Contact person name and surname

 
Contact person email address

 
Contact person telephone number

 
Proposed / Existing Name

 
Three Alternative Names

 
Registration Number if Existing Entity

 
Proposed / Current Financial Year-end

 
Authorized Shares

 
Company Physical Address

 
Company Postal Address

 
Director 1 Detail:

 
Director 1: ID Number

 
Director 1: Postal Address

 
Director 1: Physical Address

 
Director 1: Email Address

 
Director 1: Cell phone number

 
Director 2 Detail:

 
Director 2: ID Number

 
Director 2: Postal Address

 
Director 2: Physical Address

 
Director 2: Email Address

 
Director 2: Cell phone number

 
Director 3 Detail:

 
Director 3: ID Number

 
Director 3: Postal Address

 
Director 3: Physical Address

 
Director 3: Email Address

 
Director 3: Cell phone number

 
Director 4 Detail:

 
Director 4: ID Number

 
Director 4: Postal Address

 
Director 4: Physical Address

 
Director 4: Email Address

 
Director 4: Cell phone Number

 
Director 5 Detail:

 
Director 5: ID Number

 
Director 5: Postal Address

 
Director 5: Physical Address

 
Director 5: Email Address

 
Director 5: Cell phone Number

 
Shareholder 1 Detail:

 
Shareholder 1: Full Names

 
Shareholder 1: Physical address

 
Shareholder 1: ID Number / Registration Number / IT Number

 
Shareholder 2 Detail:

 
Shareholder 2: Full Names

 
Shareholder 2: Physical Address

 
Shareholder 2: ID Number / Registration Number / IT Number

 
Shareholder 3 Detail:

 
Shareholder 3: Full Names

 
Shareholder 3: Physical Address

 
Shareholder 3: ID Number / Registration Number / IT Number

 
Shareholder 4 Detail:

 
Shareholder 4: Full Names

 
Shareholder 4: Physical Address

 
Shareholder 4: ID Number / Registration Number / IT Number

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