International Ship Registries: Corporate Application Form

Name of the company to be incorporated or purchased:

First choice:
Second choice:
Third choice:
Do you want Nominee Directors?	Yes

Do you want a Power of Attorney (PoA) and for which Country?
I want a PoA	Yes
For Which Country?

Please advise the name, address and passport number of the person to appear on the Power of Attorney:

If you don't need Nominee Directors, please advise the names and addresses of your own directors (at least 3).
First Director: (President)
Second Director: (Secretary)
Third Director: (Treasurer)

Do you want ?	Regular Shares Bearer Shares
Do you want Nominee Shareholders?	Yes
Do you want your own Shareholders to appear in the Articles of Association?	Yes

Please specify the name(s) of person(s) to appear as shareholder(s):

Please list below a general description of the main activities of the company:

Special instructions (if any):


Personal Info
Name:
Date:

Address
Street:
City :	State/Province
Postal Code:	Country:
Phone:
Fax:
E-mail: (required)

Where Did You Learn About Our Company? (check all that apply)
Economist
Newsweek (Atlantic)
Newsweek (Pacific)
EuroBusiness
FT Expat
Intl Financial Advisor
High Life (British Airways)
Surfing the Net
Other
Details: