Application – Uptown Development Authority Bermuda

Uptown Development Authority Bermuda

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Applicant #1

Prefix

First Name

Middle Name

Last Name

Residential Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country *

Mailing Address (if different from above) *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country *

Home Phone

Work Phone

Cell Phone

Email *

Bermudian?YesNo

If No, please share your Nationality

ID Type

ID #

Applicant #2 (if applicable)

Prefix

First Name

Middle Name

Last Name

Residential Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Mailing Address (if different from above)

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Home Phone

Work Phone

Cell Phone

Email

Bermudian?YesNo

If No, please share your Nationality

ID #

ID Type

Development Company Details

Name of Business

Title

Business Start Date

Business Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country *

Payroll Tax ID #

Social Insurance #

Business StructurePartnershipIncorporated CompanyLLCCooperative

Registration #

Registered Company Name

Corporate Secretary

Registered Office Address

Parish/State

Postal / Zip

Country

Mailing Address

Parish / State

Postal / ZIP

Country

References & Other Contacts

Name of Professional Reference

Phone Number

Email Address

Name of Professional Reference

Phone Number

Email Address

Developer Governance History

Are you current with Payroll Tax, Social Insurance, or do you have an agreed payment plan?YesNo

If applicable, have you made all required Registrar of Companies filings?YesNo

Do you have any outstanding debts with Bermuda Credit Association?YesNo

Do you have any outstanding judgments or are you a defendant in any suits or legal actions?YesNo

Have you ever been convicted of an offense or fraud, dishonesty, or violence?YesNo

Development Site Details

Development Site Address *

Parish / State *

Postal / ZIP *

Development Site Sq. Footage

Development Site Zoning

Current Owner's Name

Email Address

Phone Number

Address:

2nd Floor, 19 Elliot Street,
City of Hamilton

Contact:

uptowndevelopment@bedc.bm

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