Company Formation Form

Requesting Party

Name of Firm:

Title:

First Name:

Last Name:

Address:

Postcode:

Suburb:

State:

Email:

Telephone:

Fax:

Date documents required:

Company Details

Name of Company:

Nature of Business:

If the proposed company name is identical to an existing business name, please complete the following information if available.

Business Name:

Registration No. / ABN:

State of Registration:

Name of Proprietor(s):

Is the sole purpose of the company to act as trustee of a superannuation fund?

Registered Office

Address:

Postcode:

Suburb:

State:

Name of Occupier if this is not
the location of the company office:

If the principal place of business is not the same as the registered office, please complete the following information.

Address:

Postcode:

Suburb:

State:

Directors

Director (1)

Full name must be provided.

Given Name(s):

Surname:

Address:

Postcode:

Suburb:

State:

Date of Birth:

Place of Birth:

Secretary

Full name must be provided.

Given Name(s):

Surname:

Address:

Postcode:

Suburb:

State:

Date of Birth:

Place of Birth:

Public Officer

Full name must be provided.

Given Name(s):

Surname:

Address:

Postcode:

Suburb:

State:

Date of Birth:

Place of Birth:

Shareholders

Shareholder (1)

Full name must be provided.

Given Name(s):
or Company Name

Surname:
or ACN

Address:

Postcode:

Suburb:

State:

Number of Shares:

Class of Shares:

Amount Paid Per Share:

Fully Paid:

If not fully paid, amount paid per share:

Shares beneficially held?

Name of beneficial owner of shares:

To: Nassaris Rossi Business Services Pty Ltd: We confirm that all of the abovementioned directors, secretaries and members have consented to their appointments under Section 117(5) of the Corporations Act 2001 (Cth) and hereby appoint Nassaris Rossi Business Services Pty Ltd to sign the Application for Registration of this Company as agent.

Yes, I confirm

General Information

Do you require a Constitution?:

Please state any special requirements you may have:

Do you require a common seal?:

In which State do you want us to register the Company?:
Note: unless you state otherwise we will register your Company in South Australia

Disclaimer - By engaging Nassaris Rossi Business Services Pty Ltd, please be aware that we do not provide legal, financial or stamp duty advice and we do not take responsibility for your legal, taxation or other liabilities which may arise from work that we may perform on your behalf. You should first obtain legal or financial advice in relation to your affairs before you provide us with your instructions.

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Company Formation Form

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