Company Incorporation – X Consultancy

Section A - Contact DetailsStep 1 of 6

Name *

Mobile Number *

Telephone Number

Fax Number

Email *

Correspondence Address *

Address Line 1

City

State / Province / Region

Zip / Postal Code

Country

Proposed Company Name

(Note: Please provide at least 2 alternative names in order of preference in the event your proposed name is unavailable)

Proposed Name #1 *

Meaning (if not self-explanatory)

Alternative Name #2 *

Meaning (if not self-explanatory)

Alternative Name #3

Meaning (if not self-explanatory)

Proposed Business Address *

Address Line 1

City

State / Province / Region

Zip / Postal Code

Country

Office Number

Fax Number

Business Activities

(Note: Please provide at least 1 business code (refer MSIC Code); limit 3 business codes only)

MSIC Code

Business Code #1 *

Business Code #2

Business Code #3

Business Description (Describe the proposed business activities of your new company) *

(Note : Please provide atleast ONE (1) resident director and ONE (1) shareholder)

Director #1

ID Type *

Army ID *

MYKAS *

NRIC *

Passport *

Police ID *

PR Number *

Full Name (as per IC/Passport) *

Age *

Date of Birth *

Nationality *

Gender *

Male
Female

Race *

Others *

Residential Address *

Address Line 1

City

State / Province / Region

Zip / Postal Code

Country

Personal Email *

Mobile Number

Office Number

Fax Number

This Person is a Shareholder? *

Number of Share(s) *

Price per Share (RM) *

(Usually RM1 per share)

Class of Share *

Attachment *

Drop your files here or click here to upload You can upload up to 2 files.

1. Please provide copy of NRIC/Passport.

2. If director/shareholder is foreigner (non resident), please provide copy of relevant page in passport showing date of entry into Malaysia.

(File must be in PDF or JPG format only)

Do You Have a Second Director?

Paragraph Text

Director #2

ID Type #2 *

Army ID #2 *

MYKAS #2 *

NRIC #2 *

Passport #2 *

Police ID #2 *

PR Number #2 *

Full Name (as per IC/Passport) #2 *

Date of Birth #2 *

Nationality #2 *

Gender #2 *

Male
Female

Race #2 *

Others #2 *

Residential Address #2 *

Address Line 1

City

State / Province / Region

Zip / Postal Code

Country

Personal Email #2 *

Mobile Number #2

Office Number #2

Fax Number #2

This Person is a Shareholder? #2 *

Number of Share(s) #2 *

Price per Share (RM) #2 *

(Usually RM1 per share)

Class of Share #2 *

Attachment #2 *

Drop your files here or click here to upload You can upload up to 2 files.

*Max 2 MB file only

1. Please provide copy of NRIC/Passport.

2. If director/shareholder is foreigner (non resident), please provide copy of relevant page in passport showing date of entry into Malaysia.

(File must be in PDF or JPG format only)

Do You Have a Third Director?

Director #3

ID Type #3 *

Army ID #3 *

MYKAS #3 *

NRIC #3 *

Passport #3 *

Police ID #3 *

PR Number #3 *

Full Name (as per IC/Passport) #3 *

Date of Birth #3 *

Nationality #3 *

Gender #3 *

Male
Female

Race #3 *

Others #3 *

Residential Address #3 *

Address Line 1

City

State / Province / Region

Zip / Postal Code

Country

Personal Email #3 *

Mobile Number #3

Office Number #3

Fax Number #3

This Person is a Shareholder? #3 *

Number of Share(s) #3 *

Price per Share (RM) #3 *

(Usually RM1 per share)

Class of Share #3 *

Attachment #3 *

Drop your files here or click here to upload You can upload up to 2 files.

*Max 2 MB file only

1. Please provide copy of NRIC/Passport.

2. If director/shareholder is foreigner (non resident), please provide copy of relevant page in passport showing date of entry into Malaysia.

(File must be in PDF or JPG format only)

Do You Have a Fourth Director?

Director #4

ID Type #4

Army ID #4

MYKAS #4

NRIC #4

Passport #4

Police ID #4

PR Number #4

Full Name (as per IC/Passport) #4

Date of Birth #4

Nationality #4

Gender #4

Male
Female

Race #4

Others #4

Residential Address #4

Address Line 1

City

State / Province / Region

Zip / Postal Code

Country

Personal Email #4

Mobile Number #4

Office Number #4

Fax Number #4

This Person is a Shareholder? #4

Number of Share(s) #4

Price per Share (RM) #4

(Usually RM1 per share)

Class of Share #4

Attachment #4

Drop your files here or click here to upload You can upload up to 2 files.

*Max 2 MB file only

1. Please provide copy of NRIC/Passport.

2. If director/shareholder is foreigner (non resident), please provide copy of relevant page in passport showing date of entry into Malaysia.

(File must be in PDF or JPG format only)

If you are not a director, please tick.

I'm not a director

(Note : Please add up details if the shareholder is not a director and is an individual/corporate shareholder)

Person #1

ID Type *

Army ID *

MYKAS *

NRIC *

Passport *

Police ID *

PR Number *

Full Name (as per IC/Passport) *

Date of Birth *

Nationality *

Gender *

Male
Female

Race *

Others *

Residential Address *

Address Line 1

City

State / Province / Region

Zip / Postal Code

Country

Company Registration Number *

Name of Company *

Name of Corporate Representative

Address of Company *

Address Line 1

City

State / Province / Region

Zip / Postal Code

Country

Email Address *

Mobile Number

Office Number

Fax Number

Number of Share(s) *

Price per Share (RM) *

(Usually RM1 per share)

Class of Share *

Attachment *

Drop your files here or click here to upload You can upload up to 2 files.

