Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1698830688631.pdf (Saint Kitts and Nevis)
Companies Regulations COMPANIES ORDINANCE OF NEVIS (Section 194) ANNUAL RETURN FOR LOCAL COMPANY 1.

Name of Company and Address of Registered Office FORM 28 2.

Company No.

3.

Reporting Period Return for the year ending December 31, 4.

Registered Office a.

Has there been a change in the location of the registered office 5.

Main type(s) of business activity during the reporting period?

b.

If yes, has Form 4 been filed?

Yes Yes No No 6.

Name(s) and Address(es) of Directors * a.


Has there been a change of director(s) during the reporting period?

b.

If yes, has a Form 9 been filed?

Yes Yes No No 7.

Name and Address of Secretary/ 8.

Corporate registers and records (ss.177 - 179) Assistant Secretary a.

Are the company registers and records kept at an address different from that of the registered office?

Yes No b.

If yes, state the address where kept and the name of any agent appointed to prepare and maintain same.

* 9.
* 9.

Financial Statements a.

Is the company a public company?

b.

If yes, have financial statements been filed in respect of the reporting period?

(s.154) c. If no, has a certificate of solvency been filed?

(s.155) Yes Yes Yes No No No 10.

Summary of Share Capital Classes of Shares No.

of Shares in class 11.

Jurisdictions in which the company carries on business a.

Does the company carry on business outside Nevis?

Yes No b.
Yes No b.

If yes, list the jurisdictions outside of Nevis where the company carries on business.

* Confirm that a Share Capital Schedule in Form 28A has been completed and attached to this Return.

Yes 12.

Real Property Has the company acquired a legal or equitable interest In land?

Yes No 13.

Registration of Charges (s.250) a.

State total amount of indebtedness of the company in in respect of mortgages and charges required to be registered b.

Has statement been filed in respect of this charge?
Yes No 14.

Corporate relationships a.

Is the company affiliated with or controlled by another company?

b.

If yes, name the affiliated company(ies) and describe the nature of the corporate relationship using ss.538-540 definitions.

* Yes No Name of Affiliated Company Relationship 15.

Certificate I, hereby certify that I am authorized by the reporting company to make this Return and that the information contained herein is true and correct to the best of my knowledge and belief.
Signature of Director/Officer Title Date * Continue on a separate page if necessary COMPANIES ORDINANCE OF NEVIS (Section 194) FOR M 28 ANNUAL RETURN FOR LOCAL COMPANY The Annual Return is a summary of information about a company including, but not limited to its business activities, the name and address of its directors and secretary, its share capital, interest in real property and corporate affiliation.
It is required to be filed by companies having share capital not later than 1st April in each year after incorporation or continuance under the Ordinance.

Late filing or failure to file the annual return is an offence for which a company is liable on summary conviction to a fine of $5,000.00.

A penalty of $10 for each day a company has committed this offence can also be imposed.

General: Yes or No responses are to be indicated by placing a tick in the applicable box.
INSTRUCTIONS Item 1: Item 2: Item 3: Item 4: Set out the full name of the company followed by the physical address of its registration office; State the company number; Insert the year of the reporting period; Indicate whether any changes have occurred in the location of the registered office during the reporting period and whether Notice of Change of Registered Office in the prescribed form was filed pursuant to s.176 of the Ordinance; Item 5: Briefly list the main type(s) of business activity carried on by the company during the reporting period; Item 6: State the first name, middle initial(s), last name and residential address of the Directors.
Indicate whether any changes have occurred in the directorship of the company during the reporting period and whether Notice of Change of Directors in the prescribed form was filed pursuant to s.77 of the Ordinance; Item 7: State the first name, middle initial (s), last name and residential address of the Company Secretary; Item 8: Item 9: Item 10: Item 11: In the event that the corporate records and registers required to be kept under ss.177-179 are not kept at the registered office of the company, indicate where they are kept and by whom; Indicate whether the company is a public company, and in the event of an affirmative answer, state whether financial statements have been filed with the Registrar in accordance with section 154 of the Ordinance.
Note that s.154 requires that a copy of financial statements be filed at least 21 days before each Annual Meeting of the Shareholders.

(All other companies are required to file Certificates of Solvency annually.

); Describe the class(es) of shares in the company by distinctive name or designation and the total number of shares in each class.
A Share Capital Schedule (Form 28A) shall accompany the Annual Return; Indicate whether the company carries on business outside the island of Nevis and if so, name the other jurisdictions where it carries on business; Item 12: Indicate whether the company has acquired an interest in land; Item 13: State the indebtedness of the company - secured by mortgages or charges; Item 14: Item 15: State whether the company is affiliated with another company within the meaning of ss.538 or 540 of the Ordinance, and it so, name all affiliated companies stating in each case the nature of the relationship between the affiliated company and the reporting company; Insert the first name, middle initial(s) and last name of the signatory to the Annual Return.
The return shall be certified by a director or officer of the company who has been duly authorized by the company to make the return.

The making of a false or misleading return is an office for which the person making the return is liable on summary conviction to a fine of $5,000.00 or to imprisonment for a term of 6 months, or both.