Application for Registration as an Australian Company - ASIC Form 201

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 in Australia. The form requires information about the proposed company name, share structure, registered office, and details of officeholders and members. It also includes a declaration by the applicant. The guide includes information about lodgement and where to find more help.

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 - No tifi cation o f de tails o f shares allo tt ed o ther than for
cash 207 Z - Cer tif ica tion 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 pho to c op y th e re l eva n t p ag e(s) a nd subm it as p art o f thi s lodg emen t
Lodg eme n t d eta ils
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 contact i f th ere is a qu ery a bou t thi s
fo rm ? ASI C regi st ered agent number (if appli c able)
123456789
F irm / organization
Lev
Cont act name /po s ition de sc rip tion
Lev fillers T elephone number (during bu s ine ss hour s )
(9876555621)
Van da Sar
E mail address (op tional)
[e-mail]
S uburb/ Ci ty St a te /T erri t or y P ostc ode
Sydney New South Wales 3232
1 S tate /terr itory of re gi strat ion
I appl y for regist 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 whic h
t he c ompany will be t ak en to be regi st ered .
Giv e St a te or T erri t or y
New South Wales
2 Deta il s of t he compa ny
Do es th e c o mp a n y h ave a p ropose d co m p an y n ame?
X Ye s
If y es, t he propo s ed c ompany name is
Chable NL
Name re s er v a tion number (i f an y )
NA
No
T he c ompany name on regi st ra tion will be its A u st ralian Company Number (A CN).
T ick t he legal elemen ts t hat appl y
Pty. Lt d. P roprie t ary Limi ted No liabili ty XNL

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 ropose 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 ompan y 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 whic h are list ed below.
AB N
5698478961
F or busine ss name s regi st ered be f ore
28 May 2012 wi t hout an AB N.
or
P rev iou s bu s in ess nu m b er P rev ious state / terr ito ry o f re gi stration
T yp e o f co m p an y
proprie tar y c ompany
public c ompany
C lass o f c o mp a n y
limit ed b y s hare s
unlimit ed wi th a s hare c apit al
limited by s hares
limit ed b y guaran tee
unlimit ed wi th a s hare c apit al
no liability
Sp eci al pu rpo se (if appli c able)
home uni t (HUN T )
s uperannuat ion tru st ee (PST C)
c hari t able purpos e s onl y (P NP C)
s uperannuat ion tru st ee (UL SS )
c hari t able purpos e s onl y (UL S N)
Sp ec i al pu rpose co m p an y
Ref er t o Guide f or de sc rip tion s o f
special purpo s e c ompanies.
A public c ompany t hat is:
• a superannuation t ru st ee , or
• for charitable purpo s es only,
must ha v e a c onst it ut ion .
If t his is a s pe c ial purpos e c ompany, t ick t he bo x below t o ma k e the dec lara t ion .
I dec lare t ha t 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 ees ) Regula t ion s 2003.
Go ver n an ce o f a publi c c o mp a n y
T he c ompany will rel y ent irel y 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 adop te 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 pplicat ion.
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 .
Regi 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 $ 1000000 (inser t amoun t)
At t he o ff i c e o f, C/ - (if applic able)
Off i c e, uni t, le v el
121

St ree t number and St ree t name
4 charge Street
S uburb/ Ci ty St at e/T erri tor y P o stc ode
Victoria New South Wales 3232
A SIC Form 201 11 December 2012 Pa g e 2 o f 8

2 Con tinued ... Fu rt her deta ils of t he compa ny
D o es th e co m p an y o cc up y th e p rem i ses?
X Y e s
No
If no , name o f o c cupier
Occupier’s c on s en t (S ele ct bo x to indi c 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 pec 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 wit hdrawn t ha t c on s ent.
a. Regi st ered off ice of a publi c c ompany is open to the publi c eac h bus ine ss day f rom at lea st 10 am t o 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 eac 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 , uni t, 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 cehold er
A public compan y mu st hav 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 Direct or S e c re t ary
A proprie t ary c ompany mu st ha v e
a minimum of 1 dire ctor (re s iden t in
A us tralia) . T he o ff i c e o f s e c re t ary is
op tional , but if appoin t ed one mu st
reside in A u st ralia .
Off i ceholder(s ) appoin t men t da te s hall
be effec tive from t he beginning of the
day on whi c h t he c ompany be c omes
regis t ered.
F amil y name Giv en names
Nes Bru Nes Bru
F ormer name

