(Labuan Company No. LL07577 l Trust License No. LT0046)
REGISTRATION FORM
LABUAN COMPANY
(LABUAN COMPANIES ACT, 1990)
This information is confidential and will be used for our internal purpose only. The
information may first be furnished by facsimile. The original copy duly completed and signed
must be sent by courier together with the other documents to the following address:Labuan Borneo Trustees Limited
Unit 3A-25, U0350, 3rd Floor, Labuan Times Square,
Jalan Merdeka,
87007 Labuan F.T, Malaysia.
Tel No: +60 87 417577 I Fax No: +60 87 423577
Email: [email protected]
IMPORTANT:
We reserve the right to accept or reject any application submitted without assigning any reason thereof.
Applicant will be notified accordingly.
Details of authorized person/ultimate beneficial owner who completed the form:
a. Name
:
b. Company
:
c.
:
Correspondence Address
d. Residential Address
:
e. Telephone No (Office)
:
(H/P)
:
f.
Fax No
:
g.
Email address
:
Labuan Borneo Trustees Limited (Co No: LL 07577) (License No: LT0046) is authorised and regulated by the Labuan Financial Services Authority and
is a member of the Association of Labuan Trust Companies.
1
(Labuan Company No. LL07577 l Trust License No. LT0046)
SECTION A – PROPOSED NAME
Please provide three (3) alternative names in order of preference.
(Please note that the proposed name must end with Ltd, Corp, Inc., Limited, Corporation, Incorporated. You
may also use (L) as part of the Labuan Company's name. Additionally, you may also use "Bhd." or "Berhad" but
it must be with (L) as part of the Labuan Company's name.)
a.
b.
c.
SECTION B – TYPE OF COMPANY
Please indicate the type of Labuan Company
a. A Company limited by shares
b. A Company limited by guarantee
c. An unlimited Company
SECTION C – PURPOSE
Please indicate the purpose or principal activity of the proposed Labuan Company
SECTION D – SOURCE OF FUND
Please indicate the source of fund of the proposed Labuan Company
SECTION E – ISSUED CAPITAL & PAID UP CAPITAL
1.
Currency
:
(other than Malaysian
Ringgit)
2.
Issued Capital
: _________________(Amount) of________________
Share(s)(No of Shares)
: _________________(Amount) of________________
Share(s)(No of Shares)
(minimum of one share
is required)
3.
Paid up Capital
(minimum of one share
is required)
Labuan Borneo Trustees Limited (Co No: LL 07577) (License No: LT0046) is authorised and regulated by the Labuan Financial Services Authority and
is a member of the Association of Labuan Trust Companies.
2
(Labuan Company No. LL07577 l Trust License No. LT0046)
Note: The incorporation fee payable to the Labuan Financial Services Authority are as follows:i. Paid up capital not exceeding the equivalent of RM50,000
ii. Paid up capital between the equivalent of RM50,000 and RM 999,999
iii. Paid up capital of or exceeding the equivalent of RM1,000,000
RM1,000
RM2,000
RM5,000
SECTION F – MEMBER(S)
(NOTE: At least one member is required. Corporate member may be appointed. )
1.
Do you need Labuan Borneo Trustees Limited or its subsidiary to
act as the first subscriber for the purpose of
incorporation?(Recommended if you need the company urgently)
:
Yes
No
If NO, please provide us with the following details of subscriber(s)/member(s).
1. Name
Occupation
Nationality
Passport/Company No.
Date of birth / incorporation
Place of birth / incorporation
Registered Address
Correspondence Address
Residential Address
Telephone No (Office)
(H/P)
Fax No
Email address
No. of share(s)
:
:
:
:
:
:
:
:
:
:
:
:
:
:
2. Name
Occupation
Nationality
Passport / Company No.
Date of birth / incorporation
Place of birth / incorporation
Registered Address
Correspondence Address
Residential Address
Telephone No (Office)
(H/P)
Fax No
Email address
No. of share(s)
:
:
:
:
:
:
:
:
:
:
:
:
:
:
Labuan Borneo Trustees Limited (Co No: LL 07577) (License No: LT0046) is authorised and regulated by the Labuan Financial Services Authority and
is a member of the Association of Labuan Trust Companies.
3
(Labuan Company No. LL07577 l Trust License No. LT0046)
3. Name
Occupation
Nationality
Passport / Company No.
Date of birth / incorporation
Place of birth / incorporation
Registered Address
Correspondence Address
Residential Address
Telephone No (Office)
(H/P)
Fax No
Email address
No. of share(s)
:
:
:
:
:
:
:
:
:
:
:
:
:
:
4. Name
Occupation
Nationality
Passport / Company No.
