Application Form For An International Business Company (Ibc) (Page 2 of 6) in pdf

Application Form For An International Business Company (Ibc) Page 2

Bearer Shares:

Beneficiaries: 1. ____________________

_________

2. _________________________

_________

Name

No. of shares

Name

No. of shares

___________________________________

_____________________________________

Address

_______________________________________

_________________________________________

Passport number

___________________________________

_____________________________________

Telephone number

( ) Copies of any Power of Attorney given by Directors

( ) Signed directors’ statement, re: nature of the business.

I/ We affirm that any changes in the status of the company or trust will be notified to Wilfred Services Ltd.

I/ We affirm that the IBC/Trust will not be used for any illegal acts and that Wilfred Services Ltd will be indemnified if

this is breached.

I/ We authorize verification of all information on this form:

_________________________________________________________

Signature (all applicants must sign)

Mail or Fax Application to:

Wilfred Services Ltd.

P.O. Box 1510

Suite 100, Beachmont Business Centre, Beachmont

Kingstown,

Saint Vincent and the Grenadines

Tel: (784) 456-2970

Fax: (877) 471-8132 / +44-808-171-1136

Email:

Application Form For An International Business Company (Ibc) Page 2