NA
St ree t number and St ree t name
9 coffee Road
S uburb/ Ci ty St a te /T erri t ory P ostc ode
Sydney New South Wales 3232
Count ry (i f not A ust ralia)
Dat e o f bir th
22/08/1988
P la c e o f bir th (town/c ity) (stat e/coun t ry )
Sydney New South Wales
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 ha v e
a minimum o f 1 dire ct or (re s iden t in
A ust ralia). T he o ff i c e o f s e c re t ary is
opt ional , bu t if appoin ted one mu st
reside in A ust ralia .
Off iceholder( s ) appoin tmen t da t e s hall
be e ff ect iv e f rom the beginning o f t he
day on whi c h the c ompany be c omes
regis tered .
Off i ce h e ld
Dire ct or
F amil y name
Lay Toes
F ormer name
NA
St ree t number and St ree t name
10 Chips street
S uburb /Ci ty
Sydney
Coun try (i f no t A u stralia)
X S e cre tar y
Giv en name s
Lay Toes
St a te /T erri t or y P ostc ode
Dat e o f bir th
18/02/1984
P la c e of birt h (t own/c ity) (st at e/c ount ry )
Sydney New South Wales
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 ha v e
a minimum o f 1 dire ct or (re s iden t in
A ust ralia). T he o ff i c e o f s e c re t ary is
opt ional , bu t if appoin ted one mu st
reside in A ust ralia .
Off iceholder( s ) appoin tmen t da t e s hall
be e ff ect iv e f rom the beginning o f t he
day on whi c h the c ompany be c omes
regis tered .

Off i ce h e ld
X Dire ct or S ec re tar y
F amil y name Giv en names
Missy Dawson Missy Dawson
F ormer name
NA
St ree t number and St ree t name
3 Cool Road
S uburb /Ci ty St at e/T erri tor y P o stc ode
Coun try (i f no t A u st ralia)
Sydney NSW 3000
Da te of bir t h
P la c e o f bir th (town /city ) (st a te /country )
Sydney NSW
4 Id ent ify ul timate holding compa ny

Will th e co m p an y h ave an ul timate holding c o mp a n y upon re gi stration?
Y es
If y es, pro v ide t he f ollowing de t ails o f t he ul tima t e holding c ompany
Company name
A CN/A RB N /AB N Count ry of in c orpora tion (i f no t A u st ralia)
X No
A SIC Form 201 11 December 2012 Pa g e 4 o f 8

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 det ail s o f s hare s t ha t the c ompany has on iss ue at the time o f t his appli c a tion .
S ta nd ard s h are cod es
Re fer to the table f or t he s hare
c la ss c odes for s ect ion 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 gov ernor’s
MA N management
ORD ordinary
RE D redeemable
P R F pre feren c e
CUMP c umula t iv e pre f eren c e
NC P non- c umula t 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 umula t iv e redeemable pre f eren c e
NCRP non- c umula t iv e redeemable pre f eren c e
PA R P par tic ipa t iv e pre f eren c e
If you are us ing t he st andard s hare c la ss c ode s 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 ers and t hen s how the full
t itle . S hare F ull t itle if no t standard T o tal number of
class code s hare s
T ot al amount
paid on t he s e
s hare s
T o tal amoun t
unpaid on the s e
s hare s
B 100 100000
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 writt en c on t 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 207 Z c er tifying t hat all st amp du tie s hav e been paid .
Publi c c o mp a ni es
Lodge a F orm 207 Z and ei ther a F orm 208 or a c op y o f t he c on tra ct.
No
If no : P r op ri etary c o mp a ni es
Continue t o S ect ion 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 il s 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 on s en ts to bec 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 heet (annex ure), c learl y indic at ing the s hare c la ss and wi t 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 eac h 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 indiv idual or c ompany
• address of the indiv idual
or compan y, and
• shareholding .
A ddress of indiv idual or c ompan y
F amily name Giv en names
OR
Company 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 abov e member ha s agreed , in wri ting , to ta k e up .
No te: B enef ic iall y held u s ually 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 men ts in rela tion t o an y div idend s. S hare s held by a per s on a s tru stee , nominee or on acc oun t o f ano t her pers on are non-benef i c ially
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 he s e s hare s (y/ n) held (y/ n)
A 10 1000 10000 NIL NIL Y N
A SIC Form 201 11 December 2012 Pa g e 6 o f 8

