ASIC Form 201: Application for Registration of an Australian Company

This document presents a completed ASIC Form 201, which is an application for registration as an Australian company under the Corporations Act 2001. The application details include the proposed company name (Alzia Pty Ltd), the type of company (proprietary limited), and the registered office address. It also outlines the appointment of officeholders, including directors Anzo Stone, Peter Maxwell, and Francis Jeorge. The share structure is detailed, showing the class A shares and the details of members, including Andrew Silver and Alzia Pty Ltd. The document also includes declarations and signatures, confirming the accuracy of the information provided. This assignment is a comprehensive example of how to fill out the ASIC Form 201, including all necessary sections and details required for company registration. This document is available on Desklib which provides study tools for students.

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 ment
Lodg eme n t d eta ils
A n image o f t his f orm will be av ailable as
par t 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 regist ered agent number (if appli c able)
80398364585
F irm / organization
Alzia Pty Ltd
Con t act name /po s ition de sc rip tion T elephone number (during bu s ine ss hour s )
( 80558364585)
Anzo Stone
E mail address (op tional)
[e-mail]
S uburb/ City St a te /T erri t or y P ostc ode
Portland Australia 2876
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
Australia
2 Deta il s of t he compa ny
D o es th e co m p an y h ave a p r opo se d c o mp a n y n ame?
X Y es
If y e s, the propos ed c ompany name is
Alzia Pty Ltd
Name re s er v at ion number (if an y )
80558364585
No
T he c ompan y name on regi st ra t ion will be its A ust ralian Company Number (A CN) .
T ick the legal elemen ts tha t appl y
X Pty. L td . P roprie tar y Limit ed No liabili ty NL

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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
558 870 45485
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
X proprie t ar y
c ompany
public c ompany
C lass o f c o mp a n y
X limit ed b y s hare s
unlimit ed wi th a s hare c apit al
limit ed b y s hare s
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)
Xs 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
X T he c ompany will rel y en t irel y on repla c eable rule s
X T he c ompany has a c onst it ut ion
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 $ 7000 (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
582

St ree t number and St ree t name
3B/1 Baker Street
S uburb/ City St at e/T erri tor y P o stc ode
Portland Australia 2876
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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 cc up y th e p rem i ses?
X Y es
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.
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 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 Dire ct 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
Anzo Stone Anzo Stone
F ormer name

NA
St ree t number and St ree t name
521 George Street
S uburb/ Ci ty St a te /T erri t or y P ostc ode
Portland Australia 2876
Count ry (if not A ust ralia)
Dat e o f bir th
2.02.1999
P la c e o f bir th (town /c ity) (st at e/count ry )
Portland Australia
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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
X Dire ct or
F amil y name
Peter Maxwell
F ormer name
NA
St ree t number and St ree t name
452 William Street
S uburb /Ci ty
Portland
Coun try (i f no t A u stralia)
S e c re t ary
Giv en name s
Peter Maxwell
St a te /T erri t or y P ostc ode
Dat e o f bir th
12/06/1984
P la c e of birt h (t own/c ity) (st at e/c ount ry )
Portland Australia
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 ice h eld
X Dire ct or S e c re t ary
F amil y name Giv en name s
Francis Jeorge Francis Jeorge
F ormer name
NA
St ree t number and St ree t name
220A,St.Peterson Street
S uburb/ Ci ty St a te /T erri t or y P ostc ode
Portland Australia 2022
Count ry (if not A ust ralia)
Dat e o f bir th
04/04/1975
P la c e of birt h (t own /c ity ) (st at e/count ry )
Portland Australia
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 /A R B N/AB N Coun try o f in c orporat ion (if not 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 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 li fe gov ernor’s
MA N managemen t
ORD ordinar y
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
NCR P non- c umulat 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
A 4000 (non-voting shares) 400000
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, c ont inue to S ect 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.
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