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RBO Filing Service Form

Beneficial Ownership Filing/ RBO Filing Service Form

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token*
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service_type*
Company Name*
Email*
How Many Beneficial Owners?*
A “beneficial owner” refers to the natural person(s) who ultimately owns or controls a legal entity through direct or indirect ownership of a sufficient percentage of the shares or voting rights or ownership interest in that company. Any person who holds more than 25% of the company’s shares (whether directly or indirectly) is a beneficial owner.
1st Beneficial Owner Name*
What date did the individual become the 1st Beneficial Owner?*
DD slash MM slash YYYY
1st Beneficial Owner's Nature of Control*
- Shares
- Voting Rights
- Ownership Interest
- Control via Other Means
- Senior Management Control
1st Beneficial Owner's Nature of Control: Please enter any additional information (if required)
Address of 1st Beneficial Owner*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please enter the 1st Beneficial Owner’s residential address
1st Beneficial Owner Nationality*
1st Beneficial Owner Date of Birth*
DD slash MM slash YYYY
Does 1st Beneficial Owner have a PPS number?*
- Yes
- No
Company Directors and Beneficial Owners of Irish Limited Companies are required by law to have a Personal Public Service (PPS) number.
Please enter 1st Owner PPS Number*
1st Beneficial Owner: Apply for PPS Number or IPN*
2nd Beneficial Owner Details
2nd Beneficial Owner Name*
What date did the individual become the 2nd Beneficial Owner?*
DD slash MM slash YYYY
2nd Beneficial Owner's Nature of Control*
- Shares
- Voting Rights
- Ownership Interest
- Control via Other Means
- Senior Management Control
2nd Beneficial Owner's Nature of Control: Please enter any additional information (if required)
Address of 2nd Beneficial Owner*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please enter the 3rd Beneficial Owner’s residential address
2nd Beneficial Owner Nationality*
2nd Beneficial Owner Date of Birth*
DD slash MM slash YYYY
Does 2nd Beneficial Owner have a PPS number?*
- Yes
- No
Company Directors and Beneficial Owners of Irish Limited Companies are required by law to have a Personal Public Service (PPS) number.
Please enter 2nd Owner PPS Number*
2nd Beneficial Owner: Apply for PPS Number or IPN*
3rd Beneficial Owner Details
3rd Beneficial Owner Name*
What date did the individual become the 3rd Beneficial Owner?*
DD slash MM slash YYYY
3rd Beneficial Owner's Nature of Control*
- Shares
- Voting Rights
- Ownership Interest
- Control via Other Means
- Senior Management Control
3rd Beneficial Owner's Nature of Control: Please enter any additional information (if required)
Address of 3rd Beneficial Owner*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please enter the 3rd Beneficial Owner’s residential address
3rd Beneficial Owner Nationality*
3rd Beneficial Owner Date of Birth*
DD slash MM slash YYYY
Does 3rd Beneficial Owner have a PPS number?*
- Yes
- No
Company Directors and Beneficial Owners of Irish Limited Companies are required by law to have a Personal Public Service (PPS) number.
Please enter 3rd Owner PPS Number*
3rd Beneficial Owner: Apply for PPS Number or IPN*
4th Beneficial Owner Details
4th Beneficial Owner Name*
What date did the individual become the 4th Beneficial Owner?*
DD slash MM slash YYYY
4th Beneficial Owner's Nature of Control*
- Shares
- Voting Rights
- Ownership Interest
- Control via Other Means
- Senior Management Control
4th Beneficial Owner's Nature of Control: Please enter any additional information (if required)
Address of 4th Beneficial Owner*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please enter the 4th Beneficial Owner’s residential address
4th Beneficial Owner Nationality*
4th Beneficial Owner Date of Birth*
DD slash MM slash YYYY
Does 4th Beneficial Owner have a PPS number?*
- Yes
- No
Company Directors and Beneficial Owners of Irish Limited Companies are required by law to have a Personal Public Service (PPS) number.
Please enter 4th Owner PPS Number*
4th Beneficial Owner: Apply for PPS Number OR IPN*

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