ZIMBABWE REVENUE AUTHORITY APPLICATION FOR NEW REGISTRATION FORM



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REV 1 ZIMBABWE REVENUE AUTHORITY APPLICATION FOR NEW REGISTRATION FORM PART [I] NATURE OF APPLICANT 1. Select appropriate category Individual Organisation Group 2. Type of Business Nature of applicant (Tick the appropriate) Private Company Public Company No. of Branches No. of Divisions Number of Subsidiaries Partnership Schools Hospitals Non Profit Making Organisation Churches P Individual in business Individual in employment Association Authority Estate Trust Colleges NGO Association Other (give details) Part [II]PARTICULARS OF APPLICANT

3. Registered Name (If an individual state surname first) 4. Trade Name 5. Date of Incorporation/ Birth 6. Date of Death (if applicable) 7. Date of Commencement of Trade 8. Registration No. (If Company insert Certificate of Incorporation Number, If individual insert national ID No.) 9. Physical Address GPS Coordinates 10. Postal Address 11. National Province 12. City/Town/Growth Point 13. Email Addresses 14. Telephone Number (s) 15. Fax Number 16. Cell Number (s) Part [III] REVENUE HEADS 17. Indicate where appropriate Value Added Tax P.A.Y.E Withholding Taxes (Specify) Presumptive Taxes (Specify) Income Tax Customs Duty Pension Deduction Directives Capital Gains Tax (for CGT only), ignore all sections below and complete supplementary CGT form Part [IV] INDUSTRY AND SECTOR DETAILS (select from attached schedule) 18.Industry Name 19.Sector Name PART [V] BRANCH /DIVISION/OTHER INFORMATION

20.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) 21. Information on Shareholders/Members/Partners (i) (ii) Number of Resident Shareholders/Members/Partners Number of Non-Resident Shareholders/Members/Partners 22. Shareholder s Details for Private Companies Name ID Number Number of Shares %age Shareholding Type of Shares 24. Details of Directors (List All and attach schedule) 1 2 3 4 5 6 7 8 Name of Director Business Partner Number Identification Number Executive/ non- Exec. Residential Address Telephone # Email Address % Shareholding.

PART [VI] BANK DETAILS The bank account to be in the name of the legal person or trading name. List all Bank Accounts. Bank 1 Bank 2 Bank 3 Bank 4 Bank 5 25. Name of Bank 26. Branch Name 27. Type of Account 28.Account Number 29. Bank Balance 30.Name of Account Holder PART [VII] PARTICULARS OF REPRESENTATIVE (Public Officer/ Liquidator /Executor/Administrator / Spouse (if sole trader) 37.Bussiness Partner Number 38. Surname 39. First Names 40.National ID Number - 41.Resident Permit Number - 42.Physical Address 43.Telephone Number(s) 44.Fax Number 45.Cell Number(s) 46.E-mail address SPOUSE BANK DETAILS Applicable to Sole Trader only Bank 1 Bank 2 Bank 3 Bank 4 Bank 5 47. Name of Bank 48. Branch Name 49. Type of Account 50.Account Number 51. Bank Balance 52.Name of Account Holder PART [VIII] PARTICULARS OF TAX CONSULTANT/TAX ADVISOR

53.Registered Name 54.Trade Name 55.Registered Number 56.Business Partner Number 57.Physical Address 58.Telephone Number(s) 59. E-mail Addresses (If an individual state surname first) (If different from above) PART [IX] INFORMATION FOR VAT REGISTRATION 60.Type of VAT Registration Compulsory Registration Voluntary Registration 61.Approximate figures for Past 12 Months Next 12 Months a. Taxable turnover b. Exempt turnover c. Value of Exports d. Value of imports 62. Assets at the time of registration Approximate Value $ a. Stocks of materials for manufacture or goods for resale b. Motor vehicles c. Furniture and Fittings d. Equipment e. Plant and Machinery f. Fixed Property g. Other (Please specify) PART [X] INFORMATION FOR PAYE REGISTRATION 63.Number of Payrolls 64.Payroll Developer 65.F.D.S Method used Average Forecasted 66.Number of Employees (Excluding directors) 67.Number of Directors/Partners/Member/Individuals 68.Number of Working Directors PART [XI] ATTACHMENTS

For whom required Registered Company Submit the following information where applicable Copy of Certificate of Incorporation Copy of Memorandum and Articles of Association Copy of current bank statement Copy of Identity documents, physical addresses and proof of residence for 2 directors CR14 ; CR6 Individual Letter of Appointing Public Officer/ Representative Proof of residence of representative Copy of current bank statement Other Organizations Partnership deed Constitution Proof of residence of representative Letter of Appointing Public Officer/ Representative Copy of current bank statement PART XII DECLARATION Warning: It is an offence to provide false information If any of the Particulars above change, you are advised to notify the Commissioner of such changes within 14 days. I.. (full name) hereby declare that the information given herein is correct and hereby apply for registration. Designation Date. Signature.. Region1 regmgrs.region1@zimra.co.zw Region2 regmgrs.region2@zimra.co.zw Region3 regmgrs.region3@zimra.co.zw Commissioner.General Commissioner.general@zimra.co.zw Commissioner.DomesticTaxes commissioner.domestictaxes@zimra.co.zw Case Managers casemanagers@zimra.co.zw