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1 1. NAME OF COMPANY JAMAICA THE COMPANIES ACT NOTICE OF APPOINTMENT OF/CHANGE OF S (Pursuant to sections 183 (2) & (3)) 1A. COMPANY NUMBER 1B. COMPANY TAXPAYER REGISTRATION NUMBER 1C. COMPANY FAX NUMBER 1D. TYPE OF COMPANY: PRIVATE PUBLIC 2. NOTICE IS GIVEN THAT ON THE DAY OF, THE FOLLOWING PERSON (S) WAS / WERE APPOINTED (S) PARTICULARS OF # 1 SURNAME: CHRISTIAN NAME: MIDDLE NAME (S) : MAIDEN NAME: RESIDENTIAL ADDRESS: OCCUPATION: NATIONALITY: 18 YEARS AND OVER UNDER 18 YEARS SEX: CONTACT # : PARTICULARS OF ANY OTHER SHIP HELD ADDRESS OF COMPANY: NAME OF COMPANY: COMPANY TAXPAYER REGISTRATION NUMBER: 1
2 PARTICULARS OF # 2 SURNAME: CHRISTIAN NAME: MIDDLE NAME (S) : MAIDEN NAME: RESIDENTIAL ADDRESS: OCCUPATION: NATIONALITY: 18 YEARS AND OVER UNDER 18 YEARS SEX: CONTACT # : PARTICULARS OF ANY OTHER SHIP HELD ADDRESS OF COMPANY: NAME OF COMPANY: COMPANY TAXPAYER REGISTRATION NUMBER: 2
3 PARTICULARS OF # 3 SURNAME: CHRISTIAN NAME: MIDDLE NAME (S) : MAIDEN NAME: RESIDENTIAL ADDRESS: OCCUPATION: NATIONALITY: 18 YEARS AND OVER UNDER 18 YEARS SEX: CONTACT # : PARTICULARS OF ANY OTHER SHIP HELD ADDRESS OF COMPANY: NAME OF COMPANY: COMPANY TAXPAYER REGISTRATION NUMBER: 3
4 3. PARTICULARS OF S THAT ARE COMPANIES #1 PRIVATE PUBLIC COMPANY NAME: LOCATION OF REGISTERED ADDRESS: PLACE OF INCORPORATION: COMPANY FAX NUMBER : COMPANY TAXPAYER REGISTRATION NUMBER 4
5 PARTICULARS OF S THAT ARE COMPANIES #2 PRIVATE PUBLIC COMPANY NAME: LOCATION OF REGISTERED ADDRESS: PLACE OF INCORPORATION: COMPANY FAX NUMBER : COMPANY TAXPAYER REGISTRATION NUMBER 5
6 PARTICULARS OF S THAT ARE COMPANIES #3 PRIVATE PUBLIC COMPANY NAME: LOCATION OF REGISTERED ADDRESS: PLACE OF INCORPORATION: COMPANY FAX NUMBER : COMPANY TAXPAYER REGISTRATION NUMBER 6
7 4. NOTICE IS GIVEN THAT ON THE DAY OF, THE FOLLOWING PERSON (S) CEASED TO HOLD OFFICE AS A NAME (S) RESIDENTIAL ADDRESS OCCUPATION CONTACT # REASON FOR CEASING 5. THE S OF THIS COMPANY AS OF THE DAY OF, ARE: NAME (S) RESIDENTIAL ADDRESS OCCUPATION CONTACT # 7
8 6. THE SHADOW S OF THIS COMPANY AS OF THE DAY OF, ARE: PARTICULARS OF SHADOW #1 SURNAME: CHRISTIAN NAME: MIDDLE NAME (S) : MAIDEN NAME: RESIDENTIAL ADDRESS: OCCUPATION: NATIONALITY: 18 YEARS AND OVER UNDER 18 YEARS SEX: CONTACT # : PARTICULARS OF ANY OTHER SHIP HELD ADDRESS OF COMPANY: NAME OF COMPANY: COMPANY TAXPAYER REGISTRATION NUMBER: 8
9 PARTICULARS OF SHADOW #2 SURNAME: CHRISTIAN NAME: MIDDLE NAME (S) : MAIDEN NAME: RESIDENTIAL ADDRESS: OCCUPATION: NATIONALITY: 18 YEARS AND OVER UNDER 18 YEARS SEX: CONTACT # : PARTICULARS OF ANY OTHER SHIP HELD ADDRESS OF COMPANY: NAME OF COMPANY: COMPANY TAXPAYER REGISTRATION NUMBER: I AM / NOT AN EMPLOYEE OF THE COMPANY OR ITS AFFILIATES (Section 172 (1) of the Companies Act 200)]. 9
10 7. PARTICULARS OF SHADOW S THAT ARE COMPANIES #1 PRIVATE PUBLIC COMPANY NAME: LOCATION OF REGISTERED ADDRESS: PLACE OF INCORPORATION: COMPANY FAX NUMBER : COMPANY TAXPAYER REGISTRATION NUMBER 10
11 PARTICULARS OF SHADOW S THAT ARE COMPANIES #2 PRIVATE PUBLIC COMPANY NAME: LOCATION OF REGISTERED ADDRESS: PLACE OF INCORPORATION: COMPANY FAX NUMBER : COMPANY TAXPAYER REGISTRATION NUMBER 11
12 PARTICULARS OF SHADOW S THAT ARE COMPANIES #3 PRIVATE PUBLIC COMPANY NAME: LOCATION OF REGISTERED ADDRESS: PLACE OF INCORPORATION: COMPANY FAX NUMBER : COMPANY TAXPAYER REGISTRATION NUMBER 8. 12
13 9. FILED BY NAME: ADDRESS: ADDRESS: CONTACT NUMBER: FAX NUMBER: 10. PARTICULARS OF S NAME OF ADDRESS TAX REGISTRATION NUMBER FOR OFFICIAL USE ONLY FILED: / / DAY MONTH YEAR 13
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