$ Authorisation to Register a Business Name I authorise TAXSIGHT to submit a Business Name registration application on my behalf. Business Name (subject to availability): Applicant Name: Date of Birth (DOB): Country of Birth: Tax File Number (TFN): Australian Business Number (ABN): Address: Phone: Email: Term: 1 year 3 year Yes, I am interested in registering a Trade Mark. Please provide more information. I have checked I am not infringing the Trade Mark of any existing business. 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. Signature: Date: Submit
