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Tks General Dealers Form

The document is an application form for the registration of a business name, TKS GENERAL DEALERS, submitted by Tapiwa Kanini Sibanda. The applicant is a 29-year-old Zambian national planning to conduct financial services from their owner-occupied premises in Chamba Valley, with a proposed commencement date of February 1, 2025. The form includes personal details, business information, and a statutory declaration confirming the accuracy of the provided information.

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30 views2 pages

Tks General Dealers Form

The document is an application form for the registration of a business name, TKS GENERAL DEALERS, submitted by Tapiwa Kanini Sibanda. The applicant is a 29-year-old Zambian national planning to conduct financial services from their owner-occupied premises in Chamba Valley, with a proposed commencement date of February 1, 2025. The form includes personal details, business information, and a statutory declaration confirming the accuracy of the provided information.

Uploaded by

simonzimba12345
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Form III

(Regulations 3(1) and 9)(To be completed in duplicate)

(Act No. 16 of 2011)


The Registration of Business Names Regulations, 2011

Shaded elds for Certicate No.


Please complete in block letters ofcial use only Reference No.
Date and Time

Approved Name of Business: TKS GENERAL DEALERS


Ö

INDIVIDUAL/ FIRM
1. (a) Present Name(s) TAPIWA KANINI

(b) Surname(s) of Applicant(s)


SIBANDA
(c) Former Name(s)

(d) Age of applicant(s) 29 YEARS

2. (a) Nationality of applicant(s) ZAMBIAN

(b) Identity card - 272553/71/1


- National Registration
Card No.(s)
- Passport No.(s)

3. (a) Notication address

Telephone/Cell No(s). +260 975 880 064


Fax No.
Email address(es) [email protected]
(b) Residential address(es) CHAMBA VALLEY NEW PLOT 100

IF APPLICANT IS A CORPORATE BODY


4. (a) Company name and No.

(b) Business address


(c) Notication/Postal address
(d) Email address

GENERAL INFORMATION
5. Type of business or undertaking
to be conducted FINANCIAL SERVICES
6. Location of proposed business Plot No. 100 Is premises owner occupier or rented premises?
CHAMBA VALLEY OWNER OCCUPIER

7. Proposed date of commencement 01/02/2025


of business (dd/mm/yy)
8. Financial year end (dd/mm/yy) 01/02/2025

9. Have you previously held a NO


certicate of registration which
was suspended or cancelled by
the Registrar
If yes, specify details:………………………………………………………………………………………………………………
Reason for cancellation:……………………………………………………………………………………………………………

of cancellation:………………………………………………………………………………………………………………
10. Do you have a valid registration in NO
respect of any other business
name?
If yes, specify details:………………………………………………………………………………………………………………
Other existing business name:……………………………………………………………………………………………………
Date of registration:……………………………………………………………………………………………………………….
11. Business names previously held by Certicate No. Location
the applicant under the
Registration of Business Names
Act or similar legislation outside
Zambia
12. Do you have any interest by way of partnership/directorship/shareholding in any business or occupation other than
the one in respect of which the application relates? NO
If yes, specify details:………………………………………………………………………………………………………………
Other existing business name:……………………………………………………………………………………………………
Date of registration:…………………………………………………………………………………………………………………
13. STATUTORY DECLARATION
I/We TAPIWA KANINI SIBANDA do solemnly declare as follows:
(a) that the information provided in this Form is correct and true

and I /we make this solemn declaration conscientiously believing the same to be true to the
best of my/our knowledge and belief.

………………………………………………….
17/01/2025
……………………………..
Applicant‘s signature(s) Date

FOR OFFICIAL USE ONLY

Received by: ………………………………………………………………... …………………………..…


Ofcer Date

Receipt No.: …………………………………………………………………


OFFICAL
Date Received: ……………………………………………………………… STAMP
Amount Received: ………………………………………………………….
Serial No. of application: …………………………………………………..

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