I declare that Business HQ Australia Pty Ltd (ABN 37 668 867 276) acting in its capacity as a Registered ASIC Agent is authorised to submit a business name application to the Australian Securities & Investments Commission (ASIC) on my behalf. I understand that Business HQ Australia Pty Ltd will utilise information supplied by me in this form to apply for a business name and will remain my ASIC agent and notify me when my business name requires renewal. I also declare that Business HQ Australia Pty Ltd is, if required, authorised to submit an ABN application to the Australian Tax Office on my behalf and to do so as my registered tax agent. I confirm that I have received the consent of all individuals referred to in this application form, to the submission of their personal information contained in this form to Business HQ Australia Pty Ltd and to the ATO and ASIC as necessary to process this application. I also confirm:
• I am not disqualified from managing corporations under
Section 206B(1) of the Corporations Act 2001.
• Within the last 5 years I have not been convicted of, or released from prison after being convicted of, and serving a term of imprisonment for, any of the criminal offences referred to in
Section 32(1)(c) or (d) of the Business Names Registration Act 2011.
• This application is submitted under, and is compliant with, the terms and conditions of the
ASIC Electronic Lodgement Protocol.
• The information supplied is, to the best of my knowledge, accurate and complete.
• I understand the best structure for my business (Company).
• I have the TFN, date of birth and name, OR name, address and date of birth for all key people in my business.
• I am not applying just because I have been asked to get an ABN as a condition of employment.
• I meet a number of the key characteristics of a business, or will once started, for example sourcing my own clients, I can delegate my work to others if I choose, I will invoice for my work and set my rate of pay, I will have a bank account for my business separate from my own bank account, I am responsible for my own public liability, professional indemnity and/or workers compensation/income protection insurance.
• I can provide evidence that I am entitled to an ABN if requested.
• To provide true and correct information in my ABN application. Penalties of up to $12,600 can apply for each false or misleading statement made in an ABN application.
• Once I have an ABN I must keep it up to date (within 28 days of any change) and cancel it once I am no longer trading or carrying on an enterprise.