6 Con tinued ... Deta ils of a not her mem ber
F amily name Giv en names
Steve Clinton Steve Clinton
OR
Company 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 Sydney St at e/T erri tor y New South WalesP 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 he s e s hare s (y/ n) held (y/ n)
A 10 1000 10000 NIL NIL Y N
6 Con tinued ... Deta ils of a not her mem ber
F amil y name Giv en name s
OR
Compan y name
A CN /A RB N / AB N
Off i c e, unit, le v el , or PO B ox number
St ree t number and St ree t name
S uburb/ City St a te /T erri t ory P ostc ode
Count ry (i f not A ust ralia)
S hare c la ss
code
Number o f
s hare s t ak en up
A mount agreed to
pa y 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 he s e s hare s
F ully 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 stration 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 cation c on cer ning th e mem b er
a nd o ff icehold ers and I/we sh a ll gi ve th e c on sen 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 cat ion 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 pplica nt
P rovide famil y 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 indi v idual - 1
s igna t ure required .
If t he applican t is a c orpora tion - a dire ct or
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
Nes Bru
Capa c ity of appli c an t
Director and Shareholder
X I ndiv idual
Corpora tion
Name of off ic eholder
A gent f or indiv idual or c orpora t ion
Name of agent
S igna ture o f applic an t
Dat e s igned
[D D] / [M M] / [Y Y]
Lodg eme n 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 ments 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. gov. 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 assi st y ou in c o mpl et ing 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) (Corporations A ct) .
Re late d Fo rms
208 - No tifi cation o f de tails o f shares allo tt ed o ther than for
cash 207 Z - Cer tif ica tion o f compliance with stamp du ty law
Sign atu re T hi s form mu st be s igned b y:
• t he applic 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 applic an t, being a per s on who ha s au t hority to s ign the form on behalf of the appli c ant (s ).
Lodg eme n t p er iod 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 ee s re fer to www .a s ic. gov. 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 onl y be
u s ed where we appro v e an appli c at ion under s 205D of the Corpora tion s Act.
Re placea ble r ul es a nd
c on st i tu t ions
T he Corpora tion s Act c on tain s ‘repla c eable rule s ’ whi c h apply to all c ompanies— exc ep t c ompanies where t he s ole
member is al s o t he s ole dire ctor —and ma y be us ed to go v ern t he in ternal running of the c ompan y. 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 hings and their own c on st itu tion f or o ther s. 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 con st itu tion , plea s e t ick t he bo x tha t s a ys ‘T he c ompany has a c on st it ut ion’ .
A c ompany wi th more t han one member/dire ct or 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 ondit ion s.
If a wri tt en c onst it ut ion go v ern s t he c ompany, a c op y of the c onst it ut ion mu st al s o be lodged . A public c ompan y tha t
is: • a s uperannuation t rus tee , or
• for c haritable purpo s es onl y,
mu st ha v e a writt en c ons tit 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 regi st ered under t he Corpora t ion s Act for ano ther body, or
• a name t hat is held or regi st ered on the bu s ine ss names regist er in re s pe ct o f ano t her indi v idual or body who is
no t t he pers on apply ing to hav e the name, or
• is unacc ept able for regist 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 whi c 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 regi st ering
t he c ompany f or t he owner of the bu s ine ss name, mu st be t he applic 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 on c erning iden t ic al bu s 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
applic 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 ni es T he differen t ty pe s o f s pe c ial purpo s e c ompanies t hat c an be est abli s hed on regi st ra t ion are :
C h ar i ta bl e pur po ses onl y
A c ompany whos e c onst it ut ion require s it t o purs ue c haritable purpo s es onl y and t o appl y its in c ome in promo ting
t hos e purpos e s; and prohibi ts t he c ompany ma k ing di st ribu tion s t o its member s 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 ary c ompany:
• t hat is the proprie tor of land on whic 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
• whos e members are en t itled t o e xc lu s iv e o cc upat ion of one or more of tho s e area s and u s e o f t he c ommon
area s, and
• whic h operat es s olel y t o f ac ili ta te the righ ts of tho s e member s 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 nnuat ion tr u stee co m p an y
A c ompany t hat acts s olely 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 Indu st ry (S uper v is ion) Act 1993 and whos e c on st it ut ion prohibits t he di st ribu tion o f its in c ome or
proper ty among its member s.
O th er ty p es o f c o m p a nies A no–liabili ty c ompany (NL) mu st be a publi c c ompany. T he Corpora t ion s Act limi ts t he a ct iv itie s of a NL c ompany 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 limi t its act iv it ie s t o c hari t able purpos e s onl y.
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 op y 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 Cer tif i c at ion of c omplian c e wi th st amp duty
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 rmation
Pho to c opi e d Fo rm 201 p ag es
If t here is in s uff ic ien t s pac e in an y s ect ion o f t he f orm , y ou ma y pho to c opy t he rele v an t page( s ) and s ubmi t a s part
o f t hi s lodgemen t.
A nn exu res
If t here is in s uff ic ien t s pac e in an y s ect ion o f t he f orm , y ou ma y al t erna tel y s ubmi t anne x ure s as par t of thi s lodgemen t.
T o ma k e an y annex ure conf orm to the regulat ion s, y ou mu st
1 . u s e A 4 s iz e paper of white 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 ompany name and A CN or A RB N
3 . number t he page s c on s e c ut iv ely
4 . prin t or type in B L OCK le tt ers in dark 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. mar k 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 . endors e t he anne x ure wit h t he word s:
T hi s annex ure (mar k ) 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 pers onal in f orma t ion . P lea s e re f er t o our pri v acy poli cy
(www. as ic.go v.au /pri v acy ) for more in forma tion abou t how we handle y our per s onal in f orma t ion , y our righ ts t o s ee k
acc ess to and c orre ct pers onal in f orma t ion , and t o c omplain abou t brea c he s of y our priv a cy.
Lodg eme n 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 ments Commiss ion ,
PO B ox 4000 , Gipp s land Mail Cen t re VI C 3841
Fo r mo re info rmat ion
W eb www. as ic.gov .au
Need help? www. as ic. go v.au /quest ion

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A SI C Fo rm 201 G uide 1 July 2014
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