - held for the benefit of self / No* - held for the benefit of other

*If you selected No to the above question, please input the beneficial owner: Share values are $1.00 each unless otherwise requested

Please return this application to FAX 02 9997 1844 or phone 1300 658 934 for inquiries

COMPANY REGISTRATION ORDER FORM (CONTINUED)

Shareholder 5
Family Name: / Full Legal Names:
Care Of: / Country*:
Unit/Suite, Floor, Building: / Street Number & Name (No P.O. Boxes) *:
Suburb/City *: / State/Region *:
Postcode/Zip *: / Date of Birth:
Country of Birth: / Town/City of Birth:
State of Birth:
Members' Primary Share Class:
Number of Shares *: / Shares Ordinary:
Are the Shares Beneficially held ? / Yes - held for the benefit of self / No* - held for the benefit of other
*If you selected No to the above question, please input the beneficial owner:
Share values are $1.00 each unless otherwise requested
Shareholder 6
Family Name: / Full Legal Names:
Care Of: / Country*:
Unit/Suite, Floor, Building: / Street Number & Name (No P.O. Boxes) *:
Suburb/City *: / State/Region *:
Postcode/Zip *: / Date of Birth:
Country of Birth: / Town/City of Birth:
State of Birth:
Members' Primary Share Class:
Number of Shares *: / Shares Ordinary:
Are the Shares Beneficially held ? / Yes - held for the benefit of self / No* - held for the benefit of other
*If you selected No to the above question, please input the beneficial owner:
Share values are $1.00 each unless otherwise requested
Shareholder 7
Family Name: / Full Legal Names:
Care Of: / Country*:
Unit/Suite, Floor, Building: / Street Number & Name (No P.O. Boxes) *:
Suburb/City *: / State/Region *:
Postcode/Zip *: / Date of Birth:
Country of Birth: / Town/City of Birth:
State of Birth:
Members' Primary Share Class:
Number of Shares *: / Shares Ordinary:
Are the Shares Beneficially held ? / Yes - held for the benefit of self / No* - held for the benefit of other

*If you selected No to the above question, please input the beneficial owner: Share values are $1.00 each unless otherwise requested

Please return this application to FAX 02 9997 1844 or phone 1300 658 934 for inquiries

COMPANY REGISTRATION ORDER FORM (CONTINUED)

Shareholder 8
Family Name: / Full Legal Names:
Care Of: / Country*:
Unit/Suite, Floor, Building: / Street Number & Name (No P.O. Boxes) *:
Suburb/City *: / State/Region *:
Postcode/Zip *: / Date of Birth:
Country of Birth: / Town/City of Birth:
State of Birth:
Members' Primary Share Class:
Number of Shares *: / Shares Ordinary:
Are the Shares Beneficially held ? / Yes - held for the benefit of self / No* - held for the benefit of other
*If you selected No to the above question, please input the beneficial owner:
Share values are $1.00 each unless otherwise requested
Shareholder 9
Family Name: / Full Legal Names:
Care Of: / Country*:
Unit/Suite, Floor, Building: / Street Number & Name (No P.O. Boxes) *:
Suburb/City *: / State/Region *:
Postcode/Zip *: / Date of Birth:
Country of Birth: / Town/City of Birth:
State of Birth:
Members' Primary Share Class:
Number of Shares *: / Shares Ordinary:
Are the Shares Beneficially held ? / Yes - held for the benefit of self / No* - held for the benefit of other
*If you selected No to the above question, please input the beneficial owner:
Share values are $1.00 each unless otherwise requested
Shareholder 10
Family Name: / Full Legal Names:
Care Of: / Country*:
Unit/Suite, Floor, Building: / Street Number & Name (No P.O. Boxes) *:
Suburb/City *: / State/Region *:
Postcode/Zip *: / Date of Birth:
Country of Birth: / Town/City of Birth:
State of Birth:
Members' Primary Share Class:
Number of Shares *: / Shares Ordinary:
Are the Shares Beneficially held ? / Yes - held for the benefit of self / No* - held for the benefit of other

*If you selected No to the above question, please input the beneficial owner: Share values are $1.00 each unless otherwise requested

Please return this application to FAX 02 9997 1844 or phone 1300 658 934 for inquiries

COMPANY REGISTRATION ORDER FORM (CONTINUED)

DECLARATION
(Must be signed for order to be processed)
I / declare that I hold the necessary consents of all the parties listed on this order form.

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

Payment Details: Bank Deposit of $600.00 (Email Version) or $670.00 (Company Register) to: Australian Incorporation Services Bank: Commonwealth Bank BSB No: 062 643 Account No: 1004 2344

*Add $39 Common Seal

*Add $22 for Bank Account Kit *Add $20 a year for .com.au website *(2.2% surcharge for credit card)

TYPE OF CARD: / Visa / Mastercard / Bankcard
CARD NUMBER: / EXPIRY DATE: ( / / / ) CVV Code:
NAME ON CARD: / SIGNATURE:

I declare this statement to be true.

Signed:Date:

Please return this application to FAX 02 9997 1844 or phone 1300 658 934 for inquiries