Company Application Form
PRINT, COMPLETE IN BLOCK CAPITALS AND RETURN BY FACSIMILE OR EMAIL
Crystal WorldWide Limited If you need help completing this form please contact
OT Center, our Agent in Hungary:
Crystal Offices
Victoria Telephone: +36 1 383 03 33
Mahe Facsimile: +36 1 383 04 33
Seychelles Email: info@crwwgroup.net
ABOUT THE COMPANY
Jurisdiction of the Company
(e.g. BVI, Seychelles, Delaware LLC, etc.)
Proposed Company Name:
First choice
Alternative one
Alternative two
Question Yes / No
Is this company name on our list of ready made companies (the “shelf list”)?
Would you like us to provide nominee shareholders?
Would you like us to provide professional directors?
Will the company require a bank account? If yes where?
Will the business require a mail forwarding service? If yes where?
Question Answer
How many people will own the company?
Purpose of Company and Source of Funds:
We need detailed information what this Company will be used for and how the Company will be funded. This
information is required so we may assess your application and ensure that our services are not use for criminal
purposes, money laundering or the financing of terrorist activities. Attach any supporting documentation.
Estimated Annual Turnover
Estimated number of transactions per month
Geographic spread of proposed business
Company Application Form 2003.02.24. Page 1 of 4
DIRECTOR / ATTORNEY A (please choose)
Will you be the Contact Person of the company for the day-to-day communication?
Family name (Mr / Mrs / Ms)
Firs names
Full Address
Postcode Occupation
Telephone Mobile
Facsimile Email
DIRECTOR / ATTORNEY B (please choose)
Will you be the Contact Person of the company for the day-to-day communication?
Family name (Mr / Mrs / Ms)
First names
Full Address
Postcode Occupation
Telephone Mobile
Facsimile Email
DIRECTOR / ATTORNEY C (please choose)
Will you be the Contact Person of the company for the day-to-day communication?
Family name (Mr / Mrs / Ms)
First names
Full Address
Postcode Occupation
Telephone Mobile
Facsimile Email
SHAREHOLDER / BENEFICIAL OWNER A (please choose) Ownership (%):
Will you be the Contact Person of the company for the day-to-day communication?
Family name (Mr / Mrs / Ms)
First names
Full Address
Postcode Occupation
Telephone Mobile
Facsimile Email
SHAREHOLDER / BENEFICIAL OWNER B (please choose) Ownership (%):
Will you be the Contact Person of the company for the day-to-day communication?
Company Application Form 2003.02.24. Page 2 of 4
Family name (Mr / Mrs / Ms)
First names
Full Address
Postcode Occupation
Telephone Mobile
Facsimile Email
SHAREHOLDER / BENEFICIAL OWNER C (please choose) Ownership (%):
Will you be the Contact Person of the company for the day-to-day communication?
Family name (Mr / Mrs / Ms)
First names
Full Address
Postcode Occupation
Telephone Mobile
Facsimile Email
SHAREHOLDER / BENEFICIAL OWNER D (please choose) Ownership (%):
Will you be the Contact Person of the company for the day-to-day communication?
Family name (Mr / Mrs / Ms)
First names
Full Address
Postcode Occupation
Telephone Mobile
Facsimile Email
MANAGING AGENT – PERSON WHO IS ENTITLED TO INSTRUCT US
Will you be the Contact Person of the company for the day-to-day communication?
Family name (Mr / Mrs / Ms)
First names
Full Address
Postcode Occupation
Telephone Mobile
Facsimile Email
F3) VERIFICATION OF IDENTITY - Important!!!
To establish the identity and signature of all parties mentioned in this Application Form you must
provide a copy of one of the following, for each party:
Current Valid Full Passport
Current Valid EU ID Card
Company Application Form 2003.02.24. Page 3 of 4
To validate the home address of all parties mentioned in this agreement, please provide one of the
following, for each party:
Original recent (not older than three months) utility bill (telephone, electricity etc.) showing the
residential address.
Original recent (not older than three months) bank statement from a recognised bank or an original
and recent (not older than three months) credit card statement showing the residential address.
Current Valid National ID Card.
The Proof of Identity and the Proof of Residential address may be faxed to us but the originals must be
sent to us by courier or mail and your company documents will not be despatched until they are
received. Please contact us if you have difficulty in producing these documents.
DECLARATION
I/We, the person(s) whose name(s) appear below, hereby declare and by our signature below confirm:
1. At the date hereof we are the ultimate beneficial Owners of the Company we have ordered from Crystal
2. We have read and understood Crystal’s Terms of Business and agree to be bound by those Terms of
Business or such other new Terms of Business as may from time to time be published on the website
of Crystal Worldwide (www.crwwgroup.net).
Date of signature
Name and Signature
Name and Signature
Name and Signature
Name and Signature
We will contact you to clarify your instructions, finalise the application process, arrange payment and to collect certain mandatory information
relating to the prevention of money laundering. In submitting this questionnarie, all persons mentioned on this form agreee to be bound by
Crystal WorlWide’s Terms of Business or such other new Terms of Business as may from time to time be published on Crystal Worldwide’s
website (www.crwwgroup.net) or about which you may otherwise be informed.
Company Application Form 2003.02.24. Page 4 of 4
