ASIC Form 201: Application for Registration as an Australian Company

This guide provides step-by-step instructions for filling out ASIC Form 201, which is used to apply for registration of a company under the Corporations Act 2001. The form requires information about the proposed company name, share structure, registered office, and details of members and officeholders. It also includes a declaration by the applicant and lodgement details.

Australian S ecu rities &
In vestmen ts Co mmi ssion
Appli cation fo r regi stration as an Australi an
co mpan y
Use this form to apply to ASI C for regis tra tion o f a company under the Corpora tions A ct 2001 .
Re late d Fo rms
208 - Notifi cation o f de tails o f shares allott ed o ther than for
cash 207 Z - Cer tif ication o f compliance with stamp du ty law
Fo rm 201
Corpora tion s Act 2001
117
I f th ere is insu ff i ci en t s p ace in a n y sect ion o f th e fo rm , you may photo c opy th e re l evan t p ag e(s) a nd sub m it as p art o f thi s lodg eme n t
Lodg eme n t d etails
A n image o f t his f orm will be av ailable as
part of the publi c regi st er.
Who should A SI C con tact i f th ere is a qu ery a bou t thi s
fo rm ? ASI C regi st ered agent number (i f appli c able)
758 964 825 58
F irm / organization
Log Pty Ltd
Cont act name /po s ition de sc rip tion
Victor Fernandez T elephone number (during bu s ine ss hour s )
(7546942664)
Viola Hastings
E mail address (op tional)[e-mail]
S uburb/ Ci ty St a te /T erri t ory P ostc ode
Brisbane Queensland 2004
1 S tate /terr itory of re gi strat ion
I appl y for regi st ra t ion of the c ompany under t he Corpora t ion s Act 2001 and nomina t e t he St at e or T erri tor y in whi c h
t he c ompany will be t ak en to be regi st ered .
Giv e St a te or T erri t ory
Queensland
2 Deta ils of t he compa ny
D o es th e co m p an y h ave a p r opo sed c o mp a n y n ame ?
X Y es
If y e s, the propos ed c ompany name is
Gold Constructions Limited
Name re s er v at ion number (if any )
AS789559B
No
T he c ompany name on regist ra t ion will be its A ust ralian Compan y Number (A CN) .
T ick the legal elemen ts tha t appl y
Pty. X Lt d. P roprie tar y X Limi ted No liabili ty NL

A SIC Form 201 11 December 2012 Pa g e 1 o f 8

2 Con tinued ... Fu rt her deta ils of t he compa ny
I s th e p ropo se d n ame id e n tica l to a re gi stere d bu s in ess n ame(s) ?
Y es X No
If y e s, I declare t hat I hold , or am regi st ering the c ompany for the holder( s ) of, t he iden t ic al
bu s ine ss name(s ), t he regi st ra tion de tail s of whi c h are li st ed below.
AB N
12301230123
F or busine ss name s regist ered bef ore
28 May 2012 wit hou t an AB N.
or
P rev iou s bu s in ess nu m b er P rev iou s state / terr ito ry o f re gi strat ion
T yp e o f co m p an y
proprie tar y c ompany
X public c ompany
C lass o f c o mp a n y
limi t ed b y s hare s
unlimit ed wi th a s hare c apit al
X limit ed by s hares
limi t ed b y guaran tee
unlimit ed wi th a s hare c apit al
no liabili ty
Sp eci al pu rpo se (i f appli c able)
home unit (HUN T )
s uperannuat ion tru stee (PST C)
c harit able purpos e s only (P NP C)
s uperannuat ion tru stee (UL SS )
c harit able purpos e s only (UL S N)
Sp eci al pu rpo se co m p an y
Re f er t o Guide f or de sc rip tion s o f
special purpo s e c ompanie s.
A public c ompany t ha t is:
• a superannuation t ru st ee , or
• for chari table purpo s es onl y,
mus t ha v e a c on st it ut ion .
If t his is a s pec ial purpos e c ompany, t ick t he bo x below t o ma k e the dec lara t ion .
I de c lare t hat thi s c ompany is a s pe c ial purpo s e c ompany a s def i ned under Regula t ion 3 o f t he
Corpora t ion s (Re v iew F ee s ) Regula t ion s 2003.
Go vern an ce o f a publi c c o mp a n y
T he c ompany will rel y en t irely on repla c eable rule s
X The compan y ha s a consti tution
A p r oposed publi c c o mp a n y whi ch h as adopte d a “ C on sti tu tion” mu st lodg e a copy o f th e c on sti tu tion
with thi s a pplication.
If t he propo s ed c ompany is t o be a public c ompany li m ite d b y gu ara n tee , st at e t he amount of the guaran tee tha t
ea c h member agree s to in wri ting .
Re gi stere d o ff i ce
Y ou cannot u s e a PO B ox
address
T he amount of the member’s guaran tee is $ 700000 (inser t amoun t)
At t he o ff i c e o f, C/ - (if appli c able)
Off i c e, unit, le v el
5

