In ___(1)____, _____(1)_____, on ______(2)____, 1994, before me, _______(3)__________, Notary Public, in and to ____(4)_____, there appears Mr. _________(5)_____________, ___(6)_____, ____(7)____, _____(8)_______, passport Nº _____(9)_____ of ______(9)______, on behalf of _____(10)_____, a ______(11)_____ duly formed under the laws of ____(12)____, both the appearer and the company domiciled at _______(13)______, _________(13)_______, ______(13)______ and states:
That he hereby grants a special power of attorney to _________ (the �??Attorneys-in-fact�??) who acting jointly or separately shall be empowered to perform the following acts:
1.- In the name and representation of _______(10)______ they may appear in the public deed by which _____(10)_____ and ______(14)______ will form a limited liability company in Chile pursuant to the laws of the Republic of Chile, as well as to execute any deed by which such Company's charter may be amended. Furthermore, the Attorneys-in-fact are empowered to act on behalf of _____(10)_____ in order to incorporate all kind of companies.
The Attorneys-in-fact are empowered to carry out with broadest powers all that is deemed necessary or convenient for the achievement of the purpose above mentioned. Specially, and without this enunciation being restrictive or limitative, they are empowered to agree on the provisions of the company charter, to establish the name and purpose of the company, to fix its capital and the form in which it will be paid, to contribute to the company funds or assets of any nature whatsoever, to determine the value or appraisement of the assets contributed, to agree on the form of management, representation and use of the company's name, and to fix the time of duration of the company. They may also agree on all and any other provision of the company charter that may be necessary or that may be considered convenient, with broad authority and without any limitations. Additionally, the Attorneys-in-fact may appoint administrators, general manager or representatives of the company, to fix their authority including the powers contained in Article 7 Paragraph 2 of the Civil Procedure Code.
2.- So that in the name and in representation of ____(10)____ they may appear to sign all presentations and forms required by the Central Bank of Chile pursuant to Chapter XIV of the Foreign Exchange Regulations, as well as any applications to the Foreign Investment Committee and the foreign investment contracts with the State of Chile. The Attorneys-in-fact are also authorized to bring foreign investment contributions into the country through the Foreign Investment Statute or the Central Bank Law, being authorized to sign the corresponding agreements, fix the terms and condition which may deem necessary.
3.- Represent _______________(10) _______________, in front of any kind of governmental authorities, either political, administrative, municipal and before all kind of public or private bodies and entities whether individuals or legal entities and specially before the Internal Revenue Service, with all kind of applications, reports and other documentation that may be necessary, including applications for Tax Identification Number and starting up activities, and waive their petitions and carry out agreements with them. The Attorneys-in-fact are authorized to receive notices for and on behalf of _______________(10) _______________ as long as there is no evidence of the extinction of their representation capacity by notice in writing given by the parties concerned to the corresponding Internal Revenue Service office.
4.- In the event that on the date of granting this Power of Attorney, the aforementioned acts had already been executed by any of its Attorneys-in-fact, _______(10)_________ hereby ratifies all the terms and conditions of such acts or agreements.
5.- The bearer of a copy of this document is authorized to legalize it in Chile before the Ministry of Foreign Affairs and to carry out all the necessary acts that may be required in order for this Power of Attorney to be valid and in force in Chile.
I, ____________(3)__________, Notary Public of ____(4)___, ________(4)________, certify:
1. That the appearer is the legal representative of _____(10)_____, and that he has sufficient authority to grant this power of attorney.
2. That _______(10)________ is a company duly formed and incorporated in ______(12)______, and presently in good standing.
(1) City and country where power is granted.
(2) Day, month and year of granting of power of attorney.
(3) Full name of Notary.
(4) City and country where Notary holds office.
(5) Full name of appearer.
(6) Nationality of appearer.
(7) Marital status of appearer.
(8) Profession or occupation of appearer.
(9) Passport number of appearer and country that issued his passport.
(10) Name of the appearing legal entity.
(11) Legal structure of appearing legal entity (stock corporation or other type of company).
(12) State and country of incorporation of the appearing legal entity.
(13) Complete domicile of appearer and corporation.
(14) Name of the other company or person that will form the local Chilean company.
(15) Signature of appearer.
(16) Signature of Notary.
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