Reference No.:
Date received:
Received by:
Form Q15-V4-NOV14
FOR OFFICIAL USE
COMPANIES REGISTRATION OFFICE
CRO ANNUAL RETURN
Firm Name:
QFC Number:
Firm type:
Period covered in this return(DD/MM/YYYY):
LLP LLC
QFCLicensed Firm
AuthorisedFirm
FORM Q15
COMPANIES
REGISTRATION
OFFICE
to
2
• Form Q15 ‘CRO annual return’ is to be completed by an LLC or a Limited Liability Partnership
(“LLP”) incorporated in the QFC. This form must be completed on the anniversary of the
incorporation; or if the last return delivered to the CRO was made up to a different date, the
anniversary of that date. The annual return period cannot be more than one calendar year.
• LLCs please refer to section 7 of the Companies Regulations for further details.
• LLPs please refer to Part 8 of the Limited Liability Partnership Regulations for further details.
• All questions must be answered in full and the use of abbreviations should be avoided.
• Dates must be provided in the following format: DD/MM/YYYY.
• Answers must be typed and additional pages attached if necessary.
• Please ensure that any supporting documentation, identified in section 8, is clearly labelled and
securely attached.
• Defined terms are identified throughout this form by the capitalisation and italicisation of the
initial letter of the word or phrase and are defined in either the Companies Regulations and/or
Limited Liability Partnerships Regulations and/or the Data Protection Regulations as appropriate.
• All documentation required to be submitted must be in the English language or accompanied by
an appropriate translation into the English language.
PURPOSE OF THIS FORM
NOTES FOR
COMPLETING THIS FORM
3
• This form must be filed in original only to:
• The CRO together with the Prescribed Fee within 28 days
following the end of the annual return period or else this
will result in a breach of the Regulations.
• The information contained in this form should generally
conform to the details in the CRO records. If it does
not then the CRO may contact you and require you to
file additional forms to rectify any details that were
not previously submitted to the CRO, such as a previous
change of director or Member which was not filed with
the CRO. However, the obligation to ensure that the CRO
records are accurate remains with the Company.
• The information contained in this form will be used
as the basis upon which the applicable registers and
databases maintained by the QFC Regulatory Authority,
the QFC Authority and the CRO are updated, subject to
applicable QFC legislation.
• The information contained in this form may be shared
between the QFC Regulatory Authority, the QFC Authority
and the CRO under arrangements between them, and in
accordance with applicable QFC confidentiality and data
protection legislation.
Companies Registration Office,QFC Tower 1,PO Box 23245,West Bay, Doha, QatarT: +974 4496 7738F: +974 4496 7752E: [email protected]
NOTES FOR
LODGING THIS FORM
4
CONTENTS
1 Contact details 5
2 LLC/LLP Information 6
3 Directors, Secretary & Member Information 7
4 Shareholder Information 9
5 Shareholder Capital 11
6 Declaration to the QFC Authority 12
7 Declaration 13
8 List of attachments 14
SECTION
5
CONTACT DETAILS
1.1 Name:
1.2 Job title:
1.3 Office address:
1.4 Telephone number (include country and area codes):
1.5 Fax number:
1.6 Email address:
1.7 Preferred method of contact for matters relating to this form:
SECTION 1
Please provide details of the principal contact responsible for this application.
6
SECTION 2
LLC/LLP INFORMATION
2.1 Please provide the address of the registered office of the LLC/LLP:
2.2 Please provide details of principal Business activities of the LLC/LLP during this reporting period:
2.3 Please provide the name and address of the auditor of the LLC/LLP:
7
SECTION 3
3.1 Please complete for each director and the secretary of the LLC and for each Member/
Designated Member of the LLP (as applicable).
(Please use additional sheets if required.)
Name:
Registered number (if applicable):
DIRECTORS, SECRETARY AND
MEMBER INFORMATION
Address:
Date of birth (if applicable): Nationality (if applicable):
Business occupation:
Director Secretary MemberDesignatedMember
Name:
Registered number (if applicable):
Address:
Date of birth (if applicable): Nationality (if applicable):
Business occupation:
Director Secretary MemberDesignatedMember
8
SECTION 3
DIRECTORS, SECRETARY AND
MEMBER INFORMATION (cont)
Name:
Registered number (if applicable):
Address:
Date of birth (if applicable): Nationality (if applicable):
Business occupation:
Director Secretary MemberDesignatedMember
Name:
Registered number (if applicable):
Address:
Date of birth (if applicable): Nationality (if applicable):
Business occupation:
Director Secretary MemberDesignatedMember
9
SECTION 4
Information required by LLC’s only (LLP’s should proceed to the Declaration section).
Name:
Address:
Class of Shares:
SHAREHOLDER INFORMATION
4.1 Please list, in respect of each class of Members, the name and address of each Member
holding more than 1% in nominal value of all the issued Shares of that class (please
use additional sheets if required):
Percentage Held: Total Paid Up:
Name:
Address:
Class of Shares:
Percentage Held: Total Paid Up:
Registered number (if applicable):
Registered number (if applicable):
10
SECTION 4
SHAREHOLDER INFORMATION (cont)
Name:
Address:
Class of Shares:
Percentage Held: Total Paid Up:
Name:
Address:
Class of Shares:
Percentage Held: Total Paid Up:
Registered number (if applicable):
Registered number (if applicable):
11
SECTION 5
SHARE CAPITAL
Information required by LLC’s only (LLP’s should proceed to the Declaration section).
Class of Shares:
Class of Shares:
Class of Shares:
Number of Shares:
Number of Shares:
Number of Shares:
Nominal Value of Shares:
Nominal Value of Shares:
Nominal Value of Shares:
5.1 Please provide details on authorised and issued share capital:
AUTHORISED SHARE CAPITAL
ISSUED SHARE CAPITAL
TOTAL PAID UP SHARE CAPITAL
12
SECTION 6
To be completed by the Company Licensed to conduct non-regulated activities only.
DECLARATION TO
THE QFC AUTHORITY
I confirm that throughout the period covered by this return, the Company has not undertaken
any Regulated Activity or other activities not expressly permitted under the terms of its Licence:
I confirm that throughout the period covered by this return, the Company has notified the
QFC Authority in the case of a change of registered function holder (SEF, MLRO and/or
Designated Representative):
YES
YES
NO
NO
13
SECTION 7
Print Name of director, secretary, Member or Designated Member:
Signature of director, secretary, Member or Designated Member:
Position: Date:
I declare that, to the best of my knowledge and belief, having made due enquiry, the
information given in this form is complete and correct. I understand that it is an offence
under Article 132 of the Companies Regulations to knowingly or recklessly provide
information to the CRO, which is false, misleading or deceptive, or to conceal information
where the concealment of such information is likely to mislead or deceive the CRO.
For the purposes of the Data Protection Regulations, the Personal Data provided in this
form will be processed by the QFC Regulatory Authority, CRO and the QFC Authority in
accordance with Article 8 of the Data Protection Regulations and by signing this form, you
consent to the CRO sharing the information with the QFC Authority and the QFC Regulatory
Authority.
I confirm that I have the authority to submit this return, to declare as specified above and
sign this form for the Company.
DECLARATION
14
SECTION 8
LIST OF ATTACHMENTS
SECTION: DOCUMENT: INCLUDED:
Supporting documentation included with this form:
Proof of Payment of Prescribed Fee
Companies Registration Office, PO Box 23245, Doha, Qatar • T: +974 4496 7777 • F: +974 4496 7676 • [email protected] • www.qfc.qa
QATAR FINANCIAL CENTRE (QFC)
