Insurance Acquisitions and Takeovers (Notices) Regulations (Cth)
I, THE
GOVERNOR-GENERAL of the Commonwealth of Australia, acting with the advice of
the Federal Executive Council and under section 4 of the
Dated 11 March 1992.
BILL HAYDEN
Governor-General
By His Excellency’s Command,
R. McMULLAN
Parliamentary Secretary to the Treasurer
for and on behalf of the
Treasurer
____________
These Regulations may be cited as the Insurance Acquisitions and Takeovers (Notices) Regulations.
These Regulations commence on the date of commencement of the
(a) in the case of a notice by a person of the person’s intention to enter into the agreement mentioned in that paragraph—Form 1 in the Schedule; and
(b) in the case of a notice by a company of the company’s intention to issue the shares mentioned in that paragraph—Form 2 in the Schedule.
________________
Paragraph 4 (1) (a)
NOTICE UNDER PARAGRAPH 24 (b) OF THE ACT OF A PERSON’S INTENTION TO ENTER INTO AN AGREEMENT TO ACQUIRE SHARES MENTIONED IN THAT PARAGRAPH
The person giving this Notice must attach to the Notice the documents required under regulation 5 of the Insurance Acquisitions and Takeovers (Notices) Regulations to be attached to this Notice.
If, in relation to any matter, the space provided in the Notice is insufficient to insert the required particulars, show the particulars in a separate attachment to this Notice.
____________________
To the Minister,
I give notice under paragraph
24 (b) of the
(the person mentioned in Part 1 of this Notice) propose to enter into an agreement with ....
............................................................................................................................................................... ,
(the person mentioned in Part 2 of this Notice) to acquire shares in........................................ ,
............................................................................................................................................................... ,
(the company referred to in Part 3 of this Notice).
Particulars of the relevant shares are set out in Part 4 of this Notice.
PART 1
PARTICULARS OF PERSON GIVING NOTICE
1. Division 1 of this Part is to be completed if the person giving notice is not a company.
2. Division 2 of this Part is to be completed if the person giving notice is a company.
Division 1
PARTICULARS OF PERSON OTHER THAN A COMPANY
____________________________________________________________________
Full name ............................................................................................................................................
Country where ordinarily resident .................................................................................................
Address in that country ....................................................................................................................
Address in Australia for service.......................................................................................................
State or Territory ............................................................................. Postcode .......................
Telephone
No
......................................................................................... (
Facsimile
No ............................................................................................. (
____________________________________________________________________
Particulars of Australian agent (if any):
Full name ............................................................................................................................................
Address ...............................................................................................................................................
State or Territory ............................................................................. Postcode .......................
Telephone
No
......................................................................................... (
Facsimile
No ............................................................................................. (
____________________________________________________________________
Particulars of trust:
Name of trust .....................................................................................................................................
Name of trustee .................................................................................................................................
Names of beneficiaries.......................................................................................................................
(
____________________________________________________________________
Division 2
PARTICULARS OF COMPANY
Name of company .............................................................................................................................
State, Territory or country where incorporated ............................................................................
Address of head office in that State, Territory or country .........................................................
Address of registered office in that State, Territory or country ................................................
Address in Australia for service .....................................................................................................
State or Territory ............................................................................. Postcode .......................
Telephone
No
......................................................................................... (
Facsimile
No ............................................................................................. (
____________________________________________________________________
Names and shareholdings of person (s) holding a substantial shareholding in the company giving notice:
| Shareholder’s full name | Shareholder’s ordinary address | Class of shares held | Number of votes attaching to a share of that class | shares of that class on issue | shares of that class held |
____________________________________________________________________
Particulars of company’s *agent/ *principal officer in Australia:
Full name ............................................................................................................................................
Title of *agent/ *principal officer....................................................................................................
Address ...............................................................................................................................................
State or Territory ............................................................................ Postcode ........................
Telephone
No
......................................................................................... (
Facsimile
No ............................................................................................. (
(
____________________________________________________________________
Particulars of trust:
Name of trust .....................................................................................................................................
Name of trustee .................................................................................................................................
Names of beneficiaries.......................................................................................................................
