Rev 1
Rev 1
REV
2. Type of Business
1. Registered Name
(If an individual state surname first)
2. Trade Name
3. Date of Incorporation/ Birth
4. Date of Death (if applicable)
5. Date of Commencement of Trade
6. Registration No.
(If Company insert Certificate of Incorporation Number,
If individual insert national ID No.)
7. Physical Address GPS – Coordinates
8. Postal Address
9. National Province
10. City/Town/Growth Point
A. REVENUE HEADS
ITEM TAX HEAD ITEM TAX HEAD ITE TAX HEAD ITEM TAX HEAD
M
Intermediated Presumptive
Royalties on
1 ATM Levy 11 Money Transfer 21 Tax - Cottage 31
Minerals
Tax industry
Capital Gains Presumptive
Non - executive
2 Tax - 12 22 Tax - Hair 32 Stamp Duty
Directors Fees
Companies Salons
Capital Gains Presumptive
Non - Resident
3 Tax - 13 23 Tax - Informal 33 Tobacco Levy
Shareholders Tax
Individuals Trade
CGT
Withholding Non - Resident Presumptive Value Added
4 14 24 34
Immovable Tax on Fees Tax - Mining Tax
Property
CGT
Presumptive
Withholding Non - Resident VAT on
5 15 25 Tax - 35
Mrktble Tax on Interest Forced Sales
Restaurant
securities
Non - Resident VAT on
Customs Presumptive
6 16 Tax on 26 36 Imported
Duty - Prime Tax - Transport
Remittances Services
Property or
Customs VAT
Non - Resident Insurance
7 Duty - Private 17 27 37 Withholding
Tax on Royalties Commission
Imports Tax
Tax
Resident Withholding
Income Tax Pay As You
8 18 28 Shareholders 38 Tax on
Companies Earn [PAYE]
Tax Tenders
Income Tax Pension
Resident Tax on
9 Individual 19 Deduction 29
Fees
Employment Directive
Income Tax
Presumptive Tax - Resident Tax on
10 Individual 20 30
Bottle Store Interest
Trade
5 BOT
6 Industrial Park Developer
7 Operator of approved Tourist Facility
8 Non-resident Satellite broadcasting Services
9 Non-resident E-Commerce operator
10 Exporting manufacturing company
NOTES: (Use the Industry Classification table at the end of the form for information on the Industry
Names, Products or goods description and codes)
1. List below particulars of branches, divisions or other businesses associated with this business
Physical Address
Name of branch, division, subsidiary or
Others
(i)
(ii)
(iii)
(iv)
2. Information on Shareholders/Members/Partners
(i) Number of Resident Shareholders/Members/Partners
(ii) Number of Non-Resident Shareholders/Members/Partners
4. Details of Directors (attach schedule of all directors and their details as below)
Identification Number
Residential Address
Telephone number
Email Address
% Shareholding
Bank Balance
Name of Account Holder
Mobile Bank/Wallet Provider
Cell Number for Mobile Bank/Wallet Account
Physical Address
Telephone Number(s)
Fax Number
Cell Number(s)
E-mail address
Bank Balance
Name of Account Holder
d. Equipment
e. Plant and Machinery
f. Fixed Property
g. Other (Please specify)
CR14 ; CR6
Letter of Appointing Public Officer/ Representative
Proof of residence for Public Officer/ Representative
Certified Copy of Identity documents for Public Officer/
Representative
If any of the Particulars above change, you are advised to notify the Commissioner of such changes
within
14 days.
Date ………………………………………….
Signature……………………………………………………………………………………………..
1. There 21 industries listed below and identify one which represents the major compenent of
your business activities.
2. The table below lists the industries and specific activities/goods/products per industry.
Select the specific activities/goods/products based on industry selected above and note the
code.
SPECIFIC
INDUSTRY CODE ACTIVITIES/GOODS/PRODUCTS
Growing of cereals (except rice), leguminous
Agriculture, forestry and fishing 0111 crops and oil seeds
Agriculture, forestry and fishing 0112 Growing of rice
Growing of vegetables and melons, roots and
Agriculture, forestry and fishing 0113 tubers
Agriculture, forestry and fishing 0114 Growing of sugar cane
Agriculture, forestry and fishing 0115 Growing of tobacco
Agriculture, forestry and fishing 0116 Growing of fibre crops
Agriculture, forestry and fishing 0119 Growing of other non-perennial crops
Agriculture, forestry and fishing 0121 Growing of grapes
Agriculture, forestry and fishing 0122 Growing of tropical and subtropical fruits
Agriculture, forestry and fishing 0123 Growing of citrus fruits
Agriculture, forestry and fishing 0124 Growing of pome fruits and stone fruits
Growing of other tree and bush fruits and
Agriculture, forestry and fishing 0125 nuts
Agriculture, forestry and fishing 0126 Growing of oleaginous fruits
Agriculture, forestry and fishing 0127 Growing of beverage crops
Growing of spices, aromatic, drug and
Agriculture, forestry and fishing 0128 pharmaceutical crops
Agriculture, forestry and fishing 0129 Growing of other perennial crops
Agriculture, forestry and fishing 0130 Plant propagation
Agriculture, forestry and fishing 0141 Raising of cattle and buffaloes
Agriculture, forestry and fishing 0142 Raising of horses and other equines
Agriculture, forestry and fishing 0143 Raising of camels and camelids
Agriculture, forestry and fishing 0144 Raising of sheep and goats
Agriculture, forestry and fishing 0145 Raising of swine/pigs
Agriculture, forestry and fishing 0146 Raising of poultry
Agriculture, forestry and fishing 0149 Raising of other animals
Agriculture, forestry and fishing 0150 Mixed farming
Agriculture, forestry and fishing 0161 Support activities for crop production
Agriculture, forestry and fishing 0162 Support activities for animal production
Agriculture, forestry and fishing 0163 Post-harvest crop activities
Agriculture, forestry and fishing 0164 Seed processing for propagation
Hunting, trapping and related service
Agriculture, forestry and fishing 0170 activities
Agriculture, forestry and fishing 0210 Silviculture and other forestry activities
Agriculture, forestry and fishing 0220 Logging
Agriculture, forestry and fishing 0230 Gathering of non-wood forest products
