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Public Company Order FormABN: 47 002 604 088

Limited by Shares

E-mail to: one: 1300 139 001Fax to: 1300 139 013

Please complete all mandatory fields (*). Reckon Docs can not be held responsible for illegible forms. By completing this form, you agree to Reckon Docs Trading Terms & Conditions on , and the customer confirms that all officeholders and shareholders have consented to their appointments under section 117(5) of the Corporations Act 2001 and confirms Reckon Docs Pty Ltd to act as the lodging agent on their behalf.

EO-1.08Reckon Docs Locked Bag 7522 McMahons Point NSW 2060March 2013

Contact Details*Date of Order:
Practice Name:
Contact Name:E-mail:
Shipping Address:Level/St.:
Shipping AddressSuburb: State:ACTNSWNTQLDSATASVICWA Postcode:
Telephone: Fax:
Special Instructions:
Payment Details*(if no method selected, the order will be placed on a 30-day account)
Reckon Docs holds a Direct Debit AuthorityDirect Deposit (fax or e-mail receipt)On Account
Credit Card Details: (discount for payment with order)Visa MasterCard AMEX Diners
Name on Card: CCV/AMEX ID:
Card Number: Expiry Date: (mm/yyyy)
Print Options*(If no option is selected, a Deluxe Binder will be provided)
Deluxe BinderSpaceSaver (slimline box)DIY Print (e-mail)
Company Seal (additional cost)Corporate Register Software: BGL/TeletaxKooyongSolution 6 / Promotion: QuickBooks Offer
Free 1 year subscription toQuickBooks Plus
Free 1 year subscription to QuickBooks Hosted
Proposed Company Details*
**Preferred Name^:
2nd Choice Name:
State of Incorp.:ACTNSWNTQLDSATASVICWA
Registered Office Address: Level/St.:
Registered Office Address: Suburb: State: ACTNSWNTQLDSATASVICWA Postcode:
The Company will occupy this office: YES, If NO, Occupant Name:
(principal place of business address is the same as the registered office address unless specified below)
Principal Place of Business: Level/St.:
Principal Place of Business: Suburb: State:ACTNSWNTQLDSATASVICWA Postcode:
Ultimate Holding Company: ACN/Country:
^The Proposed Company Name is identical to an Existing Business Name*: YES
If YES, I declare that I hold, or am registering the company on behalf of the holder(s) of the Business Names listed below:
For business names registered from28 May 2012ABN:
OR For business names registered before28 May 2012State: ACTNSWNTQLDSATASVICWABusiness Number:
**The Proposed Company Name has been Reserved*: YES, If YES, Reservation Number:
ANDfax Cancellation of Reservation Letter to 1300 139 013 (downloadable from )
If the Proposed Company Name was reserved by Reckon Docs, the applicant name is:
Internet Domain Name (add. cost)I have read and agreed to the Domain Name Eligibility and Allocation Policy Rules and the terms of sale.
Preferred Domain Name:www.
Public Companies
A public company must have at least three (3) directors. At least two (2) directors must ordinarily reside in Australia.
A public company must have at least one (1) secretary. At least one (1) of them must ordinarily reside in Australia.
Officer/Member Details*(1st Officer defaults as Chairperson and Public Officer)DirectorSecretaryShareholder
Surname/ACN:Given Names/Company:
Address: Level/St.:
Address: Suburb: State:ACTNSWNTQLDSATASVICWA Postcode:
Date of Birth:Place of Birth: State:ACTNSWNTQLDSATASVICWA Country:
Class of Shares:OrdinaryABCDEFGHIJ No. of Shares: Amt Paid/Share:$ (usually $1.00)
(all shares are held beneficially)OR as Trustee for:(e.g. trust/ super fund)
Officer/Member Details* (1st Officer defaults as Chairperson and Public Officer)Director Secretary Shareholder
Surname/ACN: Given Names/Company:
Address: Level/St.:
Address: Suburb: State:ACTNSWNTQLDSATASVICWA Postcode:
Date of Birth:Place of Birth: State:ACTNSWNTQLDSATASVICWA Country:
Class of Shares:OrdinaryABCDEFGHIJ No. of Shares: Amt Paid/Share:$ (usually $1.00)
(all shares are held beneficially) OR as Trustee for:(e.g. trust/ super fund)
Officer/Member Details* (1st Officer defaults as Chairperson and Public Officer)Director Secretary Shareholder
Surname/ACN: Given Names/Company:
Address: Level/St.:
Address: Suburb: State:ACTNSWNTQLDSATASVICWA Postcode:
Date of Birth:Place of Birth: State:ACTNSWNTQLDSATASVICWA Country:
Class of Shares:OrdinaryABCDEFGHIJ No. of Shares: Amt Paid/Share:$ (usually $1.00)
(all shares are held beneficially) OR as Trustee for:(e.g. trust/ super fund)
Officer/Member Details* (1st Officer defaults as Chairperson and Public Officer)Director Secretary Shareholder
Surname/ACN: Given Names/Company:
Address: Level/St.:
Address: Suburb: State:ACTNSWNTQLDSATASVICWA Postcode:
Date of Birth:Place of Birth: State:ACTNSWNTQLDSATASVICWA Country:
Class of Shares:OrdinaryABCDEFGHIJ No. of Shares: Amt Paid/Share:$ (usually $1.00)
(all shares are held beneficially) OR as Trustee for:(e.g. trust/ super fund)
Officer/Member Details* (1st Officer defaults as Chairperson and Public Officer)Director Secretary Shareholder
Surname/ACN: Given Names/Company:
Address: Level/St.:
Address: Suburb: State:ACTNSWNTQLDSATASVICWA Postcode:
Date of Birth:Place of Birth: State:ACTNSWNTQLDSATASVICWA Country:
Class of Shares:OrdinaryABCDEFGHIJ No. of Shares: Amt Paid/Share:$ (usually $1.00)
(all shares are held beneficially) OR as Trustee for:(e.g. trust/ super fund)
Officer/Member Details* (1st Officer defaults as Chairperson and Public Officer)Director Secretary Shareholder
Surname/ACN: Given Names/Company:
Address: Level/St.:
Address: Suburb: State:ACTNSWNTQLDSATASVICWA Postcode:
Date of Birth:Place of Birth: State:ACTNSWNTQLDSATASVICWA Country:
Class of Shares:OrdinaryABCDEFGHIJ No. of Shares: Amt Paid/Share:$ (usually $1.00)
(all shares are held beneficially) OR as Trustee for:(e.g. trust/ super fund)

EO-1.08Reckon Docs Locked Bag 7522 McMahons Point NSW 2060March 2013