The Laws of Fiji
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REGISTRAR OF COMPANIES
OF
THE REPUBLIC OF FIJI
FORM A11
Sections 50, 51, 89,
of the Companies Act 2015
CHANGE TO COMPANY DETAILS
Sections A, B or C may be lodged independently with this signed cover page to notify the Registrar of:
| A1 | Change of address | B1 | Cease company officeholder | C1 | Cancellation of shares | ||
| A2 | Change of name — officeholders and members | B2 | Appoint company officeholder | C2 | Issue of shares | ||
| C3 | Change to share structure | ||||||
| A3 | Change — ultimate holding company | C4 | Changes to the register of members |
If there is insufficient space in any section of the form, you may photocopy the relevant page(s) of the form or complete an annexure and submit the relevant page(s) or annexure as part of this lodgement.
Company details
Company name ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Company number ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Company TIN ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Lodgement details
Who should the Registrar contact if there is a query about this form?
Firm/Organisation ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Contact name ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Position description ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Telephone number (during business hours) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
E-mail address (optional) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Level/Office building ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Street number and street ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Town/City ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Island ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Signature
This form must be signed by a current officeholder of the company.
I certify that the information in this cover sheet and the attached sections of this form is true and complete.
Name ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Capacity
□ Director
□ Alternate Director
□ Company secretary
Signature ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Date signed .................................................................................................................. / .................................................................................................................. / ..................................................................................................................
Al. Change of address
This section allows a new address to be applied to one or more purposes (ie registered office, principal place of business, company officeholder and/or private company member). You must copy and attach another Section A1 for each new address.
New address
Must not be a Post Office Box. Must be a street address.
Level/Office building ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Street number and street ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Town/City ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Island/State/Territory ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Postcode ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Country (if not Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Date of change .................................................................................................................. /.................................................................................................................. / ..................................................................................................................
Apply address to:
You can apply the new address to one or more of the following — registered office, principal place of business, etc
□ Registered office
Does the company occupy the premises?
□ Yes □ No
If no, name of occupier
......................................................................................................................................................................................................................................................................................................................................................................................................................................................
□ Occupier’s consent (Select box to indicate the statement below is correct)
The occupier of the premises has consented in writing to the use of the specified address
as the address of the registered office of the company and has not withdrawn that
consent.
Opening hours for public company
Each business day for at least 3 hours between 9.00 am and 5.00 pm.
Open .................................................................................................................. am/pm Close.................................................................................................................. am/pm
□ Principal place of business
□ Company officeholder’s address
Officeholder
Surname ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
First name(s) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Former name ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Date of birth .................................................................................................................. / .................................................................................................................. / ..................................................................................................................
Place of birth ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Country of birth (if not Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
□ Private company member’s address
Individual member
Surname ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
First name(s) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Former name ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
OR
Company name ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Company number (if incorporated in Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Country of incorporation (if not Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
A2. Change of name — officeholders and members
Use this section to notify a name change of an individual or organisation with one or more roles (including member of a private company) in the company.
Tick one or more boxes to indicate an individual’s or organisation’s current role in company
□ Director
□ Alternate Director
□ Company secretary
□ Member
Personal name change
Previous name
Surname ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
First name(s) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Date of birth.................................................................................................................. /.................................................................................................................. / ..................................................................................................................
Place of birth ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Country of birth (if not Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
New name
Surname ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
First name(s) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Date of change .................................................................................................................. / .................................................................................................................. /..................................................................................................................
Organisational name change
When a member of a company is an organisation, not an individual, and the organisation has changed its name.
Previous details
Entity name ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Type of entity ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Company number (if incorporated in Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Country of incorporation (if not Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
New details
Entity name ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Type of entity ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Company number (if incorporated in Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Country of incorporation (if not Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Date of change .................................................................................................................. /.................................................................................................................. / ..................................................................................................................
A3. Change — Ultimate holding company
□ There is a new ultimate holding company.
Company name ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Company number (if incorporated in Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Country of incorporation (if not Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
□ The ultimate holding company has ceased operation as the ultimate holding company.
Company name ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Company number (if incorporated in Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Country of incorporation (if not Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
□ The ultimate holding company has changed its name.
Company name ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Company number (if incorporated in Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Country of incorporation (if not Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
B1. Cease company officeholder
• Use this section to notify if a company officeholder has ceased to be a company officeholder.
• You need to notify details separately for each ceased officeholder.
Officeholder
□ Director
□ Alternate Director
□ Company secretary
Surname ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
First name(s) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Date of birth .................................................................................................................. / .................................................................................................................. / ..................................................................................................................
Place of birth ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Country of birth (if not Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Date officeholder ceased .................................................................................................................. / .................................................................................................................. / ..................................................................................................................
Officeholder
□ Director
□ Alternate Director
□ Company secretary
Surname ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
First name(s) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Date of birth .................................................................................................................. /.................................................................................................................. / ..................................................................................................................
Place of birth ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Country of birth (if not Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Date officeholder ceased .................................................................................................................. / .................................................................................................................. / ..................................................................................................................
Officeholder
□ Director
□ Alternate Director
□ Company secretary
Surname ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
First name(s) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Date of birth .................................................................................................................. /.................................................................................................................. /..................................................................................................................
Place of birth ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Country of birth (if not Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Date officeholder ceased .................................................................................................................. / .................................................................................................................. / ..................................................................................................................
B2. Appoint company officeholder
• Use this section to notify appointment of a company officeholder.
• You need to notify details separately for each new officeholder.
• Address must not be a Post Office Box. Must be a street address.
Officeholder
Office held
□ Director
□ Alternate Director
□ Company secretary
Surname ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
First name(s) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Former name ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Level/Office building ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Street number and street ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Town/City ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Island/State/Territory ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Postcode ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Country (if not Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Date of birth .................................................................................................................. / .................................................................................................................. / ..................................................................................................................
Place of birth ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Country of birth (if not Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Date of appointment .................................................................................................................. / .................................................................................................................. / ..................................................................................................................
Officeholder
Office held
□ Director
□ Alternate Director
□ Company secretary
Surname ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
First name(s) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Former name ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Level/Office building ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Street number and street ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Town/City ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Island/State/Territory ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Postcode ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Country (if not Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Date of birth.................................................................................................................. /.................................................................................................................. /..................................................................................................................
Place of birth ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Country of birth (if not Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Date of appointment .................................................................................................................. / .................................................................................................................. / ..................................................................................................................
Officeholder
Office held
□ Director
□ Alternate Director
□ Company secretary
Surname ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
First name(s) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Former name ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Level/Office building ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Street number and street ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Town/City ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Island/State/Territory ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Postcode ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Country (if not Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Date of birth .................................................................................................................. / .................................................................................................................. / ..................................................................................................................
Place of birth ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Country of birth (if not Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Date of appointment .................................................................................................................. / .................................................................................................................. /..................................................................................................................
Section C. Completion Guide
Standard share codes
| Share class code | Share class |
|---|---|
| A | Class A ordinary shares |
| B.........................etc | Class B.........................etc ordinary shares |
| ORD | Ordinary shares |
| RED | Redeemable shares |
| REDP | Redeemable preference shares |
Use the table below to identify the sections of this form to complete (please indicate the sections that have been completed). Completion of this table is optional.
| C1 — Cancellation of shares | C2 — Issue of shares | C3 — Change to share structure table | C4 — Change to members register | ||
|---|---|---|---|---|---|
| □ | Issue of shares | Not required | ✓ | ✓ | ✓ |
| □ | Cancellation of shares | ✓ | Not required | ✓ | ✓ |
| □ | Transfer of shares | Not required | Not required | Not required | ✓ |
| □ | Changes to amounts paid | Not required | Not required | ✓ | ✓ |
| □ | Changes to beneficial ownership | Not required | Not required | Not required | ✓ |
• To notify the Registrar about a division or conversion of a class of shares, you must lodge a Form A33.
• To notify the Registrar about a conversion of shares into larger or smaller numbers, you must lodge a Form
A35.
C1. Cancellation of shares
Reason for cancellation
Please indicate the reason that shares have been cancelled (select one or more boxes).
□ Redeemable preference shares
□ Capital reduction
□ Share buy-back
□ Forfeited shares
□ Other
Description
......................................................................................................................................................................................................................................................................................................................................................................................................................................................
......................................................................................................................................................................................................................................................................................................................................................................................................................................................
......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Details of cancelled shares
List the details of shares cancelled in the following table.
| Share class code | Number of shares cancelled | Amount paid (cash or otherwise) |
|---|---|---|
Earliest date of change .................................................................................................................. / .................................................................................................................. / ..................................................................................................................
