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APPLICATION FORM

(Please print, complete and return)

PERSONAL DETAILS
FULL NAME:		NATIONALITY:
ADDRESS:		TEL NO: (including country code)	Office:
			Mobile:
			Fax:
E-MAIL:

INFORMATION ABOUT THE PROPOSED COMPANY
SUGGESTED NAME OF COMPANY (please provide three choices):
1.
2.
3.
PROPOSED COUNTRY OF REGISTRATION:
NAME(S) OF COMPANY DIRECTOR(S):
PLEASE STATE WHETHER COMPANY DIRECTOR(S) HAS/HAVE A CRIMINAL RECORD:	YES/NO (please delete)	YES/NO (please delete)	YES/NO (please delete)
NAME OF COMPANY SECRETARY:
TYPE OF BUSINESS:

NAME(S) OF SHAREHOLDERS:
DATE OF BIRTH:
PLACE OF BIRTH:
NATIONALITY:
PROFESSION:
MARITAL STATUS:

DO YOU NEED A BANK ACCOUNT? YES/NO (please delete)	DO YOU NEED A VIRTUAL OFFICE? YES/NO (please delete)
SIGNATURE:	PRINT NAME:

OTHER INFORMATION

In order to carry out our services, we require the following information: A CERTIFIED COPY OF YOUR PASSPORT TWO ORIGINAL PROOFS OF ADDRESS BASIC INFORMATION ABOUT YOURSELF PAYMENT OF 50% OF THE COMPANY FORMATION COSTS, DETAILS OF WHICH CAN BE FOUND ON OUR WEBSITE: www.openAeuropeancompany.com BUT WHICH WILL BE AGREED WITH YOU PAYMENT IN FULL FOR ANY OTHER SERVICES, WHICH WILL BE AGREED WITH YOU