Version 30 September 2019 Form IS1 Application to incorporate a society Page 1 of 5
www.societies.govt.nz | 0508 762 438
Send completed forms to: Companies Office, Private Bag 92061, Victoria Street West, Auckland 1142 or
processing@companiesoffice.govt.nz
Application to incorporate a society
Sections 7 and 21, Incorporated Societies Act 1908
NOTESThe Companies Office will endeavour to process your application form within 3 working days.
Except where specifically noted, the details you provide on this form (including details and signatures of the members and witnesses
provided with this application) will be made publicly available on the Incorporated Societies Register.
Proposed incorporated society name
The society’s name must end with the word ‘Incorporated’. The name cannot be identical or deceptively similar to that of
another body corporate (such as a company or another incorporated society). If the other organisation gives its consent to use
the name, attach their written consent to this application as a supporting document.
Annual General Meeting (AGM) month
The month the society will hold its Annual General Meeting (AGM) each year. This should be recorded in your society’s rules.
Balance date
The society’s financial statement balance date. This date should be recorded in your society’s rules.
Certificate
The certificate must be completed by an officer of, or an authorised agent for, the society who should also sign the first page
of the rules you’re submitting.
I certify that:
1. a majority of the members have consented to the application, and
2. the rules that are endorsed with the application are the rules of the society.
Signature …………………………………………………………………………………………………………..
Designation Officer Authorised agent (Accountant/Lawyer etc)
Date
Day: Month:
Signatory’s name:
Month:
Form IS1
Version 30 September 2019 Form IS1 Application to incorporate a society Page 2 of 5
Proposed incorporated society name
Addresses
Registered office address
This address must be a physical address in New Zealand and can’t be a PO Box, Private Bag or Document Exchange address.
Address for communication
This address is used for communications from the Registrar of Incorporated Societies. This can be a postal
address such as a PO Box, Private Bag or Document Exchange address.
This address will not be publicly available.
Email address for communication
The Registrar may also contact the society by email.
The email address you provide here will not be publicly available.
Contact phone number (optional)
For example: +64 For example: 09 For example: 12346587
Contact mobile number (optional)
For example: +64 For example: 21 or 27 For example: 12346587
Email address:
Care of:
Flat/house no:
Street name:
Town/City:
Suburb:
Country: New Zealand
Country code: Number: Area code:
Country code:
Number:
Area code:
Care of:
Flat/house no:
Street name:
Town/City:
Suburb:
Country:
Version 30 September 2019 Form IS1 Application to incorporate a society Page 3 of 5
Proposed incorporated society name
Officers (optional)
Providing officer details on the register is optional and only the officer’s name will be shown on the public register.
These details will make it easier for officers to access the online services for the society and will help the Registrar to keep
key people informed about any matters relating to the society.
1. Officer’s name
First name Middle name(s)Optional Last name
Role (optional)
This person’s role description such as 'Secretary' or 'Treasurer'
Residential address
This address will not be shown on the public register
Email address
This email address will not be shown on the public register
2. Officer’s name
First name Middle name(s) - Optional Last name
Role (optional)
This person’s role description such as 'Secretary' or 'Treasurer'
Residential address
This address will not be shown on the public register
Email address
This email address will not be shown on the public register
Care of:
Flat/house no:
Street name:
Town/City: Postal code:
Suburb:
Country:
Care of:
Flat/house no:
Street name:
Town/City:
Postal code:
Suburb:
Country:
Version 30 September 2019 Form IS1 Application to incorporate a society Page 4 of 5
Proposed incorporated society name
Checklist before filing your application
Have you checked that the proposed society name is available?
NoteYou can check that the name you’ve chosen is available to use by using the search options provided by the
following Companies Office websites.
Search the Incorporated Societies Register
Search the Companies Register
Search our other registers
Read our online help guide ‘Things to do before you apply
’ for links to these search options.
An officer of the society or a solicitor has completed and signed the certificate section (Page 1)
Attach the following documents
Please make sure the following documents are attached to your application
Form IS1a Signatures form
The signatures form contains the names and signatures of 15 members of the proposed society.
