Company (Limited by Guarantee) Questionnaire

Preferred Company Name(Required)

Have you reserved this name with ASIC?(Required)

Yes

Do you own a registered Business Name which is identical to your preferred Company Name?(Required)

Yes

What will be the address of the Company's registered office?

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Is the registered office the principal place of business for the Company?

Yes

If no, what will be the Company's principal place of business?

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

What are the opening hours of the Registered Office?(Required)

At least 10am-12pm and 2pm-4pm every business day

At least 3 consecutive hours between 9am-5pm every business day

[NOTE: ASIC requires the registered office to be open at least from 10am-12pm and 2pm-4pm every business day; or 3 consecutive hours between 9am-5pm every business day.]

How many Directors will hold office on registration of the Company? (minimum 3)(Required)

Will your Company have any Members who will NOT also be Directors?(Required)

Yes - some Members will not be Directors

No - all Members will be Directors

I'm not sure

Your company should have a minimum of 3 Members.

How many Members will NOT also be Directors(Required)

Director 1 Details

Full Name(Required)

First Middle Last

Previous Name (if any)

First Middle Last

Place of birth(Required)

Please enter the town or city and State of birth, or town or city and country of birth (where country is not Australia)

Date of Birth(Required)

Residential Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Tax File Number

It is not strictly necessary to provide your tax file number. If you do not provide your tax file number, the ATO may take longer to process the Company's ABN Application (up to 28 days)

Secretary/Public Officer

This person will be the Secretary [Note: One person must be the Secretary. This person can also be a Director]

This person will be the Public Officer [Note: The Public Officer is the Company’s representative to the ATO under s252 of the Income Tax Assessment Act 1936]

This person will be a Member of the Company (leave blank if unknown)

Director 2 Details

Full Name(Required)

First Middle Last

Previous Name (if any)

First Middle Last

Place of birth(Required)

Please enter the town or city and State of birth, or town or city and country of birth (where country is not Australia)

Date of Birth(Required)

Residential Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Tax File Number

It is not strictly necessary to provide your tax file number. If you do not provide your tax file number, the ATO may take longer to process the Company's ABN Application (up to 28 days)

Secretary/Public Officer

This person will be the Secretary [Note: One person must be the Secretary. This person can also be a Director]

This person will be the Public Officer [Note: The Public Officer is the Company’s representative to the ATO under s252 of the Income Tax Assessment Act 1936]

This person will be a Member of the Company (leave blank if unknown)

Director 3 Details

Full Name(Required)

First Middle Last

Previous Name (if any)

First Middle Last

Place of birth(Required)

Please enter the town or city and State of birth, or town or city and country of birth (where country is not Australia)

Date of Birth(Required)

Residential Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Tax File Number

It is not strictly necessary to provide your tax file number. If you do not provide your tax file number, the ATO may take longer to process the Company's ABN Application (up to 28 days)

Secretary/Public Officer

This person will be the Secretary [Note: One person must be the Secretary. This person can also be a Director]

This person will be the Public Officer [Note: The Public Officer is the Company’s representative to the ATO under s252 of the Income Tax Assessment Act 1936]

This person will be a Member of the Company (leave blank if unknown)

Director 4 Details

Full Name(Required)

First Middle Last

Previous Name (if any)

First Middle Last

Place of birth(Required)

Please enter the town or city and State of birth, or town or city and country of birth (where country is not Australia)

Date of Birth(Required)

Residential Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Tax File Number

It is not strictly necessary to provide your tax file number. If you do not provide your tax file number, the ATO may take longer to process the Company's ABN Application (up to 28 days)

Secretary/Public Officer

This person will be the Secretary [Note: One person must be the Secretary. This person can also be a Director]

This person will be the Public Officer [Note: The Public Officer is the Company’s representative to the ATO under s252 of the Income Tax Assessment Act 1936]

This person will be a Member of the Company (leave blank if unknown)

Director 5 Details

Full Name(Required)

First Middle Last

Previous Name (if any)

First Middle Last

Place of birth(Required)

Please enter the town or city and State of birth, or town or city and country of birth (where country is not Australia)

Date of Birth(Required)

Residential Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Tax File Number

It is not strictly necessary to provide your tax file number. If you do not provide your tax file number, the ATO may take longer to process the Company's ABN Application (up to 28 days)

Secretary/Public Officer

This person will be the Secretary [Note: One person must be the Secretary. This person can also be a Director]

This person will be the Public Officer [Note: The Public Officer is the Company’s representative to the ATO under s252 of the Income Tax Assessment Act 1936]

This person will be a Member of the Company (leave blank if unknown)

Member Information

Complete only for those Members who are not also Directors

Member 1

Full Name (Individual)

First Middle Last

OR Name of Corporate Member

ACN/ABN

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please provide the registered office for corporate member

Phone

Member 2

Complete for Members who are not also Directors

Full Name(Required)

First Middle Last

Residential Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Member 3

Complete for Members who are not also Directors

Full Name(Required)

First Middle Last

Residential Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Member 4

Complete for Members who are not also Directors

Full Name(Required)

First Middle Last

Residential Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Member 5

Complete for Members who are not also Directors

Full Name(Required)

First Middle Last

Residential Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Company (Limited by Guarantee) Questionnaire

Director 1 Details

Director 2 Details

Director 3 Details

Director 4 Details

Director 5 Details

Member Information

Member 1

Member 2

Member 3

Member 4

Member 5

Any other information or comments

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