Online Company Order Form

The first step in forming a company is to complete the below order form. The order form should be completed with all the required details and we will prepare the company formation documentation based on this order form and email you the documentation for signing. If you have any queries on completing the order form, please feel free to call us on 059 9186776 or send us an email.

We Agree to the CLS General Terms of Business and have reviewed the CLS Handy Guide to Completing the Company Order Form (Tick Box)

Agree

Anti Money Laundering Customer Due Diligence (Select)
Third Parties (Accountants, Solicitors, Tax Advisors)
We confirm that we have performed CDD on this business relationship in full compliance with Criminal Justice (Money Laundering & Terrorist Financing) Act 2010 (Note 4)
or
Non-Third Parties
If you are a Non-Third party please read Note 4 and confirm you agree to provide the Anti-Money Laundering documentation in Note 4

Incorporation Type:
(Note 5)

Company Pack Type (Select)
(Note 6)

Payment Type (Select)

Contact Details for Incorporation Purposes

Name

Practice/Company Name:

Address Line 1:

Address Line 2:

Address Line 3:

Eircode/Postcode:

Phone Number:

E-Mail Address:

Company Incorporation Required Details
(Please Complete in Full)

Proposed Company Name:
Please review before choosing a company name (Note 7)

First Choice

Second Choice

Third Choice

Principal Activity of the Company
This box must be completed setting out what will be the main activities of the company. If this is more than 40 words please complete the additional wording box (Note 8)

Principal Activity

Additional Wording

Company Type
Please choose the appropriate company type and click here for more information

Share Capital
This part does not apply to CLG’s (Note 10)

Issued Share Capital:

Nominal Amount Per Share:

Share Class:

Authorised Share Capital (Optional for LTD)

Company Secretary Details
Every company is required to have a company secretary.
If there is only one director a separate company secretary is required (Note 11)

Individual Secretary Details

Name:

Date of Birth:

Address Line 1

Address Line 2

Address Line 3

Eircode/Postcode:

Country:

Corporate Secretary Details

Company Name:

Company Number:

Company Director (signing on behalf of the Company):

Registered Office:

Address Line 1

Address Line 2

Eircode/Postcode:

Country:

Company Director(s)
LTD company may have 1 director. All other company types must have 2, and charity companies must have 3 (Note 12)
If any director has more than 3 directorships please forward these details by email to formations@clscs.ie
If any director is also a subscriber, please enter their number of shares in the second last section of the column

Director 1

Name:

Date of Birth:

Occupation:

Address Line 1:

Address Line 2:

Address Line 3:

Eircode/Postcode:

Country:

Nationality:

PPSN Number:

If you do not have a Personal Public Services Number (PPSN) then we will require an RBO transaction number or you will have to apply for a Verified Identity Number (VIN) from the Companies Registration Office. Please insert VIN if you do not have a PPSN.

Name Registered with the
Department of Social Protection

If your first or last name registered with the Department of Social Protection is different to the name given above please complete:

First Name:

Last Name:

Other Directorship 1 - Company Number:

Other Directorship 2 - Company Number:

Other Directorship 3 - Company Number:

Disqualified or Restricted:

If this director is also a subscriber, enter their number of shares:

Is the director the beneficial owner of the above shares?

Director 2

Name:

Date of Birth:

Occupation:

Address Line 1:

Address Line 2:

Address Line 3:

Eircode/Postcode:

Country:

Nationality:

PPSN Number:

Name Registered with the
Department of Social Protection

If your first or last name registered with the Department of Social Protection is different to the name given above please complete:

First Name:

Last Name:

Other Directorship 1 - Company Number:

Other Directorship 2 - Company Number:

Other Directorship 3 - Company Number:

Disqualified or Restricted:

If this director is also a subscriber, enter their number of shares:

Is the director the beneficial owner of the above shares?

Director 3

Name:

Date of Birth:

Occupation:

Address Line 1:

Address Line 2:

Address Line 3:

Eircode/Postcode:

Country:

Nationality:

PPSN Number:

Name Registered with the
Department of Social Protection

If your first or last name registered with the Department of Social Protection is different to the name given above please complete:

First Name:

Last Name:

Other Directorship 1 - Company Number:

Other Directorship 2 - Company Number:

Other Directorship 3 - Company Number:

Disqualified or Restricted:

If this director is also a subscriber, enter their number of shares:

Is the director the beneficial owner of the above shares?

Additional Director Details

Director 4

Name:

Date of Birth:

Address Line 1:

Address Line 2:

Address Line 3:

Eircode/Postcode:

Country:

Nationality:

PPSN Number:

Name Registered with the
Department of Social Protection

If your first or last name registered with the Department of Social Protection is different to the name given above please complete:

First Name:

Last Name:

Occupation:

Other Directorship 1:

Other Directorship 2 :

Other Directorship 3:

Disqualified or Restricted:

If this director is also a subscriber, enter their number of shares:

Is the director the beneficial owner of the above shares?

