Feedback

For further information on the Custom House Offshore Fund Services please complete this confidential form and click on the "Submit" button below. In order to show that yours is a serious bona fide enquiry we ask you to complete all sections of this form as far as it is applicable to you.

Click here for our privacy policy.

NB: We may not respond to this enquiry unless you complete all sections below.

Name:

Company:

Address:

Telephone Number:

Fax Number:

E-mail address:

My Business is:

Asset Manager	CPO / Investment Broker
Bank	FamilyOffice
Other (give details):

I would like further information on Custom House's services because I/my company am/are considering (please tick applicable option):

establishing a new offshore fund and am seeking an administrator

establishing a new offshore fund and would like a copy of your Questionnaire

obtaining a listing on the Irish Stock Exchange for an existing offshore fund

changing administrator for an existing offshore fund

Other, please specify:

I visited Custom House's website because: (please complete)

	I was introduced by
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	I read about Custom House in
	I was searching for a service provider
	I was invited by at Custom House

By submitting this Feedback Form I am confirming that I have read, in full, the Terms of Use carefully and understand and hereby confirm that I agree to be bound by and comply with the said Terms of Use. including regular reviewing of Custom House's Data Privacy Statement to ensure that I am up to date with its content.

Custom House is regulated by the Irish Financial Services Regulatory Authority ("IFSRA") and authorized to act as administrator of collective investment scheme under Section 10 of the Investment Intermediatories Act of 1995.

Custom House Administration & Corporate Services Ltd.
Address: 25 Eden Quay, Dublin 1, Ireland.
Tel: +353 (0)1 878 0807 / Fax: +353 (0)1 878 0827
E-mail: Dermot S.L. Butler (Chairman) dermot.butler@customhousegroup.com
or David P.M. Blair (Managing Director) david.blair@customhousegroup.com

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