The signatures must be witnessed by someone who isn’t one of the 15 members signing the form.
A copy of the society’s endorsed rules (signed by the person who completed the certificate on Page 1)
Section 6, Incorporated Societies Act 1908 requires that a society’s rules include the following
The name of the society (ending with the word Incorporated)
The objects for which the society is established
How people become members of the society and cease being members of the society
How meetings of the society will be called and held and how voting will take place
How officers of the society will be appointed
Control and use of the common seal
How the society’s funds will be controlled and invested
The powers (if any) that the society has to borrow money
How any property of the society will be distributed in the event of the society being wound up
How the rules of the society can be altered.
The fee of $102.22 is included
Please include this completed application checklist along with the completed ‘Payment detailspage
(Page 5)
Send your completed forms to us
By post to
Companies Office
Private Bag 92061
Victoria Street West
Auckland 1142
or by email to processing@companiesoffice.govt.nz
Presenter details
Postal address:
Email address:
Telephone number:
Name:
Version 30 September 2019 Form IS1 Application to incorporate a society Page 5 of 5
Proposed incorporated society name
Payment details
NOTEThis payment details page will be detached from your application before any information
is scanned for publication on the website so that your payment details remain secure.
Amount
Companies Office fee
GST exclusive
GST Total
GST inclusive
$88.89 $13.33 $102.22
Method of payment
Choose your payment method from the options below. Please do not send cash or a purchase order.
Cheque
Make your cheque payable to theMinistry of Business, Innovation and Employment
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 3 or 4-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 4-digit number printed on the front of the card, above the main credit card number.
or
Direct debit
Your (or your organisation) name:
Signature …………………………………………………………………………………
/
Version 30 September 2019 Form IS1a – Signatures form for application to incorporate a society Page 1 of 6
www.societies.govt.nz | 0508 762 438
Send completed forms to: Companies Office, Private Bag 92061, Victoria Street West, Auckland 1142 or processing@companiesoffice.govt.nz
Signatures form for application to incorporate a society
NOTE
The details you provide on this form (including details and signatures of the members and witnesses provided with this application) will be made publicly available on the Incorporated Societies Register.
Proposed incorporated society name
We, the several persons whose names are subscribed hereto, being members of the above-mentioned society, hereby make application for the incorporation of the society under the foregoing
rules, in accordance with the Incorporated Societies Act 1908.
Witnesses
There is more than one witness to the members’ signatures. Each witness should complete the appropriate witness fields on pages 2 -6.
OR
There is only one witness to all 15 members’ signatures. Please complete the witness fields below.
All members’ signatures on this form have been witnessed by
Signature ……………………………………………………………………..……………………………………………
Witness’ name
Witness’ address
Witness’ occupation
Form IS1a
Version 30 September 2019 Form IS1a – Signatures form for application to incorporate a society Page 2 of 6
Proposed incorporated society name
We, the several persons whose names are subscribed hereto, being members of the above-mentioned society, hereby make application for the incorporation of the society under the foregoing
rules, in accordance with the Incorporated Societies Act 1908
Members 1, 2 and 3
(Complete details for members 4, 5 and 6 on the next page) Witnessed by
1 Member’s signature ……………………………………………………………………………………………… 1 Witness’ signature …………………………………………………………………………………………………
2 Member’s signature ……………………………………………………………………………………………… 2 Witness’ signature …………………………………………………………………………………………………
3 Member’s signature ……………………………………………………………………………………………… 3 Witness’ signature …………………………………………………………………………………………………
Member’s name
Member’s address
Witness’ name
Witness’ address
Witness’ occupation
Member’s name
Member’s address
Witness’ name
Witness’ address
Witness’ occupation
Member’s name
Member’s address
Witness’ name
Witness’ address
Witness’ occupation
Version 30 September 2019 Form IS1a – Signatures form for application to incorporate a society Page 3 of 6
Proposed incorporated society name
We, the several persons whose names are subscribed hereto, being members of the above-mentioned society, hereby make application for the incorporation of the society under the foregoing
rules, in accordance with the Incorporated Societies Act 1908.