*Max 2 MB file only

1. Please provide copy of NRIC/Passport.

2. If shareholder is foreigner (non resident), please provide copy of relevant page in passport showing date of entry into Malaysia.

(File must be in PDF or JPG format only)

1. Please provide copy of Form 9/Section 14 of the corporate shareholder(s).

(File must be in PDF or JPG format only)

Do You Have a Second Shareholder?

Person #2

ID Type #2 *

Army ID #2 *

MYKAS #2 *

NRIC #2 *

Passport #2 *

Police ID #2 *

PR Number #2 *

Full Name (as per IC/Passport) #2 *

Date of Birth #2 *

Nationality #2 *

Gender #2 *

Male
Female

Race #2 *

Others #2 *

Residential Address #2 *

Address Line 1

City

State / Province / Region

Zip / Postal Code

Country

Company Registration Number #2 *

Name of Company #2 *

Name of Corporate Representative #2

Address of Company #2 *

Address Line 1

City

State / Province / Region

Zip / Postal Code

Country

Email Address #2 *

Mobile Number #2

Office Number #2

Fax Number #2

Number of Share(s) #2 *

Price per Share (RM) #2 *

(Usually RM1 per share)

Class of Share #2 *

Attachment #2 *

Drop your files here or click here to upload You can upload up to 2 files.

*Max 2 MB file only

1. Please provide copy of NRIC/Passport.

2. If shareholder is foreigner (non resident), please provide copy of relevant page in passport showing date of entry into Malaysia.

(File must be in PDF or JPG format only)

1. Please provide copy of Form 9/Section 14 of the corporate shareholder(s).

(File must be in PDF or JPG format only)

Do You Have a Third Shareholder?

Person #3

ID Type #3 *

Army ID #3 *

MYKAS #3 *

NRIC #3 *

Passport #3 *

Police ID #3 *

PR Number #3 *

Full Name (as per IC/Passport) #3 *

Date of Birth #3 *

Nationality #3 *

Gender #3 *

Male
Female

Race #3 *

Others #3 *

Residential Address #3 *

Address Line 1

City

State / Province / Region

Zip / Postal Code

Country

Company Registration Number #3 *

Name of Corporate Representative #3

Name of Company #3 *

Address of Company #3 *

Address Line 1

City

State / Province / Region

Zip / Postal Code

Country

Email Adress #3 *

Mobile Number #3

Office Number #3

Fax Number #3

Number of Share(s) #3 *

Price per Share (RM) #3 *

(Usually RM1 per share)

Class of Share #3 *

Attachment #3 *

Drop your files here or click here to upload You can upload up to 2 files.

*Max 2 MB file only

1. Please provide copy of NRIC/Passport.

2. If shareholder is foreigner (non resident), please provide copy of relevant page in passport showing date of entry into Malaysia.

(File must be in PDF or JPG format only)

1. Please provide copy of Form 9/Section 14 of the corporate shareholder(s).

(File must be in PDF or JPG format only)

Do You Have a Fourth Shareholder?

Person #4

ID Type #4

Army ID #4

MYKAS #4

NRIC #4

Passport #4

Police ID #4

PR Number #4

Full Name (as per IC/Passport) #4

Date of Birth #4

Nationality #4

Gender #4

Male
Female

Race #4

Others #4

Residential Address #4

Address Line 1

City

State / Province / Region

Zip / Postal Code

Country

Company Registration Number #4

Name of Corporate Representative #4

Name of Company #4

Address of Company #4

Address Line 1

City

State / Province / Region

Zip / Postal Code

Country

Email Address #4

Mobile Number #4

Office Number #4

Fax Number #4

Number of Share(s) #4

Price per Share (RM) #4

(Usually RM1 per share)

Class of Share #4

Attachment #4

Drop your files here or click here to upload You can upload up to 2 files.

*Max 2 MB file only

1. Please provide copy of NRIC/Passport.

2. If shareholder is foreigner (non resident), please provide copy of relevant page in passport showing date of entry into Malaysia.

(File must be in PDF or JPG format only)

1. Please provide copy of Form 9/Section 14 of the corporate shareholder(s).

(File must be in PDF or JPG format only)

Desired Bank to Open Bank Account

Name of Bank

Branch

Financial Year End

First financial period must be ended on a date within 18 months from the date of incorporation.

Proposed Financial Year End

Statement of Compliance by Director(s)/Promoter(s) *

I hereby declare that the Director(s)/Promoter(s) is/are not undischarged bankrupt(s).
I hereby declare that the Director(s)/Promoter(s) is/are not disqualified under the Companies Act, 2016 and has/have give consent as Director(s)/Promoter(s), as the case maybe.
I confirm that the facts and information stated in this form are true to the best of my knowledge.

ATTENTION !

It is an offense under Section 591 of the Companies Act, 2016 to make or authorize the making of a statement that a person knows is false or misleading and that person may be liable, upon conviction, to imprisonment for a term not exceeding ten years or to a fine not exceeding RM3 million or to both.

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