Form 961 Application for copies of documents (DOCIMAGE search)

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Form 961 Application for copies of documents (DOCIMAGE search) Powered By Docstoc
					Australian Securities &
Investments Commission                                                                                                 Get results faster!
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                                                                                                                               Search Form 961

Application for copies of documents
(DOCIMAGE search)

This information can be obtained online through an information broker - refer www.asic.gov.au/informationbrokers
                                          Firm/organisation
Applicant details
                                          Contact name/position description


                                          ASIC registered agent number (if applicable)


                                          Telephone number


                                          Facsimile number


                                          Postal address or DX address




Delivery method                                Email as an attachment (50 page limit)
Note - certified copies cannot be sent
by facsimile, email or Web                     Web, to download Docimages via the Internet. (Up to 500 pages can be ordered via this option)
                                              Provide an email address



                                               Post to the above address
                                               Fax (50 page limit)
                                               Collect over the counter (100 page limit)

Fee                                       Documents containing 9 pages or less:         $20
A cheque or money order to cover the      Documents containing 10 pages or more:        $36
appropriate fee should be enclosed with        - certification if required (additional): $17 per document
this application.                         The number of pages in an imaged document can be found at www.asic.gov.au/nni.


1 Document numbers
Document numbers can be found at www.asic.gov.au/nni. If you do not know the document number, then go to 2 Description of documents.
List no more than 10 documents on this form.
    Document number                       Document description and/or form number                                   Tick Box if certification is required

1
2
3
4
5
6
7
8
9
10
ASIC Form 961                                                 8 October 2008                                                                         Page 1 of 2
2 Description of documents
If you do not know the document
number then provide a description of the     A      Document(s) in relation to an organisation                                               Tick box if certification is required
documents required. Select one option               Corporation or Scheme name
only
                                                    ACN or ARBN or ARSN


                                                    Document description and/or form number


Documents lodged prior to 1991, if not
already imaged, can be ordered here.         B      Non-imaged pre-1991 document(s) in relation to an organisation                           Tick box if certification is required
                                                    State in which the documents were lodged:
You can see if pre-1991 documents have                   NSW             QLD               SA                           VIC                 WA
been imaged by checking the documents
                                                    Previous State number of organisation (not ACN)
list for the company through our website
at www.asic.gov.au/nni. All pre-1991
documents for companies registered in               Select document category
the ACT, NT, TAS and Rockhampton &
Townsville in QLD have been imaged.                  Category type              Description of contents (Categories may not contain all document types)
                                                                                Memorandum and articles; Documents amending memorandum and articles including:; Capital
Once the document has been imaged                          Type A               - resolution or court order for resolution; Name - change. Conversion. Change of status; Articles -
and is ready for delivery, you will be                                          resolutions affecting certificate of incorporation (if filmed)
informed of the number of pages and                                             Registered office, principal business office (other states); Agent for foreign company; Directors,
the cost.                                                  Type B               secretary, principal executive officer; Shares - return of allotment, contract or agreement; Official
                                                                                manager, prospectus, report of affairs, trust deeds
                                                                                Annual return (shareholders, balance sheet, if any); Winding up - liquidator’s appointment, resolution
                                                           Type C               or order for winding up, liquidator’s accounts, final meeting, dissolution
                                                                                Mortgages, charges, debentures; Satisfaction, releases; Receiver - appointment, report of affairs,
                                                           Type D               accounts, ceasing to act
                                                                                Security register relating to company charges
                                                           Type F

                                             C      Document(s) in relation to an individual                                                 Tick box if certification is required
                                                    Family name                                                 Given names


                                                    Date of birth
                                                                /               /
                                                    [D     D]       [M     M]       [Y    Y]
                                                    Document description and/or form number


Certification is not available for
these documents.                             D      Pre-AFS document(s) in relation to an insurance broker or foreign insurance agent
                                Individual          Family name                                                 Given names


                                                    Date of birth
                                                                /               /
                                                    [D     D]       [M     M]       [Y    Y]
                                                    Document description and/or form number


                              Corporation           Corporation name


                                                    ACN or ARBN or ARSN


                                                    Document description and/or form number



Lodgement                                    Send completed form and correct fee to:                                       For help or more information
                                             Australian Securities and Investments Commission,                             Telephone 1300 300 630
                                             PO Box 4000, Gippsland Mail Centre VIC 3841.                                  Email        info.enquiries@asic.gov.au
                                                                                                                           Web          www.asic.gov.au

ASIC Form 961                                                            8 October 2008                                                                                      Page 2 of 2

				
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Description: Form 961 Application for copies of documents (DOCIMAGE search)