Fiscal Services Limited

APPLICATION FORM

I/We enclose my/our cheque for .................... payable to Fiscal Services Limited Clients Account as a deposit and agree to pay the balance of the costs within fourteen days of advice. We also confirm our acceptance of Fiscal Services Limited's Terms and Conditions as detailed in its brochure.

I/We also confirm that I/We will arrange for a professional letter of introduction and all due diligence documentation as requested. I/We accept that any company incorporated as I/We request will not be used until such information has been provided to the satisfaction of Fiscal Services Limited.

Please advise the following:

  1. Directors and Shareholders if our services are not required

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  2. Description of the company's principal trade or business

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  3. Estimated turnover in its first twelve months of trading

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I/We (full names)

(1) ............................................................................................................

of (full postal address)

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Signature ...................................................................................................

Date ...................................................................................................

(2) ............................................................................................................

of (full postal address)

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Signature ...................................................................................................

Date ...................................................................................................

Telephone No's (1) ....................................................................

Fax No's (1) ....................................................................

E-Mail (1) ....................................................................

Telephone No's (2) ....................................................................

Fax No's (2) ....................................................................

E-Mail (2) ....................................................................

hereby instruct Fiscal Services Limited as my/our agent and to proceed with the formation and registration of a limited company with their choice/my choice of name, incorporated in

........................................................... (country)

lst choice ..........................................................

2nd choice ..........................................................

3rd choice ..........................................................

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Phone: +44 (0)1624 670022 - Fax: +44 (0)1624 672504
e-mail: mail@fiscalservices.co.im
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Licensed by the Isle of Man Financial Supervision Commission as a Corporate Service Provider
Website hosted by - DJN Consultants Limited - Last updated November 2004