Beruflich Dokumente
Kultur Dokumente
1-44ERXE7
1 Lodgement details
Given name Oliver
Other given
Hugo
names
Consent to
transfer number
1 year
3 years
Page 1 of 4
or
ABN
application
reference
number
Other given
HUGO
names
State /
Country NSW Australia
Residential address
Building/Property
name
Floor/Level
Street number 11
Suburb/City Mullumbimby
Unit/Office
Street
Whian St
name
State/
Territory
NSW
Postcode
2482
Country Australia
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12 Details of addresses
Address for service of
documents
Building/Property
name
Floor/Level
Unit/Office
Street
Whian St
name
Street number 11
Suburb/City Mullumbimby
State/
NSW
Territory
Postcode 2482
Building/Property
name
Floor/Level
Unit/Office
Street
Bay Vista Lane
name
Street number 42
Suburb/City Ewingsdale
State/
NSW
Territory
Postcode 2481
If the proposed business name holder is an individual, is this address the same as the
individual's residential address?
Yes
Email address
No
SMS
SMS
13 Attachments
Declarations
Declare
Declaration:
X
This transaction is submitted for lodgement under, and is compliant with, the terms and conditions of the ASIC
Electronic Lodgement Protocol.
Page 3 of 4
To the best of my knowledge, the information supplied in this transaction is complete and accurate (it is an offence
to provide false or misleading information to ASIC).
Authority:
I am lodging this application on behalf of the applicant (the proposed business name holder) and am authorised to;
-
Submit this application for lodgement on behalf of the applicant under the terms and conditions of
the ASIC Electronic Lodgement Protocol.
Make each of the above declarations on behalf of the applicant after making all due and proper
enquiries.
We may contact the applicant or lodging party if we have any questions regarding this application for registration of a business name.
03/12/2013
(DD/MM/YYYY)
Page 4 of 4