Australian Securities &

Investments Commission

Search Form 960

Application for copy of a certificate

Firm/organisation
Applicant details
Contact name/position description

ASIC registered agent number (if applicable)

Telephone number

Facsimile number

Postal address or DX address

Applications for certificates that are lodged at a Service Centre can be collected at time of lodgment. Applications sent by
Delivery method post will have the certificate(s) mailed to the address specified above. A cheque or money order to cover the appropriate
fee should be enclosed with postal applications.

Fee $17 per certificate

Certificate required Note:

Certificates for periods before 1/1/91 may only be given under previous law and only if records can be authenticated.
A certificate showing (tick one box)

A details of registration of corporation(s)

B that no corporation was registered by the name(s) nominated:

From (date) To
/ / / /
[D D] [M M] [Y Y] [D D] [M M] [Y Y]

C holding of office (director, secretary or principal executive officer) of the person(s) nominated:
From (date) To
/ / / /
[D D] [M M] [Y Y] [D D] [M M] [Y Y]

D the entry of a charge (conclusive evidence - does not apply to a charge provisionally registered).

E details of a charge (prima facie evidence).

F registration of reduction of capital (last reduction).

G other information, give details.

ASIC Form 960 8 October 2008 Page 1 of 2

Relevant details
Give the corporation name and ACN or ARBN and any other necessary details.
List no more than 10 corporations on this form.
if C name of officeholder (surname and given names)
ACN or ARBN Company name or Registered Australian body name
if D or E date of change and registered charge number
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Lodgement Send completed form 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
q @ g
Web www.asic.gov.au
g
Or lodge the form in person at your nearest Service Centre

ASIC Form 960 8 October 2008 Page 2 of 2