St ree t number and St ree t name
22 Phone Street
S uburb/ Ci ty St at e/T erri tor y P o stc ode
Victoria Queensland 2005
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2 Con tinued ... Fu rt her deta ils of t he compa ny
D o es th e co m p an y o ccup y th e p rem i ses ?
X Ye s
No
If no, name o f o c cupier
Occupier’s c ons en t (S ele ct bo x to indic at e t he st a temen t below is c orre ct)
Off ice hou rs
F or a publi c c ompany
T he occ upier of the premis es has c ons en ted in wri ting t o t he us e of the s pe c if i ed addre ss as the
address o f t he regi st ered o ff i c e o f t he c ompan y and ha s no t wi t hdrawn t ha t c ons ent.
X a . Regi st ered o ff i ce o f a public c ompany is open t o t he publi c ea c h bu s ine ss da y from a t lea st 10 am to 12
noon and 2 pm t o 4 pm .
b . Regi st ered off ice of a publi c c ompany is open to the publi c ea c h bus ine ss day f or a t lea st 3 hour s
be tween 9 am and 5 pm .
If b, in s er t hours open from am/pm c lo s e to am/pm
P rin cip al pl ace o f bu s in ess I f same as re gi stere d o ff i ce, wri te “ as abo ve ”.
Off ic e , unit, le v el
As above
St ree t number and St ree t name
As above
S uburb /Ci ty St at e/T erri tor y P o stc ode
As above As above As above
Coun try (i f no t A u st ralia)
3 A ppoin t off i ce holder
A public company mu st ha v e a
minimum o f 3 direc tor s (2 re s iden t in
A u st ralia) and 1 secre tar y (re s iden t in
A u st ralia).
Off i ce h e ld
X Dire ct or S e c re t ar y
A proprie t ary c ompany mu st ha v e
a minimum of 1 dire ct or (re s iden t in
A us tralia) . T he o ff i c e o f s e c re t ar y is
op tional , bu t if appoin t ed one mu st
reside in A u stralia .
Off i ceholder(s ) appoin t ment da te s hall
be effec tive from t he beginning of the
day on whic h t he c ompany be c ome s
regis t ered .
F amily name Giv en names
Jose Butler Jose Butler
F ormer name

NA
St ree t number and St ree t name
50 Country Lane
S uburb/ City St a te /T erri t ory P ostc ode
Brisbane Queensland 2002
Count ry (if no t A ust ralia)
Dat e o f bir th
02/08/1988
P la c e o f bir th (town/c ity) (st at e/coun t ry )
Brisbane Queensland
A SIC Form 201 11 December 2012 Pa g e 3 o f 8

