SIGN UP FORM FOR LABUAN COMPANY

1.0 TYPE OF APPLICATION

New IncorporationChange of Service ProviderRe-domicile

2.0 PROPOSED NAME OF THE LABUAN COMPANY
First Choice:

English Translation if the Proposed Name is in non-romanised characters:

Single letter(s) in the name stand for:

If the name is not in English or Bahasa Malaysia, please clarify:

If the Proposed Name contains a proper name, please state if it is a name of the director of the proposed Labuan Company:

Second Choice:

English Translation if the Proposed Name is in non-romanised characters:

Single letter(s) in the name stand for:

If the name is not in English or Bahasa Malaysia, please clarify:

If the Proposed Name contains a proper name, please state if it is a name of the director of the proposed Labuan Company:

4.0 SHARE CAPITAL AND CLASS OF SHARES

	No. of shares	Currency	Amount
Issued
Paid-up

5.0 MEMORANDUM & ARTICLES OF ASSOCIATION

6.0 NATURE OF BUSINESS
TradingNon-trading

Specify Product and Services / Type of investment

9.0 ADDITIONAL SERVICES
Bank Account
Corporate Bank AccountsPersonal Bank Accounts

If you require assistance with Bank Account Opening please indicate your preference below. Please note that where
QX Group provides Directors to the Company the Bank account must be under the control of QX Group signatories or
in special circumstance under Joint Signatory Control.

Preferred Bank and Location:

Others:

Authorised Signatory (I)

Authorised Signatory (II)

Authorised Signatory (III)

Authorised Signatory (IV)

Signing Condition:
Anyone to signAll to SignOther, please specify :

Type of Account: Current
Type of Currencies:
USDEUROGBPSGDAUDHKDRMBOthers, please specify:

Tax Agent:

Basis Period:
31 December31 June

Expatriate Services:
Employment Pass (PG1)Dependent Pass (PT)Social Visit Pass (PLS)

Your contact details:
Name:

Email address:

Phone Number:

Comment:

NAMES OF INDIVIDUALS OR LEGAL ENTITIES	Director	Shareholder	%	Beneficial Owner	%	Authorised Person