Forms

NEW SUPERANNUATION COMPANY ORDER FORM

* = Required field

Contact Details Contact Name *
Telephone *
Fax *
Email *
Address *

Proposed Company Details Preferred Company Name *
2nd Choice Company Name *
3rd Choice Company Name *
State of Incorporation *

Registered Office Address

Level/St *
Suburb *
State *
Postcode *

Will the Company occupy this office? *

Yes No

If no, Name of Occupant*

Is this the Principal Place of Business? *

Yes No

If no, Principle Place of Business:

Level/St *
Suburb *
State*
Postcode *

Officer and Member Details (1st Officer defaults as Chairman and Public Officer of the Company)

If the trustee is a company:

1. all members of the fund must be directors; or
2. if there is only one member, the member must be either:
1. 2.1 the sole director; or
2. 2.2 one of only two directors and the other director must not be the member’s employer unless he or she is a relative.

Director 1

* If a director is entered in this section, all details below must be filled out

Surname
Given Names
Company Name
ACN

Address

Level/St
Suburb
State
Postcode
Date of Birth
Place of Birth

Is this Person a Director?

Yes No

Is this Person a Secretary?

Yes No

Is this Person a Shareholder?

Yes No

Class of Shares
No of Shares

Are Shares Beneficially Owned?

Yes No

If Not, as Trustee for

Director 2

* If a director is entered in this section, all details below must be filled out

Surname
Given Names
Company Name
ACN

Address

Level/St
Suburb
State
Postcode
Date of Birth
Place of Birth

Is this Person a Director?

Yes No

Is this Person a Secretary?

Yes No

Is this Person a Shareholder?

Yes No

Class of Shares
No of Shares

Are Shares Beneficially Owned?

Yes No

If Not, as Trustee for

Director 3

* If a director is entered in this section, all details below must be filled out

Surname
Given Names
Company Name
ACN

Address

Level/St
Suburb
State
Postcode
Date of Birth
Place of Birth

Is this Person a Director?

Yes No

Is this Person a Secretary?

Yes No

Is this Person a Shareholder?

Yes No

Class of Shares
No of Shares

Are Shares Beneficially Owned?

Yes No

If Not, as Trustee for

Director 4

* If a director is entered in this section, all details below must be filled out

Surname
Given Names
Company Name
ACN

Address

Level/St
Suburb
State
Postcode
Date of Birth
Place of Birth

Is this Person a Director?

Yes No

Is this Person a Secretary?

Yes No

Is this Person a Shareholder?

Yes No

Class of Shares
No of Shares

Are Shares Beneficially Owned?

Yes No

If Not, as Trustee for

Additional Notes Enter any additional notes or comments that may be relevant

Evolution Super

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Forms

NEW SUPERANNUATION COMPANY ORDER FORM

Registered Office Address

If no, Principle Place of Business:

If the trustee is a company:

Director 1

Address

Director 2

Address

Director 3

Address

Director 4

Address