(
____________________________________________________________________
PART 2
PARTICULARS OF PERSON WITH WHOM AGREEMENT ENTERED
1. Division 1 of this Part is to be completed if the person with whom the agreement is entered is not a company.
2. Division 2 of this Part is to be completed if the person with whom the agreement is entered is a company.
Division 1
PARTICULARS OF PERSON OTHER THAN A COMPANY
____________________________________________________________________
Full name ............................................................................................................................................
Country where ordinarily resident .................................................................................................
Address in that country ....................................................................................................................
Address in Australia for service.......................................................................................................
State or Territory ............................................................................. Postcode .......................
Telephone
No
......................................................................................... (
Facsimile
No ............................................................................................. (
____________________________________________________________________
Particulars of Australian agent (if any):
Full name ............................................................................................................................................
Address ...............................................................................................................................................
State or Territory ...............................................................................................................................
Telephone
No
......................................................................................... (
Facsimile
No ............................................................................................. (
____________________________________________________________________
Division 2
PARTICULARS OF COMPANY
Name of company .............................................................................................................................
State, Territory or country where incorporated ............................................................................
Address of head office in that State, Territory or country .........................................................
Address of registered office in that State, Territory or country ................................................
Address in Australia for service .....................................................................................................
State or Territory ............................................................................. Postcode .......................
Telephone
No
......................................................................................... (
Facsimile
No ............................................................................................. (
____________________________________________________________________
Names and shareholdings of person (s) holding a substantial shareholding in the company :
| Shareholder’s full name | Shareholder’s ordinary address | Class of shares held | Number of votes attaching to a share of that class | shares of that class on issue | shares of that class held |
____________________________________________________________________
Particulars of company’s *agent/ *principal officer in Australia:
Full name ............................................................................................................................................
Title of *agent/ *principal officer....................................................................................................
Address ...............................................................................................................................................
State or Territory ............................................................................ Postcode ........................
Telephone
No
......................................................................................... (
Facsimile
No ............................................................................................. (
(
____________________________________________________________________
PART 3
PARTICULARS OF COMPANY IN WHICH IT IS PROPOSED TO ACQUIRE SHARES
This Part is to be completed in relation to the company in which the person giving notice proposes to acquire shares.
COMPANY
Name of company .............................................................................................................................
State, Territory or country where incorporated ............................................................................
Address of head office in that State, Territory or country .........................................................
Address of registered office in that State, Territory or country ................................................
Address in Australia for service .....................................................................................................
State or Territory ............................................................................. Postcode .......................
Telephone
No
......................................................................................... (
Facsimile
No ............................................................................................. (
____________________________________________________________________
Names and shareholdings of person (s) holding a substantial shareholding in the company:
| Shareholder’s full name | Shareholder’s ordinary address | Class of shares held | Number of votes attaching to a share of that class | shares of that class on issue | shares of that class on issue |
____________________________________________________________________
Particulars of company’s *agent/ *principal officer in Australia:
Full name ............................................................................................................................................
Title of *agent/ *principal officer....................................................................................................
Address ...............................................................................................................................................
State or Territory ............................................................................ Postcode ........................
Telephone
No
......................................................................................... (
Facsimile
No ............................................................................................. (
(
____________________________________________________________________
PART 4
PARTICULARS OF SHARES
The Table in this Part is to be completed in relation to the proposed acquisition of shares in the company mentioned in Part 3.
TABLE
PARTICULARS OF SHARES
PROPOSED TO BE ACQUIRED
| Class of shares | Number of votes attaching to shares of that class and that number as a percentage of the total number of votes attaching to all classes of shares on issue from the company | Number of shares of that class already held by the person and that number as a percentage of the total number of shares on issue from the company | Total number of shares of that class on issue from the company | Number of previously issued shares of that class proposed to be acquired and that number as a percentage of the total number of shares on issue from the company | Number of shares proposed to be acquired from a proposed new issue of shares of that class and that number as a percentage of the total number of shares that there will be after the proposed new issue |
The particulars specified in this Notice are true and correct to the best of my knowledge, information and belief.
Signed by or on behalf of the person giving this notice by:........................................................
Full name ............................................................................................................................................
Date.......................................................................................................................................................
FORM 2 Paragraph 4 (1) (b)
NOTICE UNDER PARAGRAPH 24 (b) OF THE ACT OF AN INTENTION TO ISSUE THE SHARES MENTIONED IN THAT PARAGRAPH
The person giving this Notice must attach to the Notice the documents required under regulation 5 of the Insurance Acquisitions and Takeovers (Notices) Regulations to be attached to this Notice.
