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    Company Account Registration Form

    Date *

    Company Details

    Company Registration Name * Registered Office Address * Business Operation Address *
    ACN *
    ABN *
    Type of Industry *

    Contact Details

    Business Number * Email * Company Website *

    Director 1 Details

    Full Name *
    Date of Birth *
    Address / Post address * Email *
    Mobile *
    Home Phone *

    2 Identification Documents *(Passport with signature / ID Card / Driver License *)

    Document 1 *
    Document 2 *

    Director 2 Details

    Full Name *
    Date of Birth *
    Address / Post address * Email *
    Mobile *
    Home Phone *

    2 Identification Documents *(Passport with signature / ID Card / Driver License *)

    Document 1 *
    Document 2 *

    Declaration

    • I declare the information that I have provided is TRUE and CORRECT.
    • I declare I am NOT political exposed person (PEPs), all my funds are not sourced from any kinds of corruption, money laundering and terrorist financing activities.
    • By providing phone number and email, I authorize Premium Wealth to contact me by phone or email. Any transaction or fund transfer conducted over the registered phone or email is legal bound. I understand that I should notify Premium Wealth as soon as possible once there are any changes to above information.
    • I have read and understand all the terms and conditions which are listed on Premium Wealth Website. My information is collected to conduct business with Premium Wealth and to comply with Anti-Money Laundering Laws.
    Director 1 Signature *
    Director 2 Signature *
    Head Office

    L12, 350 Collins Street, Melbourne VIC 3000

    Contact Detail
    info@premiumw.com.au
    +61 450 755 576
    Head Office

    L12, 350 Collins Street, Melbourne VIC 3000

    Contact Detail
    info@premiumw.com.au
    +61 450 755 576
    Head Office

    L12, 350 Collins Street, Melbourne VIC 3000

    Contact Detail
    info@premiumw.com.au
    +61 450 755 576
    Head Office

    L12, 350 Collins Street, Melbourne VIC 3000

    Contact Detail
    info@premiumw.com.au
    +61 450 755 576

    Copyright © 2021 PREMIUM WEALTH.
    All Rights Reserved

    • HOME
    • ABOUT US
    • OUR SERVICES
    • RATE
    • ONLINE FORMS
      • PERSONAL REGISTRATION
      • COMPANY REGISTRATION
      • REMITTANCE FORM
    • FAQ
    • NEWS
    • CONTACT US
    • zh_CNZH
    • en_AUEN