Members 4, 5 and 6
(Complete details for members 7, 8 and 9 on the next page) Witnessed by
4 Member’s signature ………………………………………………………………………………………………… 4 Witness’ signature …………………………………………………………………………………………………
5 Member’s signature ……………………………………………………………………………………………… 5 Witness’ signature …………………………………………………………………………………………………
6 Member’s signature ……………………………………………………………………………………………… 6 Witness’ signature …………………………………………………………………………………………………
Member’s name
Member’s address
Witness’ name
Witness’ address
Witness’ occupation
Member’s name
Member’s address
Witness’ name
Witness’ address
Witness’ occupation
Member’s name
Member’s address
Witness’ name
Witness’ address
Witness’ occupation
Version 30 September 2019 Form IS1a – Signatures form for application to incorporate a society Page 4 of 6
Proposed incorporated society name
We, the several persons whose names are subscribed hereto, being members of the above-mentioned society, hereby make application for the incorporation of the society under the foregoing
rules, in accordance with the Incorporated Societies Act 1908.
Members 7, 8 and 9
(Complete details for members 10, 11 and 12 on the next page) Witnessed by
7 Member’s signature ………………………………………………………………………………………………… 7 Witness’ signature …………………………………………………………………………………………………
8 Member’s signature ………………………………………………………………………………………………… 8 Witness’ signature …………………………………………………………………………………………………
9 Member’s signature ………………………………………………………………………………………………… 9 Witness’ signature …………………………………………………………………………………………………
Member’s name
Member’s address
Witness’ name
Witness’ address
Witness’ occupation
Member’s name
Member’s address
Witness’ name
Witness’ address
Witness’ occupation
Member’s name
Member’s address
Witness’ name
Witness’ address
Witness’ occupation
Version 30 September 2019 Form IS1a – Signatures form for application to incorporate a society Page 5 of 6
Proposed incorporated society name
We, the several persons whose names are subscribed hereto, being members of the above-mentioned society, hereby make application for the incorporation of the society under the foregoing
rules, in accordance with the Incorporated Societies Act 1908.
Members 10, 11 and 12
(Complete details for members 13, 14 and 15 on the next page) Witnessed by
10 Member’s signature ………………………………………………………………………………………………… 10 Witness’ signature …………………………………………………………………………………………………
11 Member’s signature ………………………………………………………………………………………………… 11 Witness’ signature ………………………………………………………………………………………………
12 Member’s signature ………………………………………………………………………………………………… 12 Witness’ signature ………………………………………………………………………………………………
Member’s name
Member’s address
Witness’ name
Witness’ address
Witness’ occupation
Member’s name
Member’s address
Witness’ name
Witness’ address
Witness’ occupation
Member’s name
Member’s address
Witness’ name
Witness’ address
Witness’ occupation
Version 30 September 2019 Form IS1a – Signatures form for application to incorporate a society Page 6 of 6
Proposed incorporated society name
We, the several persons whose names are subscribed hereto, being members of the above-mentioned society, hereby make application for the incorporation of the society under the foregoing
rules, in accordance with the Incorporated Societies Act 1908.
Members 13, 14 and 15
Witnessed by
13 Member’s signature ………………………………………………………………………………………………… 13 Witness’ signature …………………………………………………………………………………………………
14 Member’s signature ………………………………………………………………………………………………… 14 Witness’ signature …………………………………………………………………………………………………
15 Member’s signature ………………………………………………………………………………………………… 15 Witness’ signature …………………………………………………………………………………………………
Member’s name
Member’s address
Witness’ name
Witness’ address
Witness’ occupation
Member’s name
Member’s address
Witness’ name
Witness’ address
Witness’ occupation
Member’s name
Member’s address
Witness’ name
Witness’ address
Witness’ occupation
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