3 Con tinued ... A ppoin t ano ther off i cehold er
A public c ompany mu st ha v e a
minimum of 3 dire ct or s (2 re s iden t in
A ust ralia) and 1 s e c re t ary (re s iden t in
A ust ralia) .
A proprie tar y c ompany mu st hav e
a minimum o f 1 dire ctor (re s iden t in
A ust ralia) . T he o ff i c e o f s e c re t ar y is
op t ional, bu t if appoin ted one mu st
reside in A ust ralia .
Off iceholder( s ) appoin tment dat e s hall
be e ff ec t iv e f rom the beginning o f t he
day on whic h the c ompany bec omes
regis tered .
Off i ce h e ld
Dire ct or
F amily name
Jack Sparrow
F ormer name
NA
St ree t number and St ree t name
205 Corporate Road
S uburb /Ci ty
Brisbane
Coun try (i f no t A u st ralia)
X S e cre tar y
Giv en name s
Jack Sparrow
St a te /T erri t ory P ostc ode
Da t e o f bir th
18/02/1984
P la c e of bir t h (t own /c ity) (st at e/c oun t ry )
Brisbane Queensland
3 Con tinued ... A ppoin t a no t her off i ceholder
A public c ompany mu st ha v e a
minimum of 3 dire ct or s (2 re s iden t in
A ust ralia) and 1 s e c re t ary (re s iden t in
A ust ralia) .
A proprie tar y c ompany mu st hav e
a minimum o f 1 dire ctor (re s iden t in
A ust ralia) . T he o ff i c e o f s e c re t ar y is
op t ional, bu t if appoin ted one mu st
reside in A ust ralia .
Off iceholder( s ) appoin tment dat e s hall
be e ff ec t iv e f rom the beginning o f t he
day on whic h the c ompany bec omes
regis tered .

Off ice h eld
X Dire ct or S e c re t ary
F amil y name Giv en name s
Tiffny Myres Tiffny Myres
F ormer name
NA
St ree t number and St ree t name
5 Night Road
S uburb/ City St a te /T erri t ory P ostc ode
Count ry (if no t A ust ralia)
Sydney NSW 2001
Dat e o f bir th
P la c e of birt h (t own/c ity) (st at e/coun t ry )
Sydney NSW
4 Id ent ify ul timate holding compa ny

Will th e c o mp a n y h ave a n ul ti mate holding co m p an y upon re gi strat ion?
Y e s
If y e s, pro v ide the following de tail s of the ult ima te holding c ompany
Compan y name
A CN /AR B N/AB N Coun try o f in c orporat ion (if no t A ust ralia)
X No
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5 Sh are str uct ure ta bl e
De tails o f s hare s iss ued by t he c ompany. P lea s e s how all de t ails o f s hare s t hat the c ompany ha s on iss ue at the time o f t hi s appli c a tion .
S ta nd ar d s h are cod es
Re fer to the table f or t he s hare
c la ss c odes for s ection s 5 and 6.

S hare c la ss c ode F ull t itle S hare c la ss c ode F ull t itle
A A
B B ...e tc
E MP employ ee’s
FO U founder’s
LG life go v ernor’s
MA N management
ORD ordinary
RE D redeemable
P R F pre feren c e
CUMP c umulat iv e pre f eren c e
NC P non- c umulat iv e pre f eren c e
R E DP redeemable pre feren c e
NR P non-redeemable pre feren c e
CR P c umulat iv e redeemable pre f eren c e
NCRP non- c umulat iv e redeemable pre f eren c e
PA R P partic ipa t iv e pre f eren c e
If you are us ing t he st andard s hare c la ss c odes y ou do no t need to pro v ide the full tit le f or t he s hare s, ju st the s hare c la ss c ode.

