Trust Application Form

Instruction Sheet For The Creation of a Trust Under The Laws of Belize

PERSONAL DETAILS OF SETTLORS:

Copy the following text below into the text area and fill out;
repeat as many times as needed.
-----------------------------------------------------
Name:
Address:
Home Telephone:
Office Telephone:
Fax Number:
E-Mail Address:
Identification:
Nationality:
Date Of Birth:
Residence:
Copy of passport sent via email attachment : Yes or No
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1. NAME OF TRUST

2. TYPE OF TRUST:
(A) DISCRETIONARY
(B) IRREVOCABLE
(C) PURPOSE
If yes, state the purpose or object of the trust

3. DURATION OF TRUST:
If other please describe

SPECIAL POWERS OF TRUSTEE: SPECIFY

5. STATUTORY POWERS OF TRUSTEE:

6. IS ASSET PROTECTION PROVISIONS REQUIRED? :

7. EXLUDED PERSONS, IF ANY, BY NAME:
e.g. Governments, Tax Authorities.

8. DO YOU WISH TO BE NAMED AS A BENEFICIARY?

9. DO YOU WISH YOUR SPOUSE (IF ANY) TO BE NAMED A BENEFICIARY?
IF “YES” PLEASE PROVIDE THE FOLLOWING INFORMATION CONCERNING YOUR SPOUSE:

Copy the following text below into the text area and fill out;
repeat as many times as needed.
-----------------------------------------------------
Name:
Address:
Home Telephone:
Office Telephone:
Fax Number:
E-Mail Address:
Identification:
Nationality:
Date Of Birth:
Residence:
Copy of passport sent via email attachment : Yes or No
-----------------------------------------------------  

10. DO YOU WISH ANY OTHER PERSON TO BE NAMED A BENEFICIARY?
(OPTION FOR AMOUNT IN FIGURES AND CORRESPONDING FORM FOR EACH SHOULD APPEAR) PLEASE PROVIDE THE FOLLOWING INFORMATION REGARDING THE ADDITIONAL BENEFICIARIES:

Copy the following text below into the text area and fill out;
repeat as many times as needed.
-----------------------------------------------------
Name:
Address:
Home Telephone:
Office Telephone:
Fax Number:
E-Mail Address:
Identification:
Nationality:
Date Of Birth:
Residence:
Copy of passport sent via email attachment : Yes or No
-----------------------------------------------------  

11. INCOME UNDER THE SAID TRUST SHALL BE DISTRIBUTED AS FOLLOWS:

A. PAID TO THE BENEFICIARIES

B.  ACCUMULATED AND ADDED TO CAPITAL UNTIL NOTICE BY SETTLOR

12. UPON YOUR DEATH, DO YOU WISH THE TRUST TO BE:-


13. PLEASE PROVIDE THE FOLLOWING INFORMATION REGARDING YOUR TRUSTEE.

Copy the following text below into the text area and fill out;
repeat as many times as needed.
-----------------------------------------------------
Name:
Address:
Home Telephone:
Office Telephone:
Fax Number:
E-Mail Address:
Identification:
Nationality:
Date Of Birth:
Residence:
Copy of passport sent via email attachment : Yes or No
-----------------------------------------------------  

14. PLEASE PROVIDE THE FOLLOWING INFORMATION REGARDING YOUR PROTECTOR OF THE TRUST.

Copy the following text below into the text area and fill out;
repeat as many times as needed.
-----------------------------------------------------
Name:
Address:
Home Telephone:
Office Telephone:
Fax Number:
E-Mail Address:
Identification:
Nationality:
Date Of Birth:
Residence:
Copy of passport sent via email attachment : Yes or No
-----------------------------------------------------  

15. ALTERNATE PROTECTOR?

PLEASE PROVIDE THE FOLLOWING INFORMATION REGARDING YOUR ALTERNATE PROTECTOR

Copy the following text below into the text area and fill out;
repeat as many times as needed.
-----------------------------------------------------
Name:
Address:
Home Telephone:
Office Telephone:
Fax Number:
E-Mail Address:
Identification:
Nationality:
Date Of Birth:
Residence:
Copy of passport sent via email attachment : Yes or No
-----------------------------------------------------  

16. SPECIAL POWERS OF PROTECTOR

SPECIFY IF YES:

17. WHAT ASSETS OR SUM OF MONEY WILL BE THE INITIAL TRUST FUND?

18. WHAT (IF ANY) ADDITIONAL ASSEST DO YOU INTEND TO ADD TO THE TRUST FUND?

19. DO YOU WISH ALPHA SERVICES LIMITED TO RETAIN ACCOUNTANTS FOR YOUR TRUST?
IF “NO” PLEASE PROVIDE THE FOLLOWING INFORMATION REGARDING THE PROSPECTIVE ACCOUNTANTS OF THE TRUST

Copy the following text below into the text area and fill out;
repeat as many times as needed.
-----------------------------------------------------
Name:
Address:
Telephone:
Alt. Telephone:
Fax Number:
E-Mail Address:
-----------------------------------------------------  

20. DO YOU WISH ALPHA SERVICES LIMITED TO RETAIN AN INVESTMENT ADVISER FOR YOUR TRUST?
IF “NO” PLEASE PROVIDE THE FOLLOWING INFORMATION REGARDING THE PROSPECTIVE INVESTMENT ADVISERS OF THE TRUST

