Application to form a Corporation in the BELIZE

Client Information:

Name:

Address:

Tel. Fax. Email:

Corporation Information: Jurisdiction: Belize
Name: (please provide alternatives, in case your first choice is not available)	S.A.	Corp.	Inc.	Ltd.
1^st:
2^nd:
3^rd:
Capital: Standard Capital – $50,000 divided into 50,000 shares of US$1.00 each divided into shares of $ each; or Shares with no par value.

Shelf Corporation:

I do not wish to form a tailor-made corporation, please provide me with a list of the Shelf corporations you have available at this time.

Objective of the Company: (Give a detailed description of the purpose of the company)

Director(s) of the Company:

I would like Koru Corporate Services, Inc. to provide nominee directors for the Company (please send me a Nominee Director Agreement).

OR – I will provide the names & details of the directors of the company.

Please note: BELIZE Companies require only 1 director (minimum). There is no maximum limit.

The directors to be appointed are:

	Name	Passport #	Address
#1
#2
#3
#4
#5

Officers:

Please note: BELIZE companies – require Secretary. You can also appoint a President, Treasurer, VP, etc.

If I am providing nominee directors, then we can also appoint Nominee President, Secretary & Treasurer.

The officers to be appointed are:

President

Secretary (recommended)

Treasurer

Other (Please Specify)

Preparation of Share Certificate(s):

Please prepare the following share certificate(s) for the Company:

Cert. No.	Name	Passport #	No. of Shares to be issued	Address
001
002
003
004
005

You are authorised to accept instructions from:

Name(s)

Signature

Postal Address

Power of Attorney (Should ONLY be filled in where we are providing Nominee Directors):

Please provide me with a General (to do everything) or Special (for limited purposes only) Power of Attorney.

It should be issued to the following person(s)