Proposed New Company Company Secretary Details

Grey boxes are not compulsory

Proposed Company Name

                                       Limited LTD None (Limited by Guarantee)

 ___________________________________________________________

Second Director Details

First Director Surname     

First Director Forename(s)

Previous Surname (if applicable)   

Previous Forenames (if applicable)

Title                                 Mr Mrs Miss Dr. Ms

First Director Date of Birth (please enter as day/month/year)

First Director National Insurance Number 

First Director Nationality   

First Director Occupation  

Address Line 1                 

Address Line 2                 

Address Line 3                 

Town                                

County                              

Postcode                           

Country                              

Second Director Number of Issued Shares      (enter 0 if zero) and tick here if None

List Other Directorships in last five years (Enter company names):

Enter the first THREE letters or numbers of the answers to the following questions for the first director:

Eye Colour:        Mothers Maiden Name:         Birth place: 

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