FairIsle Management Limited - Offshore Financial Management

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Contact Details
Salutation:
First Name:
Last Name:
Position:
Company:
Street Address:
City:
State/Province:
Country:
Zip/Postal Code:
Email Address:
Name Reservation Information
Company Name:
Alternate Name 1:
Alternate Name 2:
Initials
(what do they mean?)
Relation
 (to existing affiliated companies?)
Principal Business
Acquisition Intellectual Property
Advertising Investment Holding
Agent Investment Business
Aircraft Mining
Computer Hardware Mutual Fund
Computer Software Oil & Exploration
Computer Consulting Partnership
Consultancy Pharmaceutical
Distribution Property Development
E-Commerce Publishing
Foreign Sales Corporation Shipping
Franchising Telecommunications
Guarantee Trading
Information Technology Other
Insurance/Reinsurance    
Business Description
Please describe the nature of the business of the proposed company:
Company Type

Check one box in each column:

Local Company Limited Liability Company
Exempted Company Unlimited Liability
    Guarantee
Share Capital
Currency
Currency Value
Par Value
Per Share Value at Incorporation
Payment Value
Source of Funds
Contributed Surplus
Will there be a contribution to surplus?
Source of Contributed Surplus?
Direct Ownership
Name of Direct Owner
# of Shares
% of Shares
Type
Intermediate Ownership
Intermediate & Ultimate Beneficial Owner
% of Ownership
Type
Directors & Officers
First Name
Middle
Last Name
Title (see Legend)
  
  
  
  
  
  
  

Legend: Select the number(s) appropriate to the individual, ie: the President must be a Director, so a 1 and 5 will be inserted as relevant to him/her.
1
President
2
Vice President
3
Chairman
4
Deputy Chairman
5
Director

Please complete a Section 5 form in respect of each of the officers and directors.
Organizational Requirements
Where do you wish the share certificates to be held?
Street Address
City
State/Province
Country
Zip/Postal Code
Will the company establish a business in Bermuda? YES NO
Is a Bermuda Bank required? YES NO
If yes, which bank?
Account Type
Currency
Who will have signing authority?
Name
Title
Please specify any limitations on the signing authorities:
Please provide the details of the accountant of the company:
First Name:
Last Name:
Street Address
City
State/Province
Country
Zip/Postal Code
Email Address
If an Auditor is to be appointed, please provide the following information:
First Name:
Last Name:
Street Address
City
State/Province
Country
Zip/Postal Code
Date of Financial Year End
First Accounting Period
Accountable Person
State the person to whom statements for billing, corporate administrative or resident representative services and requests for annual government fee(s) should be sent or copied.
First Name:
Last Name:
Street Address
City
State/Province
Country
Zip/Postal Code
Email Address
Special instructions for the incorporation of the company:
 
Please provide details of each proposed type of direct beneficial owner by completing either Section 1-4 of the Schedule
 
Schedule
 
Section 1
Ownership Information: Individual
Salutation:
First Name:
Last Name:
Position:
Company:
Street Address:
City:
State/Province:
Country:
Zip/Postal Code:
Email Address:
Nationality
Occupation
Date of Birth
 
Section 2
Name of Company
Place of Incorporation
Street Address
City
State/Province
Country
Zip/Postal Code
Stock Exchange
Stock Ticker Symbol
List all the shareholders holding 5% or more of the share capital of the Company:
Name
% of Shares
Type
Please note: if an intermediate or ultimate owner of the company is a private company and it is widely held (ie: by more than 25 shareholders) you are only required to provide details for each shareholder with a 5% or greater interest.
 
Section 3
Ownership Information: Trust
Type of Trust
Date of Settlement
Country of Settlement
List the settlor, trustee(s) and beneficiary(ies)
Name and Type of Settlor
(ie: individual, company)
Name and Type of Trustee(s)
Name and Type of Beneficiary(ies)
 
Section 4
Ownership Information: Partnership
Name of Partnership
Place of Formation
Street Address
City
State/Province
Country
Zip/Postal Code
Stock Exchange (if any)
Stock Ticker Symbol (if any)
General Partner Information
Occupation
Nationality
Date of Birth
Street Address
City
State/Province
Country
Zip/Postal Code
Section 5
Officers and Directors Details
Salutation:
First Name:
Middle Name:
Last Name:
Position:
Company:
Street Address:
City:
State/Province:
Country:
Zip/Postal Code:
Email Address:
Occupation
Nationality
Occupation
Date of Birth
Officers and Directors Details
Salutation:
First Name:
Middle Name:
Last Name:
Position:
Company:
Street Address:
City:
State/Province:
Country:
Zip/Postal Code:
Email Address:
Occupation
Nationality
Occupation
Date of Birth
Officers and Directors Details
Salutation:
First Name:
Middle Name:
Last Name:
Position:
Company:
Street Address:
City:
State/Province:
Country:
Zip/Postal Code:
Email Address:
Occupation
Nationality
Occupation
Date of Birth
Officers and Directors Details
Salutation:
First Name:
Middle Name:
Last Name:
Position:
Company:
Street Address:
City:
State/Province:
Country:
Zip/Postal Code:
Email Address:
Occupation
Nationality
Occupation
Date of Birth
Officers and Directors Details
Salutation:
First Name:
Middle Name:
Last Name:
Position:
Company:
Street Address:
City:
State/Province:
Country:
Zip/Postal Code:
Email Address:
Occupation
Nationality
Occupation
Date of Birth