Unit Trust Order FormRapid Companies

FROM: *

TELEPHONE: *

CONTACT NAME: *

EMAIL: *

DATE (DD/MM/YYYY): *

1. TRUSTEE/S: (If Company Name, please provide A.C.N. and Registered Office Address below)

FULL NAME: *

FULL NAME:

2. NAME OF TRUST: *

3. UNIT HOLDERS:

NAME:

A.C.N. (if applicable):

#UNITS:

PAID:

YesNo

CERT#:

CLASS:

NAME:

A.C.N. (if applicable):

#UNITS:

PAID:

YesNo

CERT#:

CLASS:

NAME:

A.C.N. (if applicable):

#UNITS:

PAID:

YesNo

CERT#:

CLASS:

NAME:

A.C.N. (if applicable):

#UNITS:

PAID:

YesNo

CERT#:

CLASS:

NAME:

A.C.N. (if applicable):

#UNITS:

PAID:

YesNo

CERT#:

CLASS:

PRICE: $363.00 (incl. GST)	TERMS: Nett 7 Days
1. Settlor and Trustee (if trustee is a Individual), must be over 18 years old. 2. If Trustee is a Company, please provide the A.C.N. 3. The Settlement amount should equal the amount of units issued times their value (eg. 100 units issued @ $0.10 = $10.00) $10.00 will be the Settlement amount

RE:	BANK DETAILS
PAYMENT BY BANK DEPOSIT
BANK:	Bank of Queensland
BRANCH:	229 Elizabeth Street, Brisbane 4000
BSB:	124001
ACCOUNT NUMBER:	10 341 706
ACCOUNT NAME:	Rapid Companies

PAYMENT OPTIONS - PLEASE CHOOSE ONE: *

Direct Credit - Confirmation of payment to be faxed to 07 3221 9982 or emailed to Rapid CompaniesCredit Card - Contact Rapid Companies with details on 07 3229 83117 Day Approved Account

Additional Information / Special Instructions

A PDF copy of this form will be sent to your email address.

Trustee Address 1 *