CORP REGISTRATION FORM — Managed Legal Services

REGISTERED NAME - Option 1

Please provide first choice name

REGISTERED NAME - Option 2

Please provide second choice name

REGISTERED NAME - Option 3

Please provide third choice name

REGISTERED NAME - Option 4

Please provide fourth choice name

REGISTERED NAME - Option 5

Please provide fifth choice name

GENERAL

OBJECT, SHARES, ADDRESS OF REGISTERED COMPANY ...

TYPE OF REGISTRATION

PRIVATE LIMITED LIABILITY

PUBLIC LISTED COMPANY

REGISTERED TRUSTEE

REGISTERED BUSINESS NAME

OBJECT OF ORGANISATION / BUSINESS

Please provide a description of the organisation.

TOTAL NUMBER OF SHARES

Minimum share capital of 30,000,000 (thirty million) shares

TOTAL NUMBER OF ISSUED SHARES

ADDRESS OF REGISTERED OFFICE

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

SHAREHOLDERS

SHAREHOLDER - 1

SHAREHOLDER - 1 - NAME

Please complete ONLY if a person

First Name

Last Name

SHAREHOLDERS - 1 - COMPANY

Please complete ONLY if a corporate

SHAREHOLDER - 1 - ADDRESS

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

SHAREHOLDER - 1 - EMAIL

SHAREHOLDER - 1 - PHONE

(###)

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NUMBER OF SHARES - 1

SHAREHOLDER - 2

SHAREHOLDER - 2 - NAME

Please complete ONLY if a person

First Name

Last Name

SHAREHOLDERS - 2 - COMPANY

Please complete ONLY if a corporate

SHAREHOLDER - 2 - ADDRESS

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

SHAREHOLDER - 2 - EMAIL

SHAREHOLDER - 2 - PHONE

(###)

###

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NUMBER OF SHARES - 2

SHAREHOLDER - 3

SHAREHOLDER - 3 - NAME

Please complete ONLY if a person

First Name

Last Name

SHAREHOLDERS - 3 - COMPANY

Please complete ONLY if a corporate

SHAREHOLDER - 3 - ADDRESS

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

SHAREHOLDER - 3 - EMAIL

SHAREHOLDER - 3 - PHONE

(###)

###

####

NUMBER OF SHARES - 3

SHAREHOLDER - 4

SHAREHOLDER - 4 - NAME

Please complete ONLY if a person

First Name

Last Name

SHAREHOLDERS - 4 - COMPANY

Please complete ONLY if a corporate

SHAREHOLDER - 4 - ADDRESS

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

SHAREHOLDER - 4 - EMAIL

SHAREHOLDER - 4 - PHONE

(###)

###

####

NUMBER OF SHARES - 4

DIRECTORS

DIRECTOR - 1

DIRECTOR - 1 - NAME

First Name

Last Name

DIRECTOR - 1 - ADDRESS

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

DIRECTOR - 1 - EMAIL

DIRECTOR - 1 - PHONE

(###)

###

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DIRECTOR - 2

DIRECTOR - 2 - NAME

First Name

Last Name

DIRECTOR - 2 - ADDRESS

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

DIRECTOR - 2 - EMAIL

DIRECTOR - 2 - PHONE

(###)

###

####

DIRECTOR - 3

DIRECTOR - 3 - NAME

First Name

Last Name

DIRECTOR - 3 - ADDRESS

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

DIRECTOR - 3 - EMAIL

DIRECTOR - 3 - PHONE

(###)

###

####

DIRECTOR - 4

DIRECTOR - 4 - NAME

First Name

Last Name

DIRECTOR - 4 - ADDRESS

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

DIRECTOR - 4 - EMAIL

DIRECTOR - 4 - PHONE

(###)

###

####

OTHERS