Shelf Company Online Order Form

Please fill in the following details. When the submit button is pressed, your order form will be sent to us for processing.

Step 1 of 5
*Required Field

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Applicant Details (FIRM)
Contact Person
Phone
Fax
Email
Street Address
Town/Suburb
State
Postcode
Country (if not Australia)

Is the Registered office of the proposed new company the same as the applicant:
Step 2 of 5
* Required Field

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Aged Company Selection

Aged Company Selection (2nd choice)

If a change of name is required, is the name identical to an existing Business Name?
No
Yes

Preferred Change of Name Choice†

Second Choice†
† any change of name attracts additional fees

I/We declare that all proprietors of the business have agreed to the use of the above mentioned company name: please tick box

The signed consent form must be faxed to us, or a copy of the Business Name Certificate faxed
For a downloadable copy of the business name consent please click here

Register Domain Name (if required)
Add Domain

Step 3 of 5

*Required Field

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Principal Place of Business
PO Boxes are not acceptable here, only street addresses, and either the street number or lot number must be provided.

Street Address

Town/Suburb

State

Postcode

Registered Office *

Check box if same as above:

Other:

Occupier's Name (If applicable):

Full Address:
PO Boxes are not acceptable here, only street addresses, and either the street number or lot number must be provided.

Street Address

Town/Suburb

State

Postcode

Officerholders / Members

Number of Officeholders/Members:

Select the number of members required above. Then click on a tab to choose a member to fill in details for.

Member
1

Member
2

Member
3

Member
4

Member
5

Member
6

Member
7

Member
8

Member
9

Member
10

Company Officeholder / Shareholder 1 *

Officer:
Shareholder:

Surname:
First Names:

(OR):

Company Name:
Company ACN:
Trust Name:

Street Address:
Town:
State:
Postcode:
Country (if not Australia):

Date & Place of Birth Details needed for Directors & Secretaries:

Date of Birth (dd/mm/yyyy):
Town:
State:
Country (if not Australia):

Type of Office Held (please tick the appropriate field(s):

Director:
Secretary:
Chairman:
Public Officer:

Shareholding:

Share Class 1 Ordinary (At least one shareholder must have at least one ordinary share)
Number Issued:
Share Value ($):

Share Class 2
Number Issued:
Share Value ($):
Explanation of share classes

Please contact DGA if you require further information about the different classes of shares

If shares held jointly please enter details of joint holder below.

Shares held jointly with:

If shares held in a trust please enter details of trustee below.

Trust:
Trustee Name:

If trustee is a corporate trustee, please provide the ACN of the corporate trustee.

Corporate Trustee ACN:

Additional Shares Comments.

Comments:

Member
1

Member
2

Member
3

Member
4

Member
5

Member
6

Member
7

Member
8

Member
9

Member
10

Step 4 of 5
*Required Field

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To DGA: I/We confirm that all the above mentioned directors, secretaries and members have consented in writing to their appointments under section 117(5) of the Corporations Act (Cth) 2001.

I/We agree
If you wish to view and print copies of the appropriate consent forms, please click as following:
To DGA: You are appointed to act as our agent to procure a Constitution and ancillary legal documentation from a solicitor, the particulars for such Constitution and legal documents being set out hereinbefore. In consideration for you acting as our agent, payment of solicitors costs, attending to compilation of materials in a register and delivery of same, we shall pay you such amounts as agreed. I/We appoint David Garry & Associates to sign the application for registration of this company as agent on our behalf.
I/We agree
Step 5 of 5
*Required Field

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Proposed Method of Payment

Direct Deposit details:

Account Name: David Garry & Associates
Bank: ANZ BankingGroup
BSB: 015-010
Account No: 9002 61003

When making payment by EFT/Direct Deposit please ensure that you include a reference to the chosen company name to assist us in correctly identifying and matching the payment.

Credit Card Title:
Credit Card Number:
Credit Card Expiry Month:
Credit Card Expiry Year:

Direct Deposit Comments:

Other form of payment (please specify arrangements):

Shelf Company Online Order Form

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Registered Office *

Officerholders / Members

Company Officeholder / Shareholder 1 *

Please contact DGA if you require further information about the different classes of shares

Company Officeholder / Shareholder 2 *

Please contact DGA if you require further information about the different classes of shares

Company Officeholder / Shareholder 3 *

Please contact DGA if you require further information about the different classes of shares

Company Officeholder / Shareholder 4 *

Please contact DGA if you require further information about the different classes of shares

Company Officeholder / Shareholder 5 *

Please contact DGA if you require further information about the different classes of shares

Company Officeholder / Shareholder 6 *

Please contact DGA if you require further information about the different classes of shares

Company Officeholder / Shareholder 7 *

Please contact DGA if you require further information about the different classes of shares

Company Officeholder / Shareholder 8 *

Please contact DGA if you require further information about the different classes of shares

Company Officeholder / Shareholder 9 *

Please contact DGA if you require further information about the different classes of shares

Company Officeholder / Shareholder 10 *

Please contact DGA if you require further information about the different classes of shares

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Direct Deposit details: