Application to Register a New Company

Applicant Details

Applicant Full Name *required Applicant Full Name is required

Applicant Firm (if applicable)

Address

Phone

Email *required Email is required

New Company Details

New Company Name *required New Company Name is required

Registered Office Address

Name of Occupier if Consenting Office

Principal Place of Business Address - Tick for same as registered office Yes

Principal Place of Business Address

Provide name of Ultimate Holding Company, A.C.N. and Country of registration, if not Australia.

If yes, I declare that I hold, or am registering the company for the holder(s) of the identical business name(s).

Please provide ABN or Business Number, State or Territory of registration, and full names of the current business name holders.

Directors and Members Details

Select Relevant Tick Boxes (First Individual)

Director

Secretary

Public Officer

Member

Full Name (First Individual)

Full Name (First Individual)1

Residential Address (First Individual)

Date of Birth (First Individual)

Town and Country of Birth (First Individual)

Number of Shares (First Individual)

Value per Share (First Individual)

Provide details - Include full names of all trustees and name of trust (First Individual)

Select Relevant Tick Boxes (Second Individual)

Director

Secretary

Public Officer

Member

Full Name (Second Individual)

Residential Address (Second Individual)

Date of Birth (Second Individual)

Town and Country of Birth (Second Individual)

Number of Shares (Second Individual)

Value per Share (Second Individual)

Provide details - Include full names of all trustees and name of trust (Second Individual)

Select Relevant Tick Boxes (Third Individual)

Director

Secretary

Public Officer

Member

Full Name (Third Individual)

Residential Address (Third Individual)

Date of Birth (Third Individual)

Town and Country of Birth (Third Individual)

Number of Shares (Third Individual)

Value per Share (Third Individual)

Provide details - Include full names of all trustees and name of trust (Third Individual)

Select Relevant Tick Boxes (Fourth Individual)

Director

Secretary

Public Officer

Member

Full Name (Fourth Individual)

Residential Address (Fourth Individual)

Date of Birth (Fourth Individual)

Town and Country of Birth (Fourth Individual)

Number of Shares (Fourth Individual)

Value per Share (Fourth Individual)

Provide details - Include full names of all trustees and name of trust (Fourth Individual)

Select Relevant Tick Boxes (Fifth Individual)

Director

Secretary

Public Officer

Member

Full Name (Fifth Individual)

Residential Address (Fifth Individual)

Date of Birth (Fifth Individual)

Town and Country of Birth (Fifth Individual)

Number of Shares (Fifth Individual)

Value per Share (Fifth Individual)

Provide details - Include full names of all trustees and name of trust (Fifth Individual)

Select Relevant Tick Boxes (Sixth Individual)

Director

Secretary

Public Officer

Member

Full Name (Sixth Individual)

Residential Address (Sixth Individual)

Date of Birth (Sixth Individual)

Town and Country of Birth (Sixth Individual)

Number of Shares (Sixth Individual)

Value per Share (Sixth Individual)

Provide details - Include full names of all trustees and name of trust (Sixth Individual)

Select Relevant Tick Boxes (Seventh Individual)

Director

Secretary

Public Officer

Member

Full Name (Seventh Individual)

Residential Address (Seventh Individual)

Date of Birth (Seventh Individual)

Town and Country of Birth (Seventh Individual)

Number of Shares (Seventh Individual)

Value per Share (Seventh Individual)

Provide details - Include full names of all trustees and name of trust (Seventh Individual)

Select Relevant Tick Boxes (Eighth Individual)

Director

Secretary

Public Officer

Member

Full Name (Eighth Individual)

Residential Address (Eighth Individual)

Date of Birth (Eighth Individual)

Town and Country of Birth (Eighth Individual)

Number of Shares (Eighth Individual)

Value per Share (Eighth Individual)

Provide details - Include full names of all trustees and name of trust (Eighth Individual)

Select Relevant Tick Boxes (Ninth Individual)

Director

Secretary

Public Officer

Member

Full Name (Ninth Individual)

Residential Address (Ninth Individual)

Date of Birth (Ninth Individual)

Town and Country of Birth (Ninth Individual)

Number of Shares (Ninth Individual)

Value per Share (Ninth Individual)

Provide details -Include full names of all trustees and name of trust (Ninth Individual)

Select Relevant Tick Boxes (Tenth Individual)

Director

Secretary

Public Officer

Member

Full Name (Tenth Individual)

Residential Address (Tenth Individual)

Date of Birth (Tenth Individual)

Town and Country of Birth (Tenth Individual)

Number of Shares (Tenth Individual)

Value per Share (Tenth Individual)

Provide details -Include full names of all trustees and name of trust (Tenth Individual)

Corporate Shareholders (if any) - Provide details of Company Shareholders

Name of Corporate Shareholder (First Shareholder)

A.C.N. (First Shareholder)

Registered Office Address (First Shareholder)

Number of Shares (First Shareholder)

Value per Share (First Shareholder)

If No, provide name of trust (First Shareholder)

Name of Corporate Shareholder (Second Shareholder)

A.C.N. (Second Shareholder)

Registered Office Address (Second Shareholder)

Number of Shares (Second Shareholder)

Value per Share (Second Shareholder)

If No, provide name of trust (Second Shareholder)

Name of Corporate Shareholder (Third Shareholder)

A.C.N. (Third Shareholder)

Registered Office Address (Third Shareholder)

Number of Shares (Third Shareholder)

Value per Share (Third Shareholder)

If No, provide name of trust (Third Shareholder)

Name of Corporate Shareholder (Fourth Shareholder)

A.C.N. (Fourth Shareholder)

Registered Office Address (Fourth Shareholder)

Number of Shares (Fourth Shareholder)

Value per Share (Fourth Shareholder)

If No, provide name of trust (Fourth Shareholder)

Name of Corporate Shareholder (Fifth Shareholder)

A.C.N. (Fifth Shareholder)

Registered Office Address (Fifth Shareholder)

Number of Shares (Fifth Shareholder)

Value per Share (Fifth Shareholder)

If No, provide name of trust (Fifth Shareholder)

Name of Corporate Shareholder (Sixth Shareholder)

A.C.N. (Sixth Shareholder)

Registered Office Address (Sixth Shareholder)

Number of Shares (Sixth Shareholder)

Value per Share (Sixth Shareholder)

If No, provide name of trust (Sixth Shareholder)

Name of Corporate Shareholder (Seventh Shareholder)

A.C.N. (Seventh Shareholder)

Registered Office Address (Seventh Shareholder)

Number of Shares (Seventh Shareholder)

Value per Share (Seventh Shareholder)

If No, provide name of trust (Seventh Shareholder)

Name of Corporate Shareholder (Eighth Shareholder)

A.C.N. (Eighth Shareholder)

Registered Office Address (Eighth Shareholder)

Number of Shares (Eighth Shareholder)

Value per Share (Eighth Shareholder)

If No, provide name of trust (Eighth Shareholder)

Name of Corporate Shareholder (Ninth Shareholder)

A.C.N. (Ninth Shareholder)

Registered Office Address (Ninth Shareholder)

Number of Shares (Ninth Shareholder)

Value per Share (Ninth Shareholder)

If No, provide name of trust (Ninth Shareholder)

Name of Corporate Shareholder (Tenth Shareholder)

A.C.N. (Tenth Shareholder)

Registered Office Address (Tenth Shareholder)

Number of Shares (Tenth Shareholder)

Value per Share (Tenth Shareholder)

If No, provide name of trust (Tenth Shareholder)

Additional information that you would like to advise us

Payment Details

Direct Deposit Yes

Credit Card Yes

To arrange payment by direct deposit these are our bank account details: ANZ Bank Account Name: Shelfcom BSB Number: 015 010 Account Number: 4036 61815 * Please use your new company name as the reference so we can match your payment. * For immediate registration of your company email confirmation of your bank transfer to admin@shelfcom.com.au

One of our team members will contact you upon receipt of your new company application to discuss payment.