APPLICATION FORM

1) Country                   

2) Company Name (please, choose one: "Ready made" or "Custom Made")

 Ready Made 

 Custom Made 1.  

                           2.  

                           3.  

3) Nominee Service

 Full Nominee Service (Director + Shareholder)
 Nominee Director (only)
 Nominee Shareholder (only)

4) Share Certificates

-1-

 Bearer Share Certificate
 Registered Share Certificate

a. Full Name 

b. Date of Birth 

c. Citizenship 

d. Shares %   

e. Address  

f. Business Occupation 

 Bearer Share Certificate
 Registered Share Certificate

a. Full Name 

b. Date of Birth 

c. Citizenship 

d. Shares %

e. Address

f. Business Occupation 

 Bearer Share Certificate
 Registered Share Certificate

a. Full Name 

b. Date of Birth 

c. Citizenship

d. Shares % 

e. Address 

f. Business Occupation 

5) Beneficial Owners

-1-

a. Full Name 

b. Date of Birth 

c. Citizenship 

d. Shares % 

e. Address 

f. Business Occupation

g. Passport number 

a. Full Name 

b. Date of Birth

c. Citizenship

d. Shares % 

e. Address

f. Business Occupation 

g. Passport number

-3-

a. Full Name 

b. Date of Birth 

c. Citizenship

d. Shares % 

e. Address 

f. Business Occupation 

g. Passport number 

6) Directors

-1-

a. Full Name 

b. Date of Birth 

c. Citizenship 

d. Shares % 

e. Address 

f. Business Occupation 

a. Full Name 

b. Date of Birth 

c. Citizenship  

d. Shares % 

e. Address 

f. Business Occupation 

-3-

a. Full Name 

b. Date of Birth 

c. Citizenship

d. Shares % 

e. Address 

f. Business Occupation 

7) Company Attorney

a. Full Name 

b. Date of Birth 

c. Citizenship 

d. Shares % 

e. Address 

f. Business Occupation

g. Type of legalization of Power of Attorney

 Apostille
 Notarization
 Without legalization

8) Bank Account

 Switzerland
 USA
 Cyprus
 Baltic Countries

9) Additional Services

 Telephone Line

 Fully Serviced Office

 Mail Forwarding Service

Address for Re-mailing 

 Telephone & Fax Service

Instructions

 Additional Corporate Set (chose type of legalization)

 Apostille
 Notarization
 Without legalization

 Power of Attorney (chose type of legalization)

 Apostille
 Notarization
 Without legalization

 Certificate of Good Standing (chose type of legalization)

 Apostille
 Notarization
 Without legalization

 Certificate of Incumbency (chose type of legalization)

 Apostille
 Notarization
 Without legalization

 Additional Pliers

Additional Seal (chose type of frame)

 Color
 Flash

10) Shipment of Company Documentation

 Courier Mail
 Regular Mail

11) Contact

Name of Contact Person 

Telephone 

Fax 

E-Mail 

VIKING CORP
phone +79178500388
mailto:viking-corp@mail.ru

Tatarstan, Naberechnye Chelny Street Chylman 110, 423826, Russia