QUESTIONAIRE:

1a)	Prefered name of company (state 3 names, in order of preference, to increase the chance of obtaining approval)
1b)	If in any of the names are initials and / or a mixture of words please give a small explanation of them:
2)	Please give a small outline of the company's main activities / objects:
3)	Proposed Share Capital (minimum authorised is CYP 10.000 and issued CYP 1.000). Number of Shares CY POUNDS Authorised Capital Issued Capital
4)	Details of shareholders (minimum 2). Name, Permanent Address, Nationality, Number of Shares If confidentiality of shareholding is required, we can appoint Nominee Shareholders (trustees) from our firm to hold the shares on your behalf. Please confirm Yes No
5)	Details of Directors Do you wish our firm to arrange for the appointment of local directors? Yes No
6)	Company Secretary and Registered Office. Do you wish to use our secretarial company and our office address? Yes No If "No" please give the following details: Secretary name: Address: Registered office in Cyprus:
7)	Name, address and Telex/Fax Number of home banks that may give references for the shareholders with respect to their financial standing, respectability, business integrity, credit worthiness and responsibility for engagements: a) For ultimate beneficial owner: Name of Source: Telex No: Postal Address: Town: Country: b) For ultimate beneficial owner: Name of Source: Telex No: Postal Address: Town: Country:
8)	The same format to be used in respect of every bank or other referee Local presence Will the enterprise open an office in Cyprus? Yes No
9)	Contact details Name and address of person to contact: Telephone number: Fax number:
10)	Other information State any other information that you believe to be important regarding the incorporation: