Business Name Application Form

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formation_type

PROFESSIONAL ADVISOR (PA) AML STATUS

Are you PA advisor regulated for AML purposes?*

yes

will you provide AML documentation when requested?*

yes

BUSINESS/TRADING NAME TYPE*

Limited Company Business Name*

If you have a Limited Company and need to register a separate Trading Name under the company

Sole Trader*

Partnership*

DETAILS FOR INVOICING PURPOSES

Your Name*

Firstname Lastname

Your Company Name (If applicable)

Address*

Street Address Address Line 2 City State / Province / Region Eircode/Postal/Zip Code Country

Phone number*

Email*

Fax

BUSINESS/TRADING NAME DETAILS TO BE REGISTERED

Name required*

Nature of Business*

Principal Place of Business*

Street Address Address Line 2 City State / Province / Region Eircode/Postal/Zip Code Country

Existing Limited Company Name/Number (if registering a business name for a Limited Company)

Beneficial owner/s of the Existing Limited company)

(if registering a business name for a Limited Company

Number of Beneficial Owner*

Beneficial Owner 1

Name*

Firstname Lastname

Nationality*

Date of Birth*

Address*

Street Address Address Line 2 City State / Province / Region Eircode/Postal/Zip Code Country

Beneficial Owner's Nature of Control*

Extent of interest/control: % owned or controlled*

Beneficial Owner 2

Name*

FIrstname Lastname

Nationality*

Date of Birth*

Address*

Street Address Address Line 2 City State / Province / Region Eircode/Postal/Zip Code Country

Beneficial Owner's Nature of Control*

Extent of interest/control: % owned or controlled*

Beneficial Owner 3

Name*

Firstname Lastname

Nationality*

Date of Birth*

Address*

Street Address Address Line 2 City State / Province / Region Eircode/Postal/Zip Code Country

Beneficial Owner's Nature of Control*

Extent of interest/control: % owned or controlled*

Beneficial Owner 4

Name*

Firstname Lastname

Nationality*

Date of Birth*

Address*

Street Address Address Line 2 City State / Province / Region Eircode/Postal/Zip Code Country

Beneficial Owner's Nature of Control*

Extent of interest/control: % owned or controlled*

Beneficial Owner 5

Name*

Firstname Lastname

Nationality*

Date of Birth*

Address*

Street Address Address Line 2 City State / Province / Region Eircode/Postal/Zip Code Country

Beneficial Owner's Nature of Control*

Extent of interest/control: % owned or controlled*

Individual’s Details (Required for Sole Trader and Partnership Only)

Number of Individuals*

1st Individual

Name*

Firstname Lastname

Address*

Street Address Address Line 2 City State / Province / Region Eircode/Postal/Zip Code Country

Occupation*

Date of Birth*

other Directorships*

yes

Nationality*

2nd Individual

Name*

Firstname Lastname

Address*

Street Address Address Line 2 City State / Province / Region Eircode/Postal/Zip Code Country

Occupation*

Date of Birth*

other Directorships*

yes

Nationality*

3rd Individual

Name*

Firstname Lastame

Address*

Street Address Address Line 2 City State / Province / Region Eircode/Postal/Zip Code Country

Occupation*

Date of Birth*

other Directorships*

yes

Nationality*

4th Individual

Name*

Firstname Lastname

Address*

Street Address Address Line 2 City State / Province / Region Eircode/Postal/Zip Code Country

Occupation*

Date of Birth*

other Directorships*

yes

Nationality*

5th Individual

Name*

Firstname Lastname

Address*

Street Address Address Line 2 City State / Province / Region Eircode/Postal/Zip Code Country

Occupation*

Date of Birth*

other Directorships*

yes

Nationality*

ADDITIONAL SERVICES REQUIRED

Tax Registration (€195+VAT or €250+VAT to include VAT registration)*

yes

Would you like more details on our accounting services?*

yes

Any other professional services we have help you with?

AML/CFT QUESTIONS

Source of funds*

Please specify source of funds*

Rationale for setting up a limited company*

Geographical area/s of trading (suppliers and customers)*

Percentage of the business that is going to be cash based (if applicable)

The annual turnover anticipated*

number of employees*

Is anyone involved in the company a PEP (Politically exposed person)?*

yes

Have any of the above persons ever been charged and/or convicted of any criminal offence other than motoring offences or have they been declared bankrupt or have they a bad credit history?*

yes

If yes, please give full details*

Special Instructions (if applicable)

PAYMENT PREFERENCE

**Please note that payment is required before we can draft your incorporation documents for signature

My preferred payment method is*

CREDIT CARD/PAYPAL (invoice with secure link for payment will follow)

BANK TRANSFER

CHEQUE

I have an account, please invoice me

Company Formation Essentials

Company Types & International Options

Pricing & Professional Support

Compliance Services

Company Changes

Company Documents

Business Services

Financial/Director Services

Marketing/Technology