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    Companies Form 4

    Uploaded by

    Ken Mwamba

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Companies Form 4

    Uploaded by

    Ken Mwamba
    0 views2 pages

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    © All Rights Reserved
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    Download as docx, pdf, or txt
    0 views2 pages

    Companies Form 4

    Uploaded by

    Ken Mwamba

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    Form 4

    (Regulation 5)
    (In typescript and completed in duplicate)

    THE PATENTS AND COMPANIES REGISTRATION AGENCY

    The Companies Act, 2017


    (Act No. 10 of 2017)
    ____________

    The Companies (Prescribed Forms) Regulations, 2018


    (Section 42)
    Available at www.pacra.org.zm

    APPLICATION FOR CHANGE OF NAME

    PART A
    COMPANY DETAILS
    1. Company Number
    Indicate the 12 digit registration
    number
    Current Company Name
    2. Ensure that the name is captured
    exactly as it appears on the
    certificate of incorporation
    New Company Name
    3. Ensure that the name is captured
    exactly as approved at name
    clearance
    Phone Number Mobile
    4. Include the
    international code
    Landline
    (e.g. +260 for
    Zambia)
    5.
    Email Address
    6.
    Reason for Change
    7.
    Date of Resolution
    PART B
    DECLARATION

    I, the undersigned, declare that the information stated in this application true and correct.

    Identity Number:

    First Name:
    8.
    Surname:

    Capacity: Director Secretary

    Signature: Date:

    PART C
    PARTICULARS OF PERSON LODGING APPLICATION
    9.
    First Name
    10.
    Surname
    11. Gender
    12.
    Date of Birth
    13.
    Nationality
    Identity Type
    14. For Zambians: NRC
    For non-Zambians: NRC/Passport/
    Driver’s Licence/Resident Permit
    15.
    Identity Number
    16. Mobile
    Phone Number
    Landline
    17.
    Email Address
    Plot/House/
    Village
    Street
    Physical
    18. Area
    Address
    Town
    Province
    Country
    19.
    Signature: Date:

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