Application for person and organisation information from the ...

Australian Securities &
Investments Commission
Application for person and organisation information
from the business names register
Use this application to request information about a person and organisation from the business names register.
Search ONLINE at
ASIC Connect at
www.asic.gov.au
and get results faster.
Some information on the business names register may be available online instantly and for free. Go to ASIC Connect at www.asic.gov.au before paying
for a search. Where information is not available for free, completing the search in paper, or through a Service Centre:
• costs an additional $3 fee, and
• takes five business days.
Please print neatly in BLOCK LETTERS with a black or blue ballpoint pen. Place a in appropriate boxes as required. If you need more space in any section, use
copies of the relevant page(s) and submit as part of this lodgement.
Save time—go online. Search free and paid information online any time at ASIC Connect—www.asic.gov.au
Lodgement
Search online at ASIC Connect—www.asic.gov.au
or
Send completed applications to:
Australian Securities & Investments Commission
PO Box 4000, Gippsland Mail Centre VIC 3841
For more information
Web www.asic.gov.au
Need help? www.asic.gov.au/question
Telephone 1300 300 630
1 Lodgement details
Firm/organisation
(if applicable)
Contact name
Phone
(business hours)
Contact addresses
Email
address
Postal address
Who should we contact if there is a query about this application?
Provide an email address and/or an Australian postal address
Suburb/
City
State/
Territory
Postcode
2 Delivery method
How do you want to receive your search result?
Email delivery
We will use the email address supplied under Contact addresses to send the pdf of the search result.
Postal delivery
We will use the postal address supplied under Contact addresses.
Application for person or organisation information from the business names register 1 July 2013 Page 1 of 2

3 Type of search
Select the type of search.
Some information on the
business names register may
be available for free. Check
ASIC Connect before paying
for a search. You can also
find out what information you
get in a search result and see
a sample extract.
Some of these searches can
also be purchased through an
ASIC–approved information
broker
(www.asic.gov.au/
informationbrokers)
The fees shown below include the additional $3 fee that applies for completing this search in paper,
or through a Service Centre.
Full payment must accompany this application.
Business name holder—person extract
Current. Fee—$21 per extract.
Current and historical. Fee—$38 per extract.
Business name holder—organisation extract
Current. Fee—$21 per extract.
Current and historical. Fee—$38 per extract.
4 Persons or organisations for which you are searching
Provide the following information so that we can identify the correct person or organisation on the business names register:
• for a person—family name, given name and other given names
• for an organisation—organisation name and ACN, ARBN or ABN if available.
List no more than 10 persons or organisations for this application.
Identifying information
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Application for person or organisation information from the business names register 1 July 2013 Page 2 of 2