If you are no t u s ing the st andard s hare c la ss c ode , en ter a c ode o f no more t han 4 le tt er s and t hen s how the full
t itle . S hare F ull t itle if no t st andard T o tal number of
class code s hare s
T ot al amount
paid on t hes e
s hare s
T o tal amount
unpaid on the s e
s hare s
B 5000 500000
A re an y of the s e s hare s iss ued ot her than f or c a s h?
Y e s
If y es, will s ome or all of the s hare s be iss ued
under a wri tt en c ont ra ct ?
Y e s
If y e s: P rop r ietary co m p ani es
X No
If no , con tinue to Sect ion 6
Deta il s o f mem b ers .
Lodge a F orm 207Z c er tify ing t ha t all st amp du tie s ha v e been paid .
Publi c c o mp a ni es
Lodge a F orm 207Z and ei ther a F orm 208 or a c opy o f t he c on tra ct.
No
If no : P r opri etary c o mp a ni es
Con tinue t o S ection 6 Deta il s o f memb ers .
Publi c c o mp a ni es
Lodge a F orm 208 .
A SIC Form 201 11 December 2012 Pa g e 5 o f 8

6 Deta ils of mem bers
Use t his se ct ion to not ify the name and addre ss o f ea c h pers on who c ons en ts to be c ome a member.
If shares are join tly owned, pro v ide name s and address es o f all join t-owners on a s eparat e s hee t (annex ure) , c learl y indi c at ing the s hare c la ss and wit h whom
t he s hares are join tly owned.
Pl ease c o mpl ete a se p arate sect ion b elow fo r each mem b er , p r int a ddi tion al copi es o f p a g e 7 if m o re mem b ers are re qui re d.
Mem b er d eta il s and s h are holding
I ndicat e whe t her the member is an
individual or a c ompany and pro v ide the :
• name o f t he indi v idual or c ompany
• address of the indiv idual
or company, and
• shareholding .
A ddress of indi v idual or c ompany
F amil y name Giv en names
Ritchy Clark Ritchy Clark
OR
Compan y name
A CN /A R B N/ AB N
Off ic e , uni t, le v el , or PO B o x number
100
St ree t number and St ree t name
S uburb /Ci ty St a te /T erri t ory P ostc ode
Coun try (i f no t A u st ralia)
Comple te eac h c olumn f or ea c h s hare c la ss t he abo v e member has agreed , in wri ting , to ta k e up .
No te: B enef ic iall y held u s uall y means t hat the owner o f t he s hare s is en tit led to the dire ct benef i t f rom the s hare s. F or e x ample, benef i ts c ould in c lude t he
ent itlemen ts to pa y ments in rela tion t o an y div idend s. S hare s held by a pers on a s tru st ee , nominee or on acc ount o f ano t her per s on are non-benef i c iall y
held .
S hare c la ss Number o f A mount agreed to T ot al $ paid on A mount unpaid T o tal $ unpaid on F ully paid B enef ic iall y
code s hare s t ak en up pay per s hare the s e s hare s per s hare t hes e s hare s (y/ n) held (y/ n)
A 1500 15000 15000 NIL NIL Y N
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6 Con tinued ... Deta il s of a no t her mem ber
F amil y name Giv en names
Tom Jerry Tom Jerry
OR
Compan y name
ABC Mining NL
A CN /A R B N/ AB N
Off ic e , uni t, le v el , or PO B o x number
St ree t number and St ree t name
2 Shares Street
S uburb /Ci ty Brisbane St at e/T erri tor y Queensland P o stc ode 1004
Coun try (i f no t A u st ralia)
S hare c la ss Number o f A mount agreed to T ot al $ paid on A mount unpaid T o tal $ unpaid on F ully paid B enef ic iall y
code s hare s t ak en up pay per s hare the s e s hare s per s hare t hes e s hare s (y/ n) held (y/ n)
6 Con tinued ... Deta il s of a no t her mem ber
F amil y name Giv en names
OR
Compan y name
A CN /A R B N/ AB N
Off ic e , uni t, le v el , or PO B o x number
St ree t number and St ree t name
S uburb /Ci ty St at e/T erri tor y P o stc ode
Count ry (if not A ustralia)
S hare c la ss
code
Number o f
s hare s t ak en up
A mount agreed to
pay per s hare
T o tal $ paid
on the s e
s hare s
A mount unpaid
per s hare
T ot al $ unpaid
on t hes e s hare s
F ull y paid
(y/ n)
B enef i c iall y
held (y/ n)

A SIC Form 201 11 December 2012 Pa g e 7 o f 8

Dec larat ion by appli ca nt
I/w e appl y fo r re gi strat ion o f a c o mp a n y on th e b asi s o f th e in fo rmat ion in thi s fo rm and a n y attac h me n ts . I/we
h ave th e n ecessary wr itte n con se n ts a nd ag reeme n ts referre d to in th e appli cat ion c oncerning th e mem b er
a nd o ff ice hold ers and I/we sh a ll gi ve th e c on se n ts and a g reeme n ts to th e co m p an y after th e co m p an y
b ec o mes re gi stere d. Th e in fo rmation p ro v ide d in thi s a ppli cation and in an y ann ex u res is tru e and c o rrect at
th e time o f s igning.
Sign at ure of a ppli ca nt
P rovide family and gi v en name s OR
c orpora tion name (in c lude A CN /A R B N if
applicable)
If t he applican t is an indiv idual - 1
s igna t ure required .
If t he applican t is a c orpora tion - a dire ctor
or secret ary to s ign .
If t he agen t f or t he appli c an t is a f irm –
a member /part ner of the f irm to s ign
X P a yment ha s been
a tt a c hed Name o f
appli c an t
Jose Butler
Capa c ity of appli c an t
Director
X I ndi v idual
Corpora tion
Name of off ic eholder
A gen t f or indi v idual or c orporat ion
Name of agent
S igna ture o f applic an t
Da t e s igned
[D D] / [M M] / [Y Y]
Lodg emen t S end c omplet ed and s igned form s t o:
A ust ralian S ec uri tie s and In v est men ts Commiss ion ,
PO B ox 4000 , Gipp s land Mail Cen t re VI C 3841
Fo r m o re in fo rmation
Web www.as ic. gov . au
Need help? www .a s ic. go v. au/ quest ion
T elephone 1300 300 630

