Company Establishment Questionnaire Form

Part A: Company Establishment
New company name*
State/Territory of registration*
Use Gladwin Legal Address?
- Yes
Registered office address*
Street Address City State / Province / Region ZIP / Postal Code Country
Principal place of business*
Street Address City State / Province / Region ZIP / Postal Code Country
Would you like to purchase a physical binder for the company register?*
- Yes, should include the price of $120 plus GST
- No
If Gladwin Legal is your care of address, which address would you like notices to be posted to?
Street Address City State / Province / Region ZIP / Postal Code Country

Part B: Company Officer Details
Note there must be at least 1 Director and 1 Secretary – this can be the same person

Name	Phone number	Date of birth	Email Address	Actions
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Note: You must add at least one officer.
Public Officer*
Public Officer*

Select one of the officers above to be the Public Officer, responsible for understanding tax obligations.
Chairman*
Chairman*

Select one of the Directors above to be the Chairman, oversees meetings and also signs off on company minutes. Depending on your shareholders agreement, they may also have a deciding vote in the case of a tie.
Director's Tax File Number(s)*

Company Name	Share Class	No of shares	Amount paid per share	Amount remaining unpaid per share	Actions
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Maximum number of entries reached.

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