Date of birth / incorporation
Place of birth / incorporation
Registered Address
Correspondence Address
Residential Address
Telephone No (Office)
(H/P)
Fax No
Email address
No. of share(s)
:
:
:
:
:
:
:
:
:
:
:
:
:
:
5. Name
Occupation
Nationality
Passport / Company No.
Date of birth / incorporation
Place of birth / incorporation
Registered Address
Correspondence Address
Residential Address
Telephone No (Office)
(H/P)
Fax No
Email address
No. of share(s)
:
:
:
:
:
:
:
:
:
:
:
:
:
:
SECTION G – DIRECTOR(S)
Labuan Borneo Trustees Limited (Co No: LL 07577) (License No: LT0046) is authorised and regulated by the Labuan Financial Services Authority and
is a member of the Association of Labuan Trust Companies.
4
(Labuan Company No. LL07577 l Trust License No. LT0046)
(NOTE: At least one Director is required. Corporate Director may be appointed. )
1.
Do you need Labuan Borneo Trustees Limited or its Trust Officer
to act as *Resident Director (* please choose one).
:
Yes
No
If NO, please provide us with the following details of director/corporate director:1. Name
Occupation
Nationality
Passport / Company No.
Date of birth / incorporation
Place of birth / incorporation
Registered Address
Correspondence Address
Residential Address
Telephone No (Office)
(H/P)
Fax No
Email address
:
:
:
:
:
:
:
:
:
:
:
:
:
2. Name
Occupation
Nationality
Passport / Company No.
Date of birth / incorporation
Place of birth / incorporation
Registered Address
Correspondence Address
Residential Address
Telephone No (Office)
(H/P)
Fax No
Email address
:
:
:
:
:
:
:
:
:
:
:
:
:
3. Name
Occupation
Nationality
Passport / Company No.
Date of birth / incorporation
Place of birth / incorporation
Registered Address
Correspondence Address
Residential Address
Telephone No (Office)
(H/P)
Fax No
Email address
4. Name
:
:
:
:
:
:
:
:
:
:
:
:
:
:
Labuan Borneo Trustees Limited (Co No: LL 07577) (License No: LT0046) is authorised and regulated by the Labuan Financial Services Authority and
is a member of the Association of Labuan Trust Companies.
5
(Labuan Company No. LL07577 l Trust License No. LT0046)
Occupation
Nationality
Passport / Company No.
Date of birth / incorporation
Place of birth / incorporation
Registered Address
Correspondence Address
Residential Address
Telephone No (Office)
(H/P)
Fax No
Email address
:
:
:
:
:
:
:
:
:
:
:
:
5. Name
Occupation
Nationality
Passport / Company No.
Date of birth / incorporation
Place of birth / incorporation
Registered Address
Correspondence Address
Residential Address
Telephone No (Office)
(H/P)
Fax No
Email address
:
:
:
:
:
:
:
:
:
:
:
:
:
SECTION H – ADDITIONAL /JOINT SECRETARY (Optional)
Do you wish to appoint additional secretary in addition to the Resident Secretary? If yes, please provide us
with the following details of additional secretary:Name
Occupation
Nationality
Passport/Company No.
Date of birth / incorporation
Place of birth / incorporation
Registered Address
Correspondence Address
Telephone No (Office)
(H/P)
Fax No
Email address
:
:
:
:
:
:
:
:
:
:
:
:
(NOTE: It is a mandatory requirement of the Labuan Companies Act 1990 for a Labuan Trust Company to be appointed
as the Resident Secretary)
Labuan Borneo Trustees Limited (Co No: LL 07577) (License No: LT0046) is authorised and regulated by the Labuan Financial Services Authority and
is a member of the Association of Labuan Trust Companies.
6
(Labuan Company No. LL07577 l Trust License No. LT0046)
SECTION I – ULTIMATE BENEFICIAL OWNER INFORMATION
Kindly provide us with the following information of ultimate beneficial owner, if different from member(s)
of the proposed Labuan Company.
Name
Occupation
Nationality
Passport / National Identity No.
Date of birth
Place of birth
Registered Address
Correspondence Address
Residential Address
Telephone No (Office)
(H/P)
Fax No
Email address
:
:
:
:
:
:
:
:
:
:
:
:
:
SECTION J – AUTHORISED PERSON
Please provide us with the following information of the authorised person if you choose to appoint
one. This person will be the individual who is authorised to instruct Labuan Borneo Trustees Limited
in respect of all the Labuan company matters on behalf of the ultimate beneficial owner.