Copy the following text below into the text area and fill out;
repeat as many times as needed.
-----------------------------------------------------
Name:
Address:
Telephone:
Alt. Telephone:
Fax Number:
E-Mail Address:
-----------------------------------------------------  

21. DO YOU WISH ALPHA SERVICES LIMITED TO RETAIN AN ATTORNEY-AT-LAW FOR YOUR TRUST?
IF “NO” PLEASE PROVIDE THE FOLLOWING INFORMATION REGARDING THE PROSPECTIVE ATTORNEY-AT-LAW OF THE TRUST

Copy the following text below into the text area and fill out;
repeat as many times as needed.
-----------------------------------------------------
Name of Company:
Address:
Telephone:
Alt. Telephone:
Fax Number:
E-Mail Address:
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22. THE TRUST IS REQUIRED TO MAINTAIN ACCOUNTING RECORDS FOR A MINIMUM OF FIVE (5) YEARS. INDICATE THE NAME AND ADDRESS OF THE PLACE WHERE THE ACCOUNTING RECORDS WILL BE KEPT, WHETHER WITHIN OR OUTSIDE OF BELIZE. IN THE EVENT OF A CHANGE, YOU ARE REQUIRED TO NOTIFY US WITHIN 14 DAYS OF SUCH CHANGE, IN DEFAULT YOUR COMPANY MAY BE STRUCK FROM THE REGISTER.

*Please include the following: Name/Company, Address, Tel.

23. SPECIAL ADMINISTRATIVE INSTRUCTIONS (IF ANY):

DUE DILIGENCE REQUIREMENTS

PROVIDE A COPY OF EACH DIRECTOR, SHAREHOLDER, BENEFICIAL OWNER, MEMBER, MANAGER, SETTLOR, TRUSTEE, PROTECTOR, FOUNDER AND ALL PERSONS REQUESTING THE REGISTRATION OF THE CORPORATION:
I. NOTARIZED COPY PASSPORT WITH PICTURE AND SIGNATURE DATA PAGES
II. IN THE ALTERNATIVE A NOTARIZED COPY OF ANY GOVERNMENT/OFFICIAL ISSUED FORM OF IDENTIFICATION WITH PICTURE AND SIGNATURE
III. IN THE ALTERNATIVE IF A COMPANY WILL HOLD ANY OF THE ABOVE POSITIONS, THEN COPY OF THE CORPORATE DOCUMENTS, A CERTIFICATE OF GOOD STANDING AND CERTIFICATE OF INCUMBENCY DETAILING THE DIRECTORS/OFFICERS AND SHAREHOLDERS/MEMBERS OF THE COMPANY
IV. RECENT UTILITY BILL WITHIN 3 MONTHS
V. TWO CHARACTER REFERENCES FROM AN ATTORNEY OR ACCOUNTANT OR BUSINESS ASSOCIATE WHICH YOU HAVE DONE BUSINESS WITH FOR MORE THAN 2 YEARS
VI. BANK REFERENCE- ONLY IF REQUESTING A BANK ACCOUNT

*I/WE DECLARE AND CONFIRM THE ABOVE INFORMATION IS TRUE AND CORRECT AND THAT THE COMPANY WILL NOT BE USED FOR MONEY LAUNDERING, TERRORIST ACTIVITIES, OR ANY OTHER ILLEGAL ACTIVITY OR IN A MANNER LIKELY TO DAMAGE THE GOOD NAME OF ALPHA SERVICES LIMITED OR THE JURISDICTION OF INCORPORATION. I/WE ACKNOWLEDGE THE REQUIREMENTS OF YOUR AML/CFT COMPLIANCE POLICY AND AGREE TO COMPLY THEREWITH. I/WE WILL TAKE INDEPENDENT LEGAL ADVICE BEFORE PROCEEDING AND I AM/WE ARE AWARE, AND INTEND, TO HONOUR MY/OUR LEGAL RESPONSIBILITIES IN MY/OUR JURISDICTION.

I/WE CONFIRM AND AGREE THAT SHOULD ANY CHANGES OCCUR IN THE INFORMATION CONTAINED HEREIN I/WE WILL INFORM ALPHA SERVICES LIMITED.

SIGNATURE OF CUSTOMER:
DATED THIS DAY OF , 20.

I AUTHORIZE ALPHA SERVICES LIMITED TO ESTABLISH A TRUST IN ACCORDANCE WITH THE FOREGOING INSTRUCTIONS AND HAVE MADE THE FOLLOWING ARRANGEMENTS FOR PAYMENT.

Amount $

WIRING INSTRUCTIONS FOR ALPHA SERVICES LIMITED
Bank of America International
100 W. 33rd St.
New York, NY 10001, USA
ABA No: 026-009-593
Swift No. BOFAUS3N
Beneficiary Bank: British Caribbean Bank International Limited
Account No.: 6550-8-260-58 for further credit to Alpha Services Limited A/C #: 500-336-1

For: Insert Invoice Number/Contact Person or Company Name


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Alpha Services Limited

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#84 Albert Street • P.O

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. Box 831

Belize City, Belize

Contacts:

Rodwell R.A. Williams – Executive Director/Attorney

Nigel Ebanks – Director/Attorney

Tania Moody – Director/Attorney

Cadine Rhamdas – Administrative Director

Tel # (501) 227-1847

Fax# (501) 227-5278

E-Mail: info@alphaservicesltd.com

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