VICKERS  INFORMATION (Partners: B J Payne & M A Childs)
Company Registration & Business Information Services
1 HIGH  STREET MEWS - WIMBLEDON  VILLAGE - LONDON  SW19  7RG
FAX:  020 8241 9879                             
E-mail: info@vickersinformation.co.uk 
Web: www.vickersinformation.co.uk           
URGENT CALLS ON 078 60 514631 
24  HOUR  ANSWERING  SERVICE 020 8944 2067
Please fill in shaded boxes
COMPANY NAME
(Please indicate if the word Limited is to be in full or as Ltd)
First Choice:         
Second Choice:        
Note: If any sensitive words, such as International, are being used special permission is needed from Companies House. We will advise on the extra information required.
REGISTERED OFFICE ADDRESS (in England and Wales)
Full Street Address:         
       
       
Town:        
County         
Post Code       
SHARES:    
There must be at least one shareholder.
SPECIAL REQUIREMENTS:
Please insert here any extra requirements:
         
         
         
DIRECTOR No. 1
Full name         
Please use usual residential address
Full Street Address:         
       
       
Town:        
County         
Post Code       
Date of Birth:      
Nationality:        
Occupation:        
Details of other directorships        
(held in last 5 years)        
       
Number of shares to be held:     
Three pieces of personal identification are required and these obviate the need for physical signatures.
Eye colour:        
Maiden name of mother:        
First name of father:        
Town of Birth:        
Passport Number:        
Telephone number:        
National Insurance Number:        
DIRECTOR No. 2
Full name         
Please use usual residential address
Full Street Address:         
       
       
Town:        
County         
Post Code       
Date of Birth:      
Nationality:        
Occupation:        
Details of other directorships        
(held in last 5 years)        
       
Number of shares to be held:     
Three pieces of personal identification are required and these obviate the need for physical signatures.
Eye colour:        
Maiden name of mother:        
First name of father:        
Town of Birth:        
Passport Number:        
Telephone number:        
National Insurance Number:        
DIRECTOR No. 3
Full name         
Please use usual residential address
Full Street Address:         
       
       
Town:        
County         
Post Code       
Date of Birth:      
Nationality:        
Occupation:        
Details of other directorships        
(held in last 5 years)        
       
Number of shares to be held:     
Three pieces of personal identification are required and these obviate the need for physical signatures.
Eye colour:        
Maiden name of mother:        
First name of father:        
Town of Birth:        
Passport Number:        
Telephone number:        
National Insurance Number:        
SECRETARY
Full name         
Please use usual residential address
Full Street Address:         
       
       
Town:        
County         
Post Code       
Number of shares to be held:     
Three pieces of personal identification are required and these obviate the need for physical signatures.
Eye colour:        
Maiden name of mother:        
First name of father:        
Town of Birth:        
Passport Number:        
Telephone number:        
National Insurance Number:        
SUBSCRIBER No. 1  (if not already shown as Director or Secretary)
Full name         
Please use usual residential address
Full Street Address:         
       
       
Town:        
County         
Post Code       
Number of shares to be held:     
Three pieces of personal identification are required and these obviate the need for physical signatures.
Eye colour:        
Maiden name of mother:        
First name of father:        
Town of Birth:        
Passport Number:        
Telephone number:        
National Insurance Number:        
SUBSCRIBER No. 2  (if not already shown as Director or Secretary)
Full name         
Please use usual residential address
Full Street Address:         
       
       
Town:        
County         
Post Code       
Number of shares to be held:     
Three pieces of personal identification are required and these obviate the need for physical signatures.
Eye colour:        
Maiden name of mother:        
First name of father:        
Town of Birth:        
Passport Number:        
Telephone number:        
National Insurance Number:        
PROOF OF IDENTITY
To cover the requirements of the Money Laundering Regulations we need a copy of your passport photograph page (or similar proof of identity) and a current utility bill. This is required for each officer and for the subscribers if they are different.   

Copyright Vickers Information 2009