Client Registration Form - Business

Please select the area of law that best relates to the services you require.

If you require assistance with filling out this form, please call 07 834 6000 or email [email protected]

Type of entity

If you require assistance with filling out this form, please call 07 834 6000 or email [email protected]

Entity name

Please also add Trading Name if applicable.

IRD and/or GST number/s

Phone number

Email Address

Address Line 1

Address Line 2

City

Postcode

Country

Director | First Name

Director | Middle Name

Director | Last Name

Director | Phone Number

Director | Email Address

Prefered Contact/Authority to Instruct (First Name)

If different from director named above.

Prefered Contact/Authority to Instruct (Middle Name)

Prefered Contact/Authority to Instruct (Last Name)

Prefered Contact/Authority to Instruct (Phone Number)

Prefered Contact/Authority to Instruct (Email address)

Accountant name

Nominees

Nominees are directors, shareholders or general partners of the business who vote or carry out their role in accordance with instructions given by another person who is not a director, shareholder or general partner of the entity.

List nominee names and contact details here.

Billing contact | First Name

If different from director named above.

Billing contact | Last Name

Billing contact | Phone Number

Billing contact | Email Address

First Name of contact person at NWM (if known)

Surname of contact person at NWM (if known)

How did you hear about us?

Referral Details E.g. Google, Facebook; Name of existing client or NWM staff member; Name of other company/professional.

Please select any newsletters you would like to receive:

*Ctrl+click for multiple choices

Name of person who filled out this form.

Agreement to terms.

By ticking this box and submitting this form, the person completing this form agrees that: 1) all of the information set out in this form is true, correct and complete; 2) they are authorised to legally bind the people and the businesses/entities described in this form; and 3) each of the people and businesses/entities described in this form agree to the Norris Ward McKinnon Terms and Conditions which are available at nwm.co.nz/client-information.

Date