Norfolk Corporate Support - Company Registration Order Form

ORDER FORM - COMPANY DEREGISTRATION

Fields marked with a * are required for the company order to be placed. Orders with required fields left blank cannot be processed.

ORDER FROM
Order From:
Contact Person: *
Address:
Suburb/State/Postcode:*
Country:
Postal Address:*
Suburb/State/Postcode:*
Country:
Phone: *
Fax:
Email: *

Please note that the ASIC fee for the Form 6010 (application for voluntary deregistration of a company) is $33 (no GST applicable)

Please Choose preferred method of application for deregistrations

Standard Paper Lodgement:
Electronic Lodgement:*

*Please note: If we electronically lodge a Deregistration we will be charged the Application Fee of $33 by ASIC upon lodgement. We will not electronically lodge the ASIC Form 6010 unless payment of the ASIC Fees are made to us before lodgement unless other arrangements are made beforehand. Please contact our staff for more details.

DETAILS FOR COMPANY TO BE DEREGISTERED
Company Name: *
Company ACN :*
Reg. Office Address:*

MAIN SIGNATORY DETAILS
Surname:*
Given Names:*
Address:*
Suburb/State/Postcode:*
Date of Birth:*
Place of Birth:*

All other Directors' details (Name, Address, DOB & POB):*

All Members/Shareholders' Details

If Company is involved, please provide it's ACN & Registered Office Address*

Comments / Further Instructions: You can enter any further Member / Shareholder details here (if required).

Please read the below information before submitting this order to ensure the company complies with the requirements for deregistration:

(Note: The ASIC Application Fee of $33 is non-refundable if they reject the application and will be payable again if subsequent applications are made)

(a) All members of the company agree to the deregistration; and
(b) the company is not carrying on business; and
(c) the company's assets are worth less than $1000; and
(d) the company has paid all fees and penalties payable under this Act; and
(e) the cfompany has no outstanding liabilities; and
(f) the company is not a party to any legal proceedings

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.
Date : *

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