Incorporation Form

1. JURISDICTION

Panama
British Virgins Island (BVI)
Bahamas
Seychelles
Belize
Samoa
Nevada
Hutt River Province (HRP)

 

 

2. NAME
(Provide 3 names in order of preference)

3. CAPITAL

 

 

4. NUMBER OF SHARES

 

5. VALUE PER SHARES

 

6. ISSUANCE OF SHARES
(Provide details on shares issuance)

 

 

7. NOMINATIVE
(Provide names of persons or entities and amount of shares per each)

Certificate No.

Holder

Amount of Shares

8. OBJECT
(Standard Broad purpose clause that enables all lawful activities)

 

 

9. DIRECTORS and OFFICERS

*Directors / Nominees Gerli & Co. Under this option Gerli & Co. will provide nominies
*Clients Directors / Provide names of directors

*BVI, Bahamas, Belize, Seychelles and Samoa one director.

Name

Nationality

Passport

Position

10. POWER OF ATTORNEY

In favour of:

Nationality

Passport

Address

11. GENERAL INFORMATION

Your Name and Surname

Company which you represent

Passport

Address

Country

Zip Code

City

State

Building

Floor

Office

Phones

Fax

Email

P. O. Box

Please Forward Documents
to the Following Address

 

 

12. PREFERRED COURIER SERVICE

TNT
DHL
FEDEX
Other

 

 

13. STATEMENTS

Let this statement serve as a true and lawful declaration that all the information herein contained is true and correct and that the company that I wish incorporate will only be used for lawful purposes. U also certify that I have received legal counsel from an Attorney at Law from the jurisdiction of said company and, in the case of juridical persons, that the client was advised to obtain legal counsel.

14. FAX REQUIRED INFORMATION

 

Provided it is first time you contact our organization, then you are kindly requested to submit within the next 24 hours (by fax or e-mail), the following documents. Si ha contactado por vez primera a nuestra oficina, dentro de las 24 horas siguiente al envi? de su solicitud de incorporaci?n deber? hacernos llegar v?a fax o por email los siguientes documentos:
Passport copy of interested person / Copia de Pasaporte del requirente
Passport copies of Directors (if applicable) / Copia de Pasaporte de los Directores
Copy of document in the form of utility bill, credit card statement, etc., confirming your address domicile / Copia de cualquier documento que confirme su direccion f?sica
Cliente identification form (Gerli & Co.Due diligence form) / Formulario de Identificaci?n del Cliente.

I AGREE WITH THE ABOVE