FORM A
REGISTRATION OF BUSINESS NAMES ACT, 1962 (ACT 151)
REGISTRATION OF BUSINESS NAME - SOLE PROPRIETORSHIP
(Sections 2)
INSTRUCTIONS: COMPLETE FORM WITH BLACK INK AND IN BLOCK LETTERS
PLEASE SPELL OUT ALL WORDS –NO ABBREVIATIONS
*INDICATES MANDATORY FIELD
(A)
Business Name:
To the Registrar of Companies: P. O. Box 118, Accra
General Nature of |
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Mining/Oil and Gas |
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Manufacturing |
Business : |
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Finance/Insurance/Real Estate |
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Commerce |
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Services |
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Construction/Civil Engineering |
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Farming/Fisheries |
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Transportation |
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Health/Pharmacy |
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Others |
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Information Communication Technology (ICT) |
Principal Activity: |
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Date of Commencement |
D D M M Y Y Y Y |
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ISIC Code |
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(B) |
Business Address Information |
Principal Place of Business
*House/Building/Flat (Name or House No. etc.) /LMB:
*Street:
*City:
*District:
*Region:
*Digital Address:
Form A Registration of Business Name – Sole Proprietorship Page 1 of 8
Ownership of Premises |
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Rented |
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Owner Occupied |
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Free Use |
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If Owner Occupied is it part rented? |
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Yes |
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No |
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If Yes provide details of Landlord |
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Landlords Name |
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(C) |
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Proprietor / Proprietress |
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Title |
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Mr |
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Mrs |
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Miss |
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Ms |
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Dr |
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First Name |
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Middle Name |
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Last Name |
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Gender |
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Male |
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Female |
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Date of Birth |
D |
D |
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M |
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M |
Y |
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Y |
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Y |
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Any Former Name |
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Nationality |
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Does Proprietor / Proprietress Have a Tax Identification Number (TIN)? |
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Yes |
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No |
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Section to be filled out by Proprietor / Proprietress who has a TIN |
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TIN |
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Section to be filled out by Proprietor / Proprietress who does not have a TIN |
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Type of Identification Used |
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Voters Card |
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National ID |
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Driver’s License |
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Date of Issue |
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Y |
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Date of Expiry |
D |
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M |
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Y |
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Country of Issue |
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Place of Issue |
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ID Number |
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Mothers Maiden Last Name |
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Mothers Maiden First Name |
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Marital Status |
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Single |
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Married |
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Divorced |
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Separated |
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Widowed |
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Widower |
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Town of Birth |
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Country of Birth |
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Region of Birth |
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District of Birth |
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Form A Registration of Business Name – Sole Proprietorship Page 2 of 8 |
Resident |
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Yes |
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No |
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Other Information |
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Importer |
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Exporter |
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Tax Consultant |
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Not Applicable |
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Current Tax Office |
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Old TIN |
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Employment Type |
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Self Employed |
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Employee |
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Employee of a Foreign Mission |
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Other (Specify) |
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Employers Name |
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Main Occupation |
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Section to be filled out if Proprietor / Proprietress Does Not have a TIN and is Self-employed
Nature of Business
Annual