A SIC Form 201 11 December 2012 Pa g e 8 o f 8

Australian S ecu rities &
In vestmen ts Co mmi ssion
Guid e:
Appli cation fo r regi stration as an Australi an
co mpan y
Thi s guid e do es no t fo rm p art o f th e p rescrib ed fo rm . It i s in clud ed b y ASI C to ass i st y ou in c o mpl eting and lodging th e Fo rm
201 .
Fo rm 201
Corpora tion s Act 2001
117
Use this form to apply to ASI C for regis tra tion o f a company under the Corpora tions A ct 2001 (C th) (Corpora tions A ct) .
Re late d Fo rms
208 - Notifi cation o f de tails o f shares allott ed o ther than for
cash 207 Z - Cer tif ication o f compliance with stamp du ty law
Sign atu re T hi s form mu st be s igned b y:
• t he appli c an t; or
• a pers on who ha s c ons en ted to bec ome a dire ct or or s ec re tar y or member o f t he c ompany; or
• t he agen t f or t he appli c an t, being a per s on who ha s aut hori ty to s ign the form on behalf of the appli c ant (s ).
Lodg eme n t p eriod Nil – t o be lodged when required .
Lodging fee A lodgemen t f ee applie s to thi s form .
F or in f orma t ion on f ees re fer to www .a s ic. go v. au /f orm s.
O ff i cehold er a dd ress Off i c eholders ’ address es mu st be their u s ual c urren t re s iden t ial addre ss. A n al terna t iv e addre ss ma y only be
u s ed where we appro v e an applic at ion under s 205D of the Corpora tion s Act.
Replacea ble r ul es a nd
c on sti tu t ions
T he Corpora tion s Act c on tain s ‘repla c eable rule s ’ whic h appl y to all c ompanie s— exc ep t c ompanies where t he s ole
member is al s o t he s ole dire ct or —and ma y be us ed to go v ern t he in ternal running of the c ompany. Companie s ma y
di s pla c e s ome o f t he repla c eable rule s b y a c on st itu tion and be gov erned by a c ombina tion o f repla c eable rule s f or
s ome t hing s and their own c on st itu tion f or o thers. W here the propos ed c ompany is to be go v erned b y a c ombina t ion
o f repla c eable rule s and a const itu tion , pleas e t ick t he bo x tha t s a ys ‘T he c ompany ha s a c on st it ut ion’ .
A c ompany wi th more t han one member /dire ctor ma y adopt a c on st itu tion pro v ided all pers ons who have agreed
t o be c ome a member o f t he c ompany agree to the term s and c ondi t ion s.
If a writt en c on st it ut ion go v ern s t he c ompany, a c op y of the c on st it ut ion mu st als o be lodged . A publi c c ompany tha t
is: • a s uperannuation t rus tee , or
• for c haritable purpo s es onl y,
mu st ha v e a wri tt en c onstit ut ion .
Co mp a n y n ames A name is av ailable unle ss it is iden tic al to :
• a name t hat is c urren t ly re s er v ed or regist ered under t he Corpora t ion s Act for another bod y, or
• a name t hat is held or regist ered on the bus ine ss names regi st er in re s pect o f anot her indi v idual or body who is
no t t he pers on appl y ing to hav e the name, or
• is unacc ept able for regi st ra t ion under t he Corpora t ion s Regula tion s 2001 .
If it is propos ed to regi st er a name whic h is iden tic al to a regi st ered bu s ine ss name(s ), we mu st be s a tisf i ed tha t t he
propo s ed c ompany is en tit led to the us e of the name under s 147 . T here f ore eit her the owner, or s omeone registering
t he c ompany f or t he owner of the bus ine ss name, mu st be t he appli c an t f or regist ra tion and t he que st ion s regarding
t he bu s ine ss name(s ) s hown on the F orm 201 mu st be c omple ted .
T he in forma tion c onc erning iden t ic al bus ine ss name s on t he F orm 201 ma y in st ead be gi v en in a st at ement
a tt ac hed t o t he F orm 201 (a s an anne x ure) under t he heading ‘De c lara t ion Regarding Regi st ered B u s ine ss
Name(s )’ . B e s ure to pro v ide the s ame in f orma t ion a s is required on t he F orm 201. T he st a temen t mu st be d ate d
a nd sign ed b y the
appli c an t a s being ‘t rue and c orre ct ’ as f ollow s: ‘I de c lare tha t t he in forma tion gi v en in thi s stat ement is true and c orre ct ’.

