Shareholder Registration Form

Either fill out our online form below or download the PDF.

Once you have completed ALL SECTIONS of this form,
please forward to:

Kusabs Lasike Ltd
1141 Pukaki St, Rotorua or PO Box 441, Rotorua 3040
Email: megan@kll.co.nz

Pre form checklist

Section 1: Shareholder Details

Gender
MaleFemale

DOB

One form of identification: drivers licence or passport or birth certificate.

Section 2: Verified New Zealand Bank Details

Please upload a letter from your bank with your banking details, or an ATM slip showing all bank account details.

Section 3: Personal Details

Section 4: Declaration (Required)

I hereby certify that the information in this form is correct.

I consent to any of this information being available to the Trust/Incorporation for statistical purposes only.

I consent to the Trust/Incorporation contacting any Agencies to verify that information in this application is true and correct, in accordance with the Privacy Act 1993.

Kusabs Lasike Limited

Chartered Accountants

Shareholder Registration Form

Shareholder Registration Form

Pre form checklist

Section 1: Shareholder Details

Section 2: Verified New Zealand Bank Details

Section 3: Personal Details

Section 4: Declaration (Required)

To find out how we can help, please get in touch