Director 5

Name:

Date of Birth:

Address Line 1:

Address Line 2:

Address Line 3:

Eircode/Postcode:

Country:

Nationality:

PPSN Number:

Name Registered with the
Department of Social Protection

If your first or last name registered with the Department of Social Protection is different to the name given above please complete:

First Name:

Last Name:

Occupation:

Other Directorship 1:

Other Directorship 2:

Other Directorship 3:

Disqualified or Restricted:

If this director is also a subscriber, enter their number of shares:

Is the director the beneficial owner of the above shares?

Director 6

Name:

Date of Birth:

Address Line 1:

Address Line 2:

Address Line 3:

Eircode/Postcode:

Country:

Nationality:

PPSN Number:

Name Registered with the
Department of Social Protection

If your first or last name registered with the Department of Social Protection is different to the name given above please complete:

First Name:

Last Name:

Occupation:

Other Directorship 1:

Other Directorship 2 :

Other Directorship 3:

Disqualified or Restricted:

If this director is also a subscriber, enter their number of shares:

Is the director the beneficial owner of the above shares?

Director 7

Name:

Date of Birth:

Address Line 1:

Address Line 2:

Address Line 3:

Eircode/Postcode:

Country:

Nationality:

PPSN Number:

Name Registered with the
Department of Social Protection

If your first or last name registered with the Department of Social Protection is different to the name given above please complete:

Corporate Subscriber 1

Company Name:

Company Number:

Company Director (Signing):

Registered Office Address:

Address Line 2:

Address Line 3:

Eircode/Postcode:

Country:

Number of Shares:

Corporate Subscriber 2

Company Name:

Company Number:

Company Director (Signing):

Registered Office Address:

Address Line 2:

Address Line 3:

Eircode/Postcode:

Country:

Number of Shares:

Corporate Subscriber 3

Company Name:

Beneficial Owner 1

Name:

Address Line 1:

Address Line 2:

Address Line 3:

Eircode/Postcode:

Country:

Nationality

Occupation:

Nature of Beneficial Ownership:

Beneficial Owner 2

Name:

Address Line 1:

Address Line 2:

Address Line 3:

Eircode/Postcode:

Country:

Nationality

Occupation:

Nature of Beneficial Ownership:

Beneficial Owner 3

Name:

Registered Office Address

This must be in the Republic of Ireland (Note 15)

Address Line 1

Address Line 2

Address Line 3

Eircode/Postcode:

Business / Central Administration Address
(If different from Registered Address)

Address Line 1

Address Line 2

Address Line 3

Eircode/Postcode:

The registered office address is also the business / central administration address

Contact Details for Incorporation Purposes

Company Incorporation Required Details (Please Complete in Full)

Share Capital This part does not apply to CLG’s (Note 10)

Company Secretary Details Every company is required to have a company secretary. If there is only one director a separate company secretary is required (Note 11)

Individual Secretary Details

Corporate Secretary Details

Director 1

Director 2

Director 3

Additional Director Details

Director 4

Director 5

Director 6

Director 7

Subscriber Details (Individual) The subscribers are the first shareholders / members of the company and at least one is required (Note 13)NOTE: If a Subscriber is a Corporate Body only please enter N/A for Subscriber details (individual) and complete Subscriber Details (Corporate)

Subscriber 1

Subscriber 2

Subscriber 3

Additional Subscriber Details (Individual)

Subscriber 4

Subscriber 5

Subscriber 6

Subscriber 7

Corporate Subscriber Details This section must be completed if the shares are to be owned by a body corporate (Note 13)

Corporate Subscriber 1

Corporate Subscriber 2

Corporate Subscriber 3

Additional Corporate Subscriber Details

Corporate Subscriber 4

Corporate Subscriber 5

Corporate Subscriber 6

Corporate Subscriber 7

Beneficial Owners This section must be completed if the subscribers are not the beneficial owners of the shares in this company or the shares are being held by a corporate subscriber (Note 14)

Beneficial Owner 1

Beneficial Owner 2

Beneficial Owner 3

Additional Beneficial Owner Details

Beneficial Owner 4

Beneficial Owner 5

Beneficial Owner 6

Beneficial Owner 7

Address Details

Registered Office Address This must be in the Republic of Ireland (Note 15)

Business / Central Administration Address (If different from Registered Address)

Additional Information (Note 16)

Location

Contact

Social

Company Incorporation Required Details
(Please Complete in Full)

Share Capital
This part does not apply to CLG’s (Note 10)

Company Secretary Details
Every company is required to have a company secretary.
If there is only one director a separate company secretary is required (Note 11)

Subscriber Details (Individual)
The subscribers are the first shareholders / members of the company and at least one is required (Note 13)NOTE: If a Subscriber is a Corporate Body only please enter N/A for Subscriber details (individual) and complete Subscriber Details (Corporate)

Corporate Subscriber Details
This section must be completed if the shares are to be owned by a body corporate (Note 13)

Beneficial Owners
This section must be completed if the subscribers are not the beneficial owners of the shares in this company or the shares are being held by a corporate subscriber (Note 14)

Registered Office Address

This must be in the Republic of Ireland (Note 15)

Business / Central Administration Address
(If different from Registered Address)

Additional Information
(Note 16)