C2. Issue of shares
List details of new share issues in the following table.
| Share class code | Number of shares issued | Amount paid per share | Amount unpaid per share |
|---|---|---|---|
Earliest date of change .................................................................................................................. / .................................................................................................................. / ..................................................................................................................
If shares were issued for other than cash, were some or all of the shares issued under a written contract?
□ Yes
You must lodge a copy of the contract in relation to the share issue.
□ No
Details of the non-cash consideration
......................................................................................................................................................................................................................................................................................................................................................................................................................................................
......................................................................................................................................................................................................................................................................................................................................................................................................................................................
......................................................................................................................................................................................................................................................................................................................................................................................................................................................
C3. Change to share structure
Where a change to the share structure table has occurred (eg as a result of the issue or cancellation of shares), please show the updated details for the share classes affected. Details of share classes not affected by the change are not required here.
| Share class code | Full title if not standard | Total number of shares (current after changes) | Total amount paid on these shares | Total amount unpaid on these shares |
|---|---|---|---|---|
Earliest date of change .................................................................................................................. / .................................................................................................................. / ..................................................................................................................
C4. Changes to the register of members
• Use this section to notify changes to the register of members for your company (changes to the shareholdings
of members).
• If shares are jointly owned, you must also provide names and addresses of all joint owners on a separate sheet
(annexure), clearly indicating the share class and with whom the shares are jointly owned.
Member
Surname ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
First name(s) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Former name ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
OR
Entity name ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Type of entity ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Company number (if incorporated in Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Country of incorporation (if not Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Level/Office building ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Street number and street ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Town/City ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Island/State/Territory ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Postcode ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Country (if not Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
• Complete each column for each share class the above member has agreed, in writing, to take up.
• Beneficially held usually means that the owner of the shares is entitled to the direct benefit from the shares.
For example, benefits could include the entitlements to payments in relation to any dividends. Shares held by
a person as trustee, nominee or on account of another person are non-beneficially held.
| Share class code | Shares increased by ......................... (number) | Shares decreased by ......................... (number) | Total number now held | Total $ paid on these shares | Total $ unpaid on these shares | Fully paid (Y/N) | Beneficially held (Y/N) |
|---|---|---|---|---|---|---|---|
Earliest date of change .................................................................................................................. / .................................................................................................................. / ..................................................................................................................
Member
Surname ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
First name(s) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Former name ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
OR
Entity name ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Type of entity ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Company number (if incorporated in Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Country of incorporation (if not Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Level/Office building ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Street number and street ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Town/City ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Island/State/Territory ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Postcode ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Country (if not Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
• Complete each column for each share class the above member has agreed, in writing, to take up.
• Beneficially held usually means that the owner of the shares is entitled to the direct benefit from the shares.
For example, benefits could include the entitlements to payments in relation to any dividends. Shares held by
a person as trustee, nominee or on account of another person are non-beneficially held.
| Share class code | Shares increased by ......................... (number) | Shares decreased by ......................... (number) | Total number now held | Total $ paid on these shares | Total $ unpaid on these shares | Fully paid (Y/N) | Beneficially held (Y/N) |
|---|---|---|---|---|---|---|---|
Earliest date of change .................................................................................................................. / .................................................................................................................. / ..................................................................................................................
Member
Surname ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
First name(s) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Former name ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
OR
Entity name ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Type of entity ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Company number (if incorporated in Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Country of incorporation (if not Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Level/Office building ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Street number and street ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Town/City ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Island/State/Territory ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Postcode ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Country (if not Fiji) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
• Complete each column for each share class the above member has agreed, in writing, to take up.
• Beneficially held usually means that the owner of the shares is entitled to the direct benefit from the shares.
For example, benefits could include the entitlements to payments in relation to any dividends. Shares held by
a person as trustee, nominee or on account of another person are non-beneficially held.
| Share class code | Shares increased by ......................... (number) | Shares decreased by ......................... (number) | Total number now held | Total $ paid on these shares | Total $ unpaid on these shares | Fully paid (Y/N) | Beneficially held (Y/N) |
|---|---|---|---|---|---|---|---|
Earliest date of change .................................................................................................................. /.................................................................................................................. / ..................................................................................................................