If, in relation to any matter, the space provided in the Notice is insufficient to insert the required particulars, show the particulars in a separate attachment to this Notice.
___________________
To the Minister,
I give
notice under paragraph 24 (b) of the
(the company mentioned in Part 1 of this Notice) proposes to issue shares to..................... ,
............................................................................................................................................................... ,
(the person mentioned in Part 2 of this Notice).
Particulars of the shares that the company proposes to issue are set out in Part 3 of this Notice.
PART 1
PARTICULARS OF PERSON GIVING NOTICE
The company should complete this Part in relation to itself.
PARTICULARS OF THE COMPANY
Name of company .............................................................................................................................
State, Territory or country where incorporated ............................................................................
Address of head office in that State, Territory or country .........................................................
Address of registered office in that State, Territory or country ................................................
Address in Australia for service .....................................................................................................
State or Territory ............................................................................. Postcode .......................
Telephone
No
...................................................................................(
Facsimile
No
...................................................................................(
____________________________________________________________________
Names and shareholdings of person (s) holding a substantial shareholding in the company giving notice:
| Shareholder’s full name | Shareholder’s ordinary address | Class of shares held | Number of votes attaching to a share of that class | shares of that class on issue | shares of that class on issue |
____________________________________________________________________
Particulars of company’s *agent/ *principal officer in Australia:
Full name ............................................................................................................................................
Title of *agent/ *principal officer....................................................................................................
Address ...............................................................................................................................................
State or Territory ............................................................................ Postcode ........................
Telephone
No
......................................................................................... (
Facsimile
No ............................................................................................. (
(
________________________________________________________________________
PART 2
PARTICULARS OF PERSON TO WHOM SHARES ARE TO BE ISSUED
1. Division 1 of this Part is to be completed if the person to whom shares are to be issued is a not a company.
2. Division 2 of this Part is to be completed if the person to whom shares are to be issued is a company.
Division 1
PARTICULARS OF A PERSON OTHER THAN A COMPANY
____________________________________________________________________
Full name ............................................................................................................................................
Country where ordinarily resident...................................................................................................
Address in that country ....................................................................................................................
Address in Australia for service .....................................................................................................
State or Territory ...................................................................... Postcode ...............................
Telephone
No
......................................................................................... (
Facsimile
No ............................................................................................. (
____________________________________________________________________
Particulars of Australian agent (if any):
Full name ............................................................................................................................................
Address ...............................................................................................................................................
State or Territory ...............................................................................................................................
Telephone
No
......................................................................................... (
Facsimile
No ............................................................................................. (
____________________________________________________________________
Division 2
PARTICULARS OF COMPANY
Name of company .............................................................................................................................
State, Territory or country where incorporated ............................................................................
Address of head office in that State, Territory or country .........................................................
Address of registered office in that State, Territory or country ................................................
Address in Australia for service .....................................................................................................
State or Territory ............................................................................. Postcode .......................
Telephone
No
......................................................................................... (
Facsimile
No ............................................................................................. (
____________________________________________________________________
Names and shareholdings of person (s) holding a substantial shareholding in the company :
| Shareholder’s full name | Shareholder’s ordinary address | Class of shares held | Number of votes attaching to a share of that class | shares of that class on issue | shares of that class held |
____________________________________________________________________
Particulars of company’s *agent/ *principal officer in Australia:
Full name ............................................................................................................................................
Title of *agent/ *principal officer....................................................................................................
Address ...............................................................................................................................................
State or Territory ............................................................................ Postcode ........................
Telephone
No
................................................................................
(
Telephone
No
................................................................................
(
(
________________________________________________________________________
PART 3
PARTICULARS OF SHARES
The company should complete the table in relation to the shares it proposes to issue to the person mentioned in Part 2.
TABLE
PARTICULARS OF SHARES PROPOSED
TO BE ISSUED
| Class of shares | Number of votes attaching to shares of that class and that number as a percentage of the total number of votes attaching to all classes of shares on issue from the company | Number of shares of that class already held by the person and that number as a percentage of the total number of shares on issue from the company | Total number of shares of that class on issue from the company | Number of previously issued shares of that class proposed to be issued and that number as a percentage of the total number of shares on issue from the company | Number of shares proposed to be issued from a proposed new issue of shares of that class and that number as a percentage of the total number of shares that there will be after the proposed new issue |
The particulars specified in this Notice are true and correct to the best of my knowledge, information and belief.
