NZCR Form 03 Shareholder Consent

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Form 3
Form version | November 2021

IMPORTANT! Please do not return your signed consent by post.


You must upload this document online. Refer to our help guide on filing shareholder consent forms

Consent of shareholder of proposed company


Section 12(1) Companies Act 1993

Name of proposed company Name reservation number

EVERGREEN CLEAN & CUT SERVICE LIMITED 9239920


Proposed company number

9239920

Shareholder’s full legal name Yan Zhao


Shareholder’s address
19 seafarer cres, Auckland

Number of shares held 100%


Shareholder’s consent
I consent to act as shareholder of the above proposed company and to taking the number of shares specified.

…………………………………………………………………………………………………………………………………………………
(Signature)

Name of signatory Yan Zhao


Date 15/05/2024
IMPORTANT INFORMATION
Shareholders
› A trust, whether expressed, implied or constructive, cannot be entered on the share register. Where, for example, shares are held by a family
trust the name of the trustees must be entered individually as members of a share parcel.
› Initials of the person’s name are not allowed. The full legal name must be provided.
› A postal address, private bag or DX number is not permitted for the shareholder’s address.
› Only one person must complete this form. If the shares are held jointly with others then each shareholder must complete and sign their own
form, indicating they own them jointly.
› If the shareholder is a natural person, please give a residential address. If the shareholder is a body corporate, please give the address of its
registered office or, if it does not have a registered office, the address of its principal place of business.
› If this form has been signed by an agent, it must be accompanied by the instrument authorising the agent to sign it. An example where this
would be used is when the shareholder is overseas and unable to sign the form when the company is to be incorporated.
For more information on this process including a sample authorisation form, visit our website -
https://companies-register.companiesoffice.govt.nz/filing-consent-forms.
› If this form is signed under power of attorney, the attorney must provide a Certificate of Non-Revocation.
For more information on this process, visit our website – https://companies-register.companiesoffice.govt.nz/filing-consent-forms

Completed by Name:
Yan Zhao
Postal address:
19 seafarer cres, Auckland

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