Agriculture, forestry and fishing 0240 Support services to forestry
Agriculture, forestry and fishing 0311 Marine fishing
Wholesale and retail trade; repair of motor vehicles and motorcycles 4510 Sale of motor vehicles
Wholesale and retail trade; repair of motor vehicles and motorcycles 4520 Maintenance and repair of motor vehicles
Wholesale and retail trade; repair of motor vehicles and motorcycles 4530 Sale of motor vehicle parts and accessories
Sale, maintenance and repair of motorcycles
Wholesale and retail trade; repair of motor vehicles and motorcycles 4540 and related parts and accessories
Wholesale and retail trade; repair of motor vehicles and motorcycles 4610 Wholesale on a fee or contract basis
Wholesale of agricultural raw materials and
Wholesale and retail trade; repair of motor vehicles and motorcycles 4620 live animals
Wholesale and retail trade; repair of motor vehicles and motorcycles 4630 Wholesale of food, beverages and tobacco
Wholesale and retail trade; repair of motor vehicles and motorcycles 4641 Wholesale of textiles, clothing and footwear
Wholesale and retail trade; repair of motor vehicles and motorcycles 4649 Wholesale of other household goods
Accommodation and food service activities 5510 Short term accommodation activities
Camping grounds, recreational vehicle parks
Accommodation and food service activities 5520 and trailer parks
Accommodation and food service activities 5590 Other accommodation
Accommodation and food service activities 5610 Restaurants and mobile food service activities
Accommodation and food service activities 5621 Event catering
Accommodation and food service activities 5629 Other food service activities
Accommodation and food service activities 5630 Beverage serving activities
Administrative and support service activities 7710 Renting and leasing of motor vehicles
Renting and leasing of recreational and sports
Administrative and support service activities 7721 goods
Administrative and support service activities 7722 Renting of video tapes and disks
Renting and leasing of other personal and
Administrative and support service activities 7729 household goods
Renting and leasing of other machinery,
Administrative and support service activities 7730 equipment and tangible goods
Leasing of intellectual property and similar
Administrative and support service activities 7740 products, except copyrighted works
Administrative and support service activities 7810 Activities of employment placement agencies
Administrative and support service activities 7820 Temporary employment agency activities
Administrative and support service activities 7830 Other human resources provision
Administrative and support service activities 7911 Travel agency activities
Administrative and support service activities 7912 Tour operator activities
Administrative and support service activities 7990 Other reservation service and related activities
Administrative and support service activities 8010 Private security activities
Administrative and support service activities 8020 Security systems service activities
Administrative and support service activities 8030 Investigation activities
Administrative and support service activities 8110 Combined facilities support activities
Administrative and support service activities 8121 General cleaning of buildings
Other building and industrial cleaning
Administrative and support service activities 8129 activities
Landscape care and maintenance service
Administrative and support service activities 8130 activities
Combined office administrative service
Administrative and support service activities 8211 activities
Photocopying, document preparation
Administrative and support service activities 8219 and other specialized office support
activities
Administrative and support service activities 8220 Activities of call centres
Administrative and support service activities 8230 Organization of conventions and trade shows
Activities of collection agencies and credit
Administrative and support service activities 8291 bureaus
Administrative and support service activities 8292 Packaging activities
Administrative and support service activities 8299 Other business support service activities n.e.c.
Public administration and defence; compulsory social security 8411 General public administration activities
Regulation of the activities of providing
health care, education, cultural services and
Public administration and defence; compulsory social security 8412 other
social services, excluding social security
Regulation of and contribution to more
Public administration and defence; compulsory social security 8413 efficient operation of businesses
Public administration and defence; compulsory social security 8421 Foreign affairs
Public administration and defence; compulsory social security 8422 Defence activities
Public administration and defence; compulsory social security 8423 Public order and safety activities
Public administration and defence; compulsory social security 8430 Compulsory social security activities
Arts, entertainment and recreation 9000 Creative, arts and entertainment activities
Arts, entertainment and recreation 9101 Library and archives activities
Museums activities and operation of historical
Arts, entertainment and recreation 9102 sites and buildings
Botanical and zoological gardens and nature
Arts, entertainment and recreation 9103 reserves activities
Arts, entertainment and recreation 9200 Gambling and betting activities
Arts, entertainment and recreation 9311 Operation of sports facilities
Arts, entertainment and recreation 9312 Activities of sports clubs
Arts, entertainment and recreation 9319 Other sports activities
Activities of amusement parks and theme
Arts, entertainment and recreation 9321 parks
Other amusement and recreation activities
Arts, entertainment and recreation 9329 n.e.c.