Continuation: Corporate Director

Email Address:
Proposed Company Name:


Corporate Director Details
Title:*
Full Name of Company:
Full Company Address:
Electronic Filing Details (All Required)
First 3 letters of Town of Birth:
Last 3 numbers of Home Phone No.
First 3 letters of Mothers Maiden Name:
Number of Shares to be Taken:
*Mr *Mrs *Miss *Ms *Dr
Electronic Filing Details

These MUST be the details of the person being appointed in this section.
Authorised Representative
Full Forename(s):
Surname
Where the Company/Firm
is registered
Company No:
I consent to act as Director/Shareholder
This box must be ticked before submitting Form
P.S.C. Details (Person of Significant Control)
Is this Person a PSC :
YES / NO (If yes complete box below)

P.S.C. Details (Person of Significant Control)
Relevant Legal Entity

Trustee of a Trust

Firm
TYPE OF CONTROL
NATURE AND EXTENT  OF CONTROL

Select the appropriate statement from the options below.

The person/entity holds the Rights directly or indirectly

The person/entity exercises or has the right to exercise significant influence or control over the activities of a trust whose trustees hold the Rights

The person/entity exercises or has the right to exercise significant influence or control over the activities of a firm whose members hold the Rights

Indicate the nature and extent of the control from the options below.  Please select all relevant options that apply to this person (but it is not necessary to select the fourth option if one or more of the first three options applies).
For more guidance please click here.
Power to appoint or remove the majority of the board of directors

Right to exercise significant influence or control