PRUDENTIAL CORPORATE SERVICES PTE LTD

Company Registration No: 198002814D

Questionnaire for Registration of Singapore Company

1. Proposed Company Name(s)

(1)      

(2)      

(3)      

2. Brief Description of Proposed Business Activities

(1) To provide financial and management advisory services     

(2)      

3. Share Capital

(1) Number of shares to be subscribed :      

at the time of incorporation

(2) Amount to be paid on each share :      

(Please indicate the currency)

4. Singapore Office Address

(1) Registered :      

(2) Business :      

5. Directors (Only individuals allowed)

(Please complete FORM 1 attached)

6. Shareholders

For individuals : (Please complete FORM 1 attached)

For Corporations : (Please complete FORM 2 attached)

7. Proposed Financial Year End: Month:       Year:      

8. Which are the primary countries the new Entity will have dealings with?

     
London, Dubai, United States of America

9. Referred by:      

     

Name of Person Completing Form Signature Date

 FORM 1
PARTICULARS OF *FIRST DIRECTOR/SHAREHOLDER (Individuals)
     
Name of Proposed Singapore Company

Name in Full:      

(according to identity card / passport /
employment pass)

Are you a Registrable Controller: *YES / *NO

(Refer to definition on last page)

Address in Country of Birth:      

Date of Birth:      

Citizenship (a) At Birth:      

(b) Current:      
Permanent Residence (if any and if held in
country different from that of citizenship)
:      

Passport / Identity Card No. / FIN:      

(Please produce the original for verification OR attach a copy of your identification
document certified as true copy by a Notary Public or Lawyer or Public Accountant)

Country of Issue:      

Date of Issue:       Date of Expiry:      

Current Residential Address:      

Documentary Address Proof: (Please produce the original for verification OR attach a copy of your
Address Proof certified as true copy by a Notary Public or Lawyer or
(e.g. Telephone/Utility/Credit Card Bill OR Public Accountant)
Bank Statement/Income Tax Statement
OR Driving Licence issued less than 3
months ago)

Email Address:      

Contact Telephone No:      

Current Occupation:      

(TO BE COMPLETED ONLY IF THE DIRECTOR IS ALSO A SHAREHOLDER)

Number of Ordinary Shares :      

to be subscribed

Amount to be paid in cash :      

for each Ordinary Share
(Please indicate the currency)

Source of funds :       (e.g. Savings / Earnings / Inheritance etc.)

Signature: Date:      

Name of Person Completing this form:      

* Please delete where inapplicable.
 FORM 2

PARTICULARS OF CORPORATE SHAREHOLDER

     

Name of Proposed Singapore Company

Number of Ordinary Shares :      

to be subscribed

Amount to be paid in cash :      

for each Ordinary Share
(Please indicate the currency)

Source of Funds :      

Corporate Name :      

(according to Certificate of
Incorporation or Registration)

Is this a Registrable Controller:

Y/N (Refer to definition on last page)

Country of Incorporation :      

Registered Address in Country :      

of Incorporation

Name of person authorised to

sign the new Constitution on
behalf of the shareholding
company subscribing to shares :
(Please attach passport copy)

Company Registration No :      

Documents to be attached Certificate of Incorporation / Registration

(Certified True Copies)
(Certified by Registrar of Companies)
Memorandum and Articles of Association
(Certified by Registrar of Companies or Notary
Public)
Identity of Directors (Certified by Registrar of
Companies or Notary Public)
Certificate of Incumbency (Certified by Registrar of
Companies or Notary Public)

Signature: Date:      

Name of Person Completing this form:      

Definitions of “Controller”, “significant interest” or “significant control”

A Controller is defined as an individual or a legal entity that has a “significant interest” in

or “significant control” over the company.
 
An individual or legal entity has a “significant interest” in or a “significant control” over a
company if the individual or legal entity:

(i) holds directly or indirectly more than 25% of the shares in the company;

(ii) holds directly or indirectly more than 25% of the total voting powers in the
company where the company has a share capital;

(iii) olds the right to share in more than 25% of the capital or profits of the company
where the company has no share capital;

(iv) holds directly or indirectly the right to appoint or remove the directors holding a
majority of the votes that can be cast at a meeting of the board of directors;

(v) holds directly or indirectly more than 25% of the rights to vote on those matters
that are to be decided upon by a vote of the members of the company; or

(vi) has the right to exercise, or actually exercises, significant influence or control over
the company.

Personal Data Privacy Policy:

By signing this form, each signatory:

(i) consents to the collection, use and disclosure of the personal data by Prudential
Corporate Services Pte Ltd (“PCS”) for the purpose of the due diligence processing,
administration and analysis by PCS (or its agents) and the preparation and
compilation of documents relating to the proposed new company’s registration, and
in order for PCS (or its agents) to comply with any applicable laws, rules,
regulations and/or guidelines (collectively, the “Purposes”);

(ii) warrants that where the signatory discloses the personal data of the directors and
individual shareholders (“Director and Shareholders”) of the proposed new company
to PCS (or its agents), the signatory has obtained the prior consent of such
Directors and Shareholders for the collection, use and disclosure by PCS (or its
agents) of the personal data of such Directors and Shareholders for the Purposes;
and

(iii) agrees to indemnify PCS in respect of any penalties, liabilities, claims, demands,
losses and damages as a result of the signatory’s breach of warranty.