FAMILY ASSET PLANNING   |   BUSINESS SERVICES   |  TECHNOLOGY LAW   |   DISPUTE RESOLUTION

Level 6, 44 Waymouth Street
Adelaide SA 5000 Australia
Phone:  (08) 8415 5000
Fax:  (08) 8415 5099

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PROPRIETARY COMPANY INCORPORATION
INSTRUCTION FORM

CLIENT DETAILS
Name 
Organisation
Email 
Phone
Fax
Billing Address
City
State
Postcode
 
COMPANY NAME
Alternative name, if preferred name not available
Reservation Number (if name already reserved)
Preferred Date of Incorporation
Identical to Registered Business Name?
Registered Business Name Number (if any)

REGISTERED OFFICE
Name of Occupier, if not the company
Level, no. and street, suburb & postcode

Principal Place Of Business (if not same as registered office)

Nature of Business
Constitution required?
Common seal required?

DIRECTOR 1
Full Name
Former name (if any)
Residential Address
(PO Boxes cannot be
accepted)
Date and Place of Birth
Occupation
To be Company Secretary?

DIRECTOR 2
Full Name
Former name (if any)
Residential Address
(PO Boxes cannot be
accepted)
Date and Place of Birth
Occupation
To be Company Secretary?

DIRECTOR 3
Full Name
Former name (if any)
Residential Address
(PO Boxes cannot be
accepted)
Date and Place of Birth
Occupation
To be Company Secretary?

COMPANY SECRETARY (IF NOT A DIRECTOR)
Full Name
Former name (if any)
Residential Address
(PO Boxes cannot be
accepted)
Date and Place of Birth
Occupation
 
Is this to be a single director/shareholder Company?

SHAREHOLDER 1
Full Name
(or company name and ACN if applicable)
Address
Number of shares
Amount paid per share
Class of shares

SHAREHOLDER 2
Full Name
(or company name and ACN if applicable)
Address
Number of shares
Amount paid per share
Class of shares

SHAREHOLDER 3
Full Name
(or company name and ACN if applicable)
Address
Number of shares
Amount paid per share
Class of shares

SHAREHOLDER 4
Full Name
(or company name and ACN if applicable)
Address
Number of shares
Amount paid per share
Class of shares
 
Please note the following special instructions:
(Include details of additional directors or shareholders if necessary)

Have the persons named above as director(s), company secretary and shareholder(s)
consented in writing to become directors, company secretary or shareholders (as the case may be) 
of the company upon registration and do you have those consents?           

You can download a consent form (PDF format) by right-clicking here

Do you confirm that the information set out above is true and correct and that Adelta Legal is instructed
to apply on your behalf to register a new proprietary limited company in South Australia using this information?                                                                                    

 

Please provide information on the following legal services 
 
Would you like to be informed by email of important changes to company law and compliance rules?  
 
 

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