SECTION ONE

Contact Name

First Name

Last Name

Phone

Country

(###)

###

####

Address

Proposed Company Name

Alternative Name (if first choice unavailable)

Proposed Company Email

Registered Office Address

If you wish to use 13 Classon House Dundrum Business Park, Dundrum D14W9Y3 please select the box below. Alternatively please fill in the proposed address as follows.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Use MBSL as the Registered Office address.

If you wish MBSL to provide company secretarial and ancillary services please select as appropriate

Full company secretarial maintenance and compliance

Provision of a Company Secretary

Tax Registration

Bank Account opening

Virtual Office – call and post forwarding together with Boardroom facilities

Outsourced Finance Function

Tax Compliance

Other (Please complete below)

Special Instructions

Entity Type

Proposed Company Activity

SECTION TWO - COMPANY SECRETARY DETAILS

Please note that a Single Director Company must appoint a separate Company Secretary (i.e. there must be at least two Officers of the Company).

Company Secretary Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Company Secretary Type

Please select one of the below

SECTION THREE - DIRECTOR DETAILS

Please note as per the Companies Act 2014 a company must have at minimum one Director, the minimum age for a Director in Ireland is 18.

Director 1 Name

First Name

Last Name

Director Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Birth

YYYY

Nationality

European Economic Area/ EEA Resident

Yes

Director Occupation

Other Directorships - If Applicable

Please include Company Name, Company Registration Number and Country of Registration.

Director 2 Name

First Name

Last Name

Director Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Birth

YYYY

Nationality

European Economic Area/ EEA Resident

Yes

Director Occupation

Other Directorships - If Applicable

If there are additional Directors required please include here.

SECTION 4 - SHARE CAPITAL

Authorised Share Capital

Default authorised share capital is €100,000 divided into 100,000 Ordinary shares of €1 each.

Nominal Value per Share

Number of Authorised Shares

Share Class

Ordinary

Preference

Issued Share Capital

Nominal Value Per Share

Number of Issued Shares

SECTION 5 - SHAREHOLDER DETAILS

Shareholder 1 Name

First Name

Last Name

Shareholder Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Shareholder Date of Birth

YYYY

Number of Shares Held

Shareholder 2 Name

First Name

Last Name

Shareholder Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Number of Shares Held

Shareholder Date of Birth

YYYY

DATA PRIVACY NOTICE

Your Data is Important to Us.

The information you provide will be emailed directly to MBSL for the purpose of incorporation and any ancillary services that you require. No third party will have access to the information supplied nor will the information be shared in any way to any third party, other than with the Companies Registration Office. All information submitted will be treated in the strictest confidence. In order to comply with Irish and EU Anti Money Laundering Legislation, formal identification is required for all Directors and Shareholders with a holding of 20% or more shares. The types of formal identification accepted include; Proof of Identity i.e. Current valid Passport or Driving Licence. Proof of Address i.e. A Utility / Phone Bill dated within the last three months. You may be required to have these documents certified externally and the originals returned to MBSL. All personal data is retained in line with our Data Retention and Privacy Policy which is available below.

I have read and agree to the terms and conditions detailed in this Data Privacy Notice and MBSLs Data Privacy Policy.

Thank you. Your form has been received and one of our Team will be in touch shortly to discuss your requirements.

Should you have any further queries please do not hesitate to contact us directly at +353 1 298 4366

New Company Formation Order Form