Signed by or on behalf of the person giving this notice by:........................................................
Full name ............................................................................................................................................
Date.......................................................................................................................................................
FORM 3 Subregulation 4 (2)
NOTICE UNDER PARAGRAPH 38 (b) OF THE ACT OF INTENTION TO ACQUIRE THE ASSETS, INTERESTS, RIGHTS OR BENEFITS, OR TO ENTER THE ARRANGEMENT MENTIONED IN THAT PARAGRAPH
The person giving this Notice must attach to the Notice the documents required under regulation 5 of the Insurance Acquisitions and Takeovers (Notices) Regulations to be attached to this Notice.
If, in relation to any matter, the space provided in the Notice is insufficient to insert the required particulars, show the particulars in a separate attachment to this Notice.
____________________
To the Minister,
I
give notice under paragraph 38 (b) of the
the person mentioned in Part 1 of this Notice:
* propose to enter into a transaction with................................................ (the person mentioned in Division 1 of Part 2 of this Notice) to acquire assets of an Australian-registered insurance company...................................................................................................(the company mentioned in Division 2 of Part 2 of this Notice); or
* propose to enter into an arrangement with .................................................................. (the company mentioned in Division 1 of Part 2 of this Notice) in relation to the leasing or letting on hire of, or the granting of other rights to use, assets of an Australian-registered insurance company, namely ..................................................................................(the company mentioned in Division 2 of Part 2 of this notice; or
* propose to acquire any or all of the interests, rights or benefits of an Australian-registered insurance company ......................................(the company mentioned in Division 2 of Part 2 of this notice) under one or more contracts of insurance where the company is the insurer.
Particulars of the relevant assets, interests, rights, benefits, contract or arrangement (if any) are set out in Part 3 of this Notice.
PART 1
PARTICULARS OF PERSON GIVING NOTICE
1. Division 1 of this Part is to be completed if the person giving notice is not a company.
2. Division 2 of this Part is to be completed if the person giving notice is a company.
Division 1
PARTICULARS OF A PERSON OTHER THAN A COMPANY
____________________________________________________________________
Full name..............................................................................................................................................
Country where ordinarily resident...................................................................................................
Address in that country......................................................................................................................
Address in Australia for service.......................................................................................................
State or Territory..............................................................................Postcode..........................
Telephone
No...................................................................................................
Facsimile
No....................................................................................................
____________________________________________________________________
Particulars of Australian agent (if any):
Full name..............................................................................................................................................
Address.................................................................................................................................................
State or Territory...................................................................................Postcode....................
Telephone
No...................................................................................................
Facsimile
No....................................................................................................
____________________________________________________________________
Particulars of trust:
Name of trust .....................................................................................................................................
Name of trustee .................................................................................................................................
Names of beneficiaries.......................................................................................................................
(
Division 2
PARTICULARS OF COMPANY
Name of company .............................................................................................................................
State, Territory or country where incorporated ............................................................................
Address of head office in that State, Territory or country .........................................................
Address of registered office in that State, Territory or country ................................................
Address in Australia for service .....................................................................................................
State or Territory ............................................................................. Postcode .......................
Telephone
No...................................................................................................
Facsimile
No....................................................................................................
Names and shareholdings of person (s) holding a substantial shareholding in the company giving notice:
| Shareholder’s full name | Shareholder’s ordinary address | Class of shares held | Number of votes attaching to a share of that class | shares of that class on issue | shares of that class held |
____________________________________________________________________
Particulars of company’s *agent/ *principal officer in Australia:
Full name ............................................................................................................................................
Title of *agent/ *principal officer....................................................................................................
Address ...............................................................................................................................................
State or Territory ............................................................................ Postcode ........................
Telephone
No...................................................................................................
Facsimile
No....................................................................................................
(
________________________________________________________________________
Particulars of trust:
Name of trust .....................................................................................................................................
Name of trustee .................................................................................................................................
Names of beneficiaries.......................................................................................................................
(
PART 2
PARTICULARS OF PERSONS OTHER THAN
PERSON GIVING NOTICE
1. If the person giving notice states that the person proposes to enter a transaction to acquire assets of an Australian-registered insurance company, Division 1 should be completed in relation to the person with whom the agreement is made. Division 2 should be completed in relation to the Australian-registered insurance company. If the proposed transaction is to be entered with the Australian-registered insurance company the person giving notice may insert “as above” in Division 2.
2. If the person giving notice states that the person proposes to enter into an arrangement with a person in relation to the leasing or letting on hire of, or the granting of other rights to use, assets of an Australian-registered company, Division 1 should be completed in relation to the person with whom the arrangement is made. Division 2 should be completed in relation to the Australian-registered insurance company. If the proposed arrangement is to be entered with the Australian-registered insurance company the person giving notice may insert “as above” in Division 2.
3. If the person giving notice states that the person proposes to acquire any or all of the interests, rights or benefits of an Australian-registered insurance company under one, or more contracts of insurance where the company is the insurer, Division 2 should be completed in relation to the company.
________________
Division 1
PARTICULARS OF PERSON WITH WHOM
ARRANGEMENT/TRANSACTION MADE
PARTICULARS OF A PERSON OTHER THAN A COMPANY
Full name..............................................................................................................................................
Country where ordinarily resident...................................................................................................
Address in that country......................................................................................................................
Address in Australia for service.......................................................................................................
State or Territory..............................................................................Postcode..........................
Telephone
No...................................................................................................
Facsimile
No....................................................................................................
____________________________________________________________________
Particulars of Australian agent (if any):
Full name..............................................................................................................................................
Address.................................................................................................................................................
State or Territory...................................................................................Postcode....................
Telephone
No...................................................................................................
Facsimile
No....................................................................................................
____________________________________________________________________
PARTICULARS OF COMPANY
Name of company .............................................................................................................................
State, Territory or country where incorporated ............................................................................
Address of head office in that State, Territory or country .........................................................
Address of registered office in that State, Territory or country ................................................
Address in Australia for service .....................................................................................................
State or Territory ............................................................................. Postcode .......................
Telephone
No...................................................................................................
Facsimile
No....................................................................................................
Names and shareholdings of person (s) holding a substantial shareholding in the company :
| Shareholder’s full name | Shareholder’s ordinary address | Class of shares held | Number of votes attaching to a share of that class | shares of that class on issue | shares of that class held |
____________________________________________________________________
Particulars of company’s *agent/ *principal officer in Australia:
Full name ............................................................................................................................................
Title of *agent/ *principal officer....................................................................................................
Address ...............................................................................................................................................
State or Territory ............................................................................ Postcode ........................
Telephone
No...................................................................................................
Facsimile
No....................................................................................................
(
Division 2
PARTICULARS OF AUSTRALIAN-REGISTERED INSURANCE COMPANY
Name of company...............................................................................................................................
State, Territory or country where incorporated.............................................................................
Address of registered or head office in that State, Territory or country...................................
Address of head office in that State, Territory or country...........................................................
Address in Australia for service.......................................................................................................
State or Territory...............................................................................Postcode.........................
Telephone
No...................................................................................................
Facsimile
No....................................................................................................
PART 3
PARTICULARS OF ASSETS, INTERESTS, RIGHTS, BENEFITS, CONTRACTS OR ARRANGEMENT
1. If the person giving notice states that the person proposes to acquire assets of an Australian-registered insurance company, Division 1 of Part 3 should be completed.
2. If the person giving notice states that the person proposes to enter into an arrangement in relation to the leasing or letting on hire of, or the granting of other rights to use, assets of an Australian-registered insurance company, Division 2 of Part 3 should be completed.
3. If the person giving notice proposes to acquire any or all of the interests, rights or benefits of an Australian-registered insurance company under one or more contracts of insurance where the company is the insurer, Division 3 of Part 3 should be completed.
Division 1
PARTICULARS OF THE TRANSACTION UNDER WHICH THE PERSON GIVING NOTICE PROPOSES TO ACQUIRE ASSETS OF THE AUSTRALIAN-REGISTERED INSURANCE COMPANY
____________________________________________________________________
Particulars of proposed transaction..................................................................................................
Description and value of assets to which the proposed transaction relates..............................
____________________________________________________________________
Division 2
PARTICULARS OF ARRANGEMENT THAT PERSON GIVING NOTICE PROPOSES TO ENTER
____________________________________________________________________
Particulars of proposed arrangement...............................................................................................
Description and value of assets to which the proposed arrangement relates............................
____________________________________________________________________
Division 3
PARTICULARS OF CONTRACT OR CONTRACTS OF INSURANCE WHERE THE AUSTRALIAN-REGISTERED INSURANCE COMPANY IS THE INSURER
Particulars of proposed contract/s:...................................................................................................
Description and value of interests, rights or benefits of the Australian-registered insurance company under the relevant contract of insurance...............................................................................................................................................
................................................................................................................................................................
____________________________________________________________________
The particulars specified in this Notice are true and correct to the best of my knowledge, information and belief.
Signed by or on behalf of the person giving this notice by:........................................................
Full name ............................................................................................................................................
Date.......................................................................................................................................................
FORM 4 Subregulation 4 (3)
NOTICE UNDER PARAGRAPH 52 (b) OF THE ACT OF A PERSON’S INTENTION TO ENTER INTO AN AGREEMENT MENTIONED IN THAT PARAGRAPH
The person giving this Notice must attach to the Notice the documents required under regulation 5 of the Insurance Acquisitions and Takeovers (Notices) Regulations to be attached to this Notice.
If, in relation to any matter, the space provided in the Notice is insufficient to insert the required particulars, show the particulars in a separate attachment to this Notice.
____________________
To the Minister,
I
give notice under paragraph 52 (b) of the
(the person mentioned in Part 1 of this Notice) propose to enter into an agreement with.....
................................................................................................................................................................
(the person mentioned in Part 2 of this Notice) in relation to an Australian-registered insurance company
(the company mentioned in Part 3 of this notice).
Particulars of the agreement are set out in Part 4 of this Notice.
_____________________
PART 1
PARTICULARS OF PERSON GIVING NOTICE
1. Division 1 of this Part is to be completed if the person giving notice is not a company.
2. Division 2 of this Part is to be completed if the person giving notice is a company.
Division 1
PARTICULARS OF PERSON OTHER THAN COMPANY
____________________________________________________________________
Full name..............................................................................................................................................
Country where ordinarily resident...................................................................................................
Address in that country......................................................................................................................
Address in Australia for service .....................................................................................................
State or Territory..............................................................................Postcode..........................
Telephone
No...................................................................................................
Facsimile
No....................................................................................................
____________________________________________________________________
Particulars of Australian agent (if any):
Full name..............................................................................................................................................
Address.................................................................................................................................................
State or Territory...................................................................................Postcode....................
Telephone
No...................................................................................................
Facsimile
No....................................................................................................
____________________________________________________________________
Particulars of trust:
Name of trust .....................................................................................................................................
Name of trustee .................................................................................................................................
Names of beneficiaries.......................................................................................................................
(
Division 2
PARTICULARS OF COMPANY GIVING NOTICE
Name of company .............................................................................................................................
State, Territory or country where incorporated ............................................................................
Address of head office in that State, Territory or country .........................................................
Address of registered office in that State, Territory or country ................................................
Address in Australia for service .....................................................................................................
State or Territory ............................................................................. Postcode .......................
Telephone
No...................................................................................................
Facsimile
No....................................................................................................
____________________________________________________________________
Names and shareholdings of person (s) holding a substantial shareholding in the company:
| Shareholder’s full name | Shareholder’s ordinary address | Class of shares held | Number of votes attaching to a share of that class | shares of that class on issue | shares of that class held |
____________________________________________________________________
Particulars of company’s *agent/ *principal officer in Australia:
Full name ............................................................................................................................................
Title of *agent/ *principal officer....................................................................................................
Address ...............................................................................................................................................
State or Territory ............................................................................ Postcode ........................
Telephone
No...................................................................................................
Facsimile
No....................................................................................................
(
Particulars of trust:
Name of trust .....................................................................................................................................
Name of trustee .................................................................................................................................
Names of beneficiaries.......................................................................................................................
(
____________________________________________________________________
PART 2
PARTICULARS OF PERSON WITH WHOM AGREEMENT ENTERED
1. Division 1 of this Part is to be completed if the person with whom the agreement is entered is not a company.
2. Division 2 of this Part is to be completed if the person with whom the agreement is entered is a company.
Division 1
PARTICULARS OF PERSON OTHER THAN A COMPANY
____________________________________________________________________
Full name..............................................................................................................................................
Country where ordinarily resident...................................................................................................
Address in that country......................................................................................................................
Address in Australia for service .....................................................................................................
State or Territory..............................................................................Postcode..........................
Telephone
No...................................................................................................
Facsimile
No....................................................................................................
____________________________________________________________________
Particulars of Australian agent (if any):
Full name..............................................................................................................................................
Address.................................................................................................................................................
State or Territory...................................................................................Postcode....................
Telephone
No...................................................................................................
Facsimile
No....................................................................................................
____________________________________________________________________
Division 2
PARTICULARS OF COMPANY
Name of company .............................................................................................................................
State, Territory or country where incorporated ............................................................................
Address of head office in that State, Territory or country .........................................................
Address of registered office in that State, Territory or country ................................................
Address in Australia for service .....................................................................................................
State or Territory ............................................................................. Postcode .......................
Telephone
No...................................................................................................
Facsimile
No....................................................................................................
____________________________________________________________________
Names and shareholdings of person (s) holding a substantial shareholding in the company:
| Shareholder’s full name | Shareholder’s ordinary address | Class of shares held | Number of votes attaching to a share of that class | shares of that class on issue | shares of that class held |
____________________________________________________________________
Particulars of company’s *agent/ *principal officer in Australia:
Full name ............................................................................................................................................
Title of *agent/ *principal officer....................................................................................................
Address ...............................................................................................................................................
State or Territory ............................................................................ Postcode ........................
Telephone
No...................................................................................................
Facsimile
No....................................................................................................
(
PART 3
PARTICULARS OF AUSTRALIAN REGISTERED-INSURANCE COMPANY
Name of company...............................................................................................................................
Place of incorporation........................................................................................................................
Address of head office in that State, Territory or country .........................................................
Address of registered office in that State, Territory or country ................................................
Address in Australia for service.......................................................................................................
State or Territory...............................................................................Postcode.........................
Telephone
No...................................................................................................
Facsimile
No....................................................................................................
PART 4
PARTICULARS OF AGREEMENT
____________________________________________________________________
Particulars of proposed agreement:
____________________________________________________________________
The particulars specified in this Notice are true and correct to the best of my knowledge, information and belief.
Signed by or on behalf of the person giving this notice...............................................................
Full name..............................................................................................................................................
Date.......................................................................................................................................................
FORM 5 Subregulation 4 (4)
NOTICE UNDER PARAGRAPH 52 (c) OF THE ACT
PROPOSAL MENTIONED IN THAT PARAGRAPH TO ALTER A CONSTITUENT DOCUMENT OF A COMPANY
The person giving this Notice must attach to the Notice the documents required under regulation 5 of the Insurance Acquisitions and Takeovers (Notices) Regulations to be attached to this Notice.
If, in relation to any matter, the space provided in the Notice is insufficient to insert the required particulars, show the particulars in a separate attachment to this Notice.
____________________
To the Minister,
I
give notice under paragraph 52 (c) of the
(the company mentioned in Part 1 of this Notice).
Particulars of the constituent document are set out in Part 2 of this Notice
PART 1
PARTICULARS OF COMPANY GIVING NOTICE
This part is to be completed in relation to the Australian-registered insurance company of which it is proposed to alter a constituent document.
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PARTICULARS OF AUSTRALIAN-REGISTERED INSURANCE COMPANY GIVING NOTICE
Name of company...............................................................................................................................
Place of incorporation........................................................................................................................
Address of head office.......................................................................................................................
Address in Australia of registered office ......................................................................................
Address in Australia for service .....................................................................................................
State or Territory...............................................................................Postcode.........................
Telephone
No...................................................................................................
Facsimile
No....................................................................................................
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PART 2
PARTICULARS OF CONSTITUENT DOCUMENT
This Part is to be completed in relation to the constituent document proposed to be altered.
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PARTICULARS OF THE PROPOSED ALTERATION OF THE CONSTITUENT DOCUMENT
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Description of document to be altered............................................................................................
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Particulars of alterations:
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Relevant text prior alteration | Relevant text after alteration |
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The particulars specified in this Notice are true and correct to the best of my knowledge, information and belief.
Signed by or on behalf of the person giving this notice:.............................................................
Full name..............................................................................................................................................
Date.......................................................................................................................................................
1. Notified in the
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