Norfolk Corporate Support - Shelf Company Order Form

ORDER FOR A SHELF COMPANY

ORDER FROM
Order From:
Contact Person: *
Address:
Suburb/State/Postcode:
Country:
Postal Address:
Suburb/State/Postcode:
Country:
Phone: *
Fax:
Email: *
BGL CAS Users: Do you require CAS datafile to be:	Emailed Copied to Disk
Do you require complete company binder to be sent with incorporation documents?	Yes No
Address for delivery of documents:

DETAILS FOR SHELF COMPANY
NAME OF COMPANY: * (ring NCS to pick from current list)
Standard constitution provided?
Date of Appointment of New Directors:*
Main Signatory/Chair Person:
Registered Office:
Principal Business Address:
Business Phone Number:
Nature of Business:
Do you require a company seal? (not compulsory, no additional cost)

DETAILS OF COMPANY OFFICERS AND SHAREHOLDERS
#1
Surname:
Given Names:
Address:
Suburb/State/Postcode:
Occupation:
Date of Birth:*
Town of Birth:*
Country/State:*
Director:	Secretary: Public Officer:
Shareholder:
Ordinary Shares Issued: No. of Shares: Standard Shelf Company will be set up with 12 Ordinary $1 shares issued to be transferred to shareholder/s

#2
Surname:
Given Names:
Address:
Suburb/State/Postcode:
Occupation:
Date of Birth:*
Town of Birth:*
Country/State:*
Director:	Secretary: Public Officer:
Shareholder:
Ordinary Shares Issued: No. of Shares:

Any additional information or instructions? Please include address for correspondence & documents,
if different from the address given in the first section of this form.

I * upon submission of this order form, confirm that the parties listed above have consented to act as officers of the proposed company. I have read over the information supplied and confirm that it is correct. I understand that typing/spelling errors or incorrect information given is my responsibility and additional costs will be incurred to correct errors in order forms after the registration of the company.
Please note the Company Binder, including all Minutes, Consents to Act, Share Certificates & Transfers, Constitutions, Registrations Forms, Registers & Company Seal remain the property of Norfolk Corporate Support until this invoice is paid in full.
Date : *

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