Client Name(s) 

Street Address  
Line 1

Street Address 
Line 2

Desired Company Name Choices - Note that title must end with INC., S.A., LTD. or C x A

Please Select Yes, No or As Indicated

If Using Own Directors, Please Indicate Names & Other Information:

Desired Company Domicile -All Companies will be registered in the jurisdiction of incorporation, but you may indicate that the company is doing business or has an official office elsewhere.

Address 1.

Address 2.

Desired Company Business – Required by some jurisdictions (Example = Real Estate Sales, General Marketing, Professional Services, Trading, Holding Company, Etc)

_____________________________________________________________________________

Desired Title Choices:

1.

2.

3.

If Using Own Trustee or Council Members, Please Indicate Names & Other Information:

Beneficiaries and Interest Percentage:

Special Instructions:

I / We hereby authorize Ascot Advisory Services, and or its agent(s), to constitute the above mentioned entities. I / We understand that Ascot Advisory Services will not disclose any information to third parties. As a result I / We understand that it is my / our responsibility for any reporting requirements or tax issues as they relate to our country of citizenship or residency.
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Signature (1) Print Name & Date
____________________________________ __________________________________

Signature (2) Print Name & Date

• Our Business is The Protection of Our Clients Confidentiality & Their Assets
• Unbiased & Solid Advice Regarding Offshore Incorporations
• Offshore Bank Accounts, Mutual Funds, Brokerage Services
• Special Services in The Dominican Republic & Panama regarding Residency, Real Estate Matters, Relocation & Apartment Assistance

 REAL ESTATE OR APARTMENT GUIDELINES:

Special Requirements:

• Sign The Confidential Application Form
• Include Two (2) Clear Copies of Passport for each Name on Application and each Name Submitted for a Directors Position
• Include Your Check or Money Order in US Dollars Payable to "Ascot". Please Contact Our Office should you wish to Wire Transfer Funds or use Western Union Service.