Name
Occupation
Nationality
Passport / National Identity No.
Registered Address
Date of birth
Place of birth
Correspondence Address
Residential Address
Telephone No (Office)
(H/P)
Fax No
Email address
Specimen signature
:
:
:
:
:
:
:
:
:
:
:
:
:
:
Labuan Borneo Trustees Limited (Co No: LL 07577) (License No: LT0046) is authorised and regulated by the Labuan Financial Services Authority and
is a member of the Association of Labuan Trust Companies.
7
(Labuan Company No. LL07577 l Trust License No. LT0046)
SECTION K – OTHER INFORMATION
1.
Financial Year End
:
2.
Tax status
:
3.
Any special Articles required
:
Yes
No
If YES, please provide us with the information:
______________________________________________________
______________________________________________________
4.
Audit
:
Yes
No
If YES, please provide us your preferred Approved Auditor :
5.
________________________
Do you need Labuan Borneo Trustees Limited to act as tax agent to :
file the Tax Return of the Labuan Company?
If NO, please provide us your preferred tax agent
:
6.
Do you need Labuan Borneo Trustees Limited to assist you with
the opening of bank account? If yes, please provide us your
preferred Banker.
:
7.
Do you need internet banking facility ( if you choose option 6)
:
8.
Do you require work permit? If yes, do you need Labuan Borneo
Trustees Limited to assist you with the application?
9.
Yes
No
Yes
No
Yes
No
Other services required:___________________________________________________________________________
___________________________________________________________________________
Labuan Borneo Trustees Limited (Co No: LL 07577) (License No: LT0046) is authorised and regulated by the Labuan Financial Services Authority and
is a member of the Association of Labuan Trust Companies.
8
(Labuan Company No. LL07577 l Trust License No. LT0046)
SECTION L – DUE DILIGENCE DOCUMENTS REQUIRED
In line with international Standards of Anti-Money Laundering and Anti-Terrorism Financing Act 2001, all
Trust Company Service Providers are now subject to the said Act. In view of that, we are required to carry
Customer Due Diligence on all Ultimate Beneficial Owners, Directors, Shareholders and any Authorised
Persons.
The following original documents MUST be provided to us for Customer Due Diligence review and record
keeping.
All documents MUST BE CERTIFIED by a member of a professional body i.e. lawyer, auditor, company
secretary or commissioner of oath, unless the original is provided.
For Individual
1.
2.
3.
4.
5.
6.
Copy of Passport
Copy of National Identity Document
Other beneficial identification documentations
Proof of address i.e utility bill or bank statement (not more than 3 months old)
Reference letter from a Banker or Professional
Personal resume
For Corporation
1.
2.
3.
4.
5.
6.
7.
Memorandum and Articles of Association
Certificate of Incorporation or Certificate of Incumbency
Letter of Information or Letter of Good Standing
Certificate of Change of Name (if any)
Current Register of Members& Directors
Member and Director Resolution authorising the establishment of the Labuan Company
The contact details of the Registered Secretary or Registered Agent
Labuan Borneo Trustees Limited (Co No: LL 07577) (License No: LT0046) is authorised and regulated by the Labuan Financial Services Authority and
is a member of the Association of Labuan Trust Companies.
9
(Labuan Company No. LL07577 l Trust License No. LT0046)
DECLARATION AND INDEMNITY
I/we the * ultimate beneficial owner or the authorised person of the Labuan company does solemnly and
sincerely affirm that:(a) all information provided in this registration form is correct to the best of my/our knowledge;
(b) I/we have read and accept the terms and conditions outlined in this registration form and the
Fee Schedule;
(c) to indemnify Labuan Borneo Trustees Limited, its subsidiaries and its employees or its agents for
all and any loss, damage, claims, charges, fees, taxes, costs and expenses howsoever suffered or
incurred from any claims, actions or proceedings initiated or brought by any persons arising from
the corporate secretarial services provided to me/us including the provision of resident directors
and the opening of bank accounts for and on my/our behalf and for taking and acting on the
instructions of my/our authorized person(s) unless the same is caused by gross negligence or
willful default.
_____________________________
Signature
Name:
Passport or NRIC No.:
Ultimate Beneficial Owner or Authorised Person
Date :
Witnessed By :
__________________________________
Signature
Name:
Passport or NRIC No.:
Labuan Borneo Trustees Limited (Co No: LL 07577) (License No: LT0046) is authorised and regulated by the Labuan Financial Services Authority and
is a member of the Association of Labuan Trust Companies.
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