ASIC Form 201 G uide 1 July 2014 P a g e 1 o f 2

Spec i a l pu r po se c o m p a nies T he di fferen t ty pes o f s pe c ial purpo s e c ompanies t hat c an be est ablis hed on regist ra t ion are :
C h ar i ta bl e pur po ses onl y
A c ompany who s e c onst it ut ion require s it t o pur s ue c hari table purpo s es only and t o appl y its in c ome in promo ting
t hos e purpos e s; and prohibits t he c ompany ma k ing di st ribu tion s t o its members and pa y ing fee s to its dire ct ors; and
require s its dire ct or s to approv e all o ther pa y ments the c ompany ma k es t o t hem .
H o me uni t c o mp a n y
A proprie t ar y c ompany:
• t hat is the proprie tor of land on whi c h a building is ere ct ed and div ided in to s eparat e re s iden tial area s and area s
f or c ommon u s age
• who s e member s are ent itled t o e xc lu s iv e o cc upa t ion of one or more of tho s e area s and u s e o f t he c ommon
area s, and
• whi c h operat es s olely t o f ac ili ta te the righ ts of tho s e members in rela tion t o t heir exc lu s iv e occ upa tion o f
t hos e re s iden t ial area s and main t enanc e of the c ommon area s.
Sup era nnu at ion tr u stee co m p an y
A c ompany t ha t acts s olel y a s the tru st ee o f a regulat ed s uperannuat ion fund wi thin t he meaning o f s 19 of the
S uperannuat ion Indust ry (S uperv is ion) Act 1993 and whos e c onst it ut ion prohibits t he di st ribu tion o f its in c ome or
proper ty among its members.
O th er ty p es o f c o m p a nies A no–liability c ompan y (NL) mu st be a public c ompany. T he Corpora t ion s Act limi ts t he a ct iv itie s of a NL c ompan y to
mining purpos e s only and obliges a NL c ompany ’s c on st itu tion t o st a te , amongst o ther t hing s, tha t its s ole obje cts
are mining purpos e s onl y.
A c ompany limi ted b y guaran t ee (LM GT ) mu st be a publi c c ompany. I n order for a LM GT c ompany t o quali fy a s
a ‘s pe c ial purpos e c ompany ’ as def i ned b y t he Corpora tion s (Re v iew F ee s ) Regula t ion s 2003 , its c on st itu tion
mu st c on tain , amongst ot her thing s, pro v is ion s whi c h limit its act iv it ie s t o c harit able purpos e s only.
Shares i ss u e d o t h er th a n
f o r cas h o r und er a w r itte n
c on tract
Fo r public co m p ani es
If s hare s will be iss ued for ot her than c a s h, then a F orm 208 Notif i c at ion of det ail s o f s hare s allo tt ed ot her than f or
c a s h, or a c opy o f t he ‘c on tra ct ’ mu st be lodged .
If t he s hare s will be iss ued under wri tt en c on tra ct, t hen a F orm 207Z Certif i c at ion of c omplian c e wi th st amp du ty
law mu st al s o be lodged .
Fo r p ropr ietary co m p ani es
If s hare s will be iss ued under wri tt en c on tra ct or iss ued for ot her than c a s h, a F orm 207Z Cer t if ic a tion o f
c omplian c e wit h st amp du ty law mu st be lodged .
How to p r o v id e a ddi t ion a l
in f o rmat ion
Pho to c opi e d Fo rm 201 p ag es
If t here is in s uff ic ien t s pa c e in an y s ect ion o f t he f orm , y ou ma y photo c op y t he rele v an t page(s ) and s ubmi t a s par t
o f t his lodgemen t.
A nn ex u res
If t here is in s uff ic ien t s pa c e in an y s ect ion o f t he f orm , y ou ma y alt erna tel y s ubmit anne x ure s as par t of thi s lodgement.
T o ma k e an y annex ure con f orm to the regulat ion s, y ou mu st
1 . u s e A 4 s iz e paper of whi te or ligh t past el c olour wi th a margin of at lea st 10mm on all
s ide s 2 . s how t he c ompan y name and A CN or A RB N
3 . number t he page s c ons e c ut iv el y
4 . prin t or type in B L OCK le tt ers in dar k blue or bla ck in k s o tha t t he do c ument is c learl y legible when
phot oc opied 5. mark the annex ure wi th an iden t ify ing le tt er or sy mbol eg a ,b ,c or 1 ,2 ,3 etc.
6 . endor s e t he anne x ure wi t h t he word s:
T hi s annex ure (mark ) o f (number) pages re ferred to in f orm (form number and t itle)
7 . s ign and da te the annex ure
T he annex ure mu st be signed b y the s ame pers on( s ) who s igned t he f orm .
P r ivacy T he in forma tion pro v ided t o ASI C in thi s form ma y in c lude per s onal in f orma t ion . P lea s e re f er t o our pri v acy policy
(www. as ic. go v.au /pri v acy ) for more in forma tion abou t how we handle y our pers onal in f orma t ion , y our righ ts t o s ee k
acc ess to and c orre ct per s onal in f orma t ion , and t o c omplain abou t brea c he s of y our pri v a cy.
Lodg emen t S end c omplet ed and s igned form s t o:
A ust ralian S ec uri tie s and In v est men ts Commi ss ion ,
PO B ox 4000 , Gipp s land Mail Cent re VI C 3841
Fo r mo re info rmat ion
W eb www. as ic. gov .au
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A SI C Fo rm 201 G uide 1 July 2014 Pa g e 2 o f 2