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TURKS & CAICOS ISLANDS FINANCIAL SERVICES COMMISSION
TURKS AND CAICOS ISLANDS REGISTRATION OF BUSINESS NAMES
NEW APPLICANT: RENEWAL: AMENDMENT: Registration No:
Period (Year/s) of renewal: / / /
I/We (Full names of person/s or firm applying)
_ Hereby apply for Registration under Section5 of the Registration of Business Names Ordinance and furnish the following statement of particulars.
1. Business Name:
2. General Nature of Business: _
3. Principal place of Business (Full address)
_
4. Particulars of individual or partners of the firm applying:
Full name/s:
Names of any former business/s:
Nationality:
Nationality of origin (P.O.B):
Usual Residence (address):
5. Date of commencement of Business
6. Any other Business Name(s) under which the Business is carried on:
7. If the business has more than one location please provide details of each branch location
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If the Firm includes one or more Corporation(s)
Name of Corporation
Registered Office Registered No. Country of Incorporation
CERTIFICATE COLLECTION AUTHORIZATION
I hereby authorize:
to collect the certificate on my behalf upon submission of identification.
Dated this _________ day of __________________________20 .
Name:
Contact Information
Name/s: _______________________________________________________________________.
Signature/s: __________________________________________________________________.
__________________________________________
Telephone No.
___________________________________________
E-mail:
PLEASE NOTE:
___________________________________________
• This application must be signed by the Individual or all Partners of the Firm
applying for registration. In the case of a Corporation a Director or Secretary
may and should state the capacity in which he or she does so.
• The Registrar may request the applicant/s to provide any other relevant
document in respect of this application.
• All Applicant/s must sign and must produce a valid government issued ID
before submitting this application for processing.
• All applicant/s must renew registration certificates on the anniversary of
the registration date. PRCOCESSING OFFICER
(OFFICIAL USE ONLY)
Initial:
Charges:
Date: