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REGISTRAR OF COMPANIES
OF
THE REPUBLIC OF FIJI
FORM A22
of the Companies Act 2015
STATEMENT TO VERIFY FINANCIAL STATEMENTS OF A FOREIGN COMPANY
If there is insufficient space in any section of the form, you may photocopy the relevant page(s) of the form or complete an annexure and submit the relevant page(s) or annexure as part of this lodgement.
Foreign company details
Foreign company name ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Foreign company number ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Financial year ended .................................................................................................................. / .................................................................................................................. / ..................................................................................................................
Lodgement details
Who should the Registrar contact if there is a query about this form?
Firm/Organisation ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Contact name ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Position description ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Telephone number (during business hours) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
E-mail address (optional) ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Level/Office building ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Street number and street ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Town/City ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Island ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Signature
I verify that the copies of financial statements annexed to this form are true copies of those financial statements and that the information in this form is true and complete.
Name ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Capacity
□ Director (or equivalent) of the foreign company
□ Secretary of the foreign company
□ Duly appointed local agent of the foreign company
Signature ......................................................................................................................................................................................................................................................................................................................................................................................................................................................
Date signed .................................................................................................................. / .................................................................................................................. / ..................................................................................................................