New Zealand Gazette – 2013 – No. 24

Page 637

✨ Company Annual Return Form



28 FEBRUARY 2013 NEW ZEALAND GAZETTE, No. 24 637

Annual return (continued)

Form 12 Form version 1 August 2012

Company name:

Company number:

Payment details

Amount
$45.00

Method of payment

[ ] Please do not send cash or a purchase order

  • [ ] Cheque
    Make your cheque payable to the ‘MBIE - Economic Development’

or

  • [ ] Credit card
    Credit card type:
  • [ ] Visa
  • [ ] Mastercard
  • [ ] Amex
  • [ ] Diners

Expiry date:
/

Name of cardholder:

Card number:

Card Security Code:

Signature of cardholder:

NOTE:
Your Card Security Code number is the three or four-digit number printed on your card.
For Visa, Mastercard & Diners cards this is typically found printed on the signature panel on the back of your card.
On Amex cards this is a four-digit number printed on the front of the card, above the main credit card number.

or

  • [ ] Direct debit

Your name:

User ID No:

Signature:

MBIE-MAKO-3775244



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Online Sources for this page:

Gazette.govt.nz — PDF NZ Gazette 2013, No 24




✨ LLM interpretation of page content

🏭 Annual Return for Companies – Prescribed Form for Annual Return (continued from previous page)

🏭 Trade, Customs & Industry
28 February 2013
Companies Act 1993, Annual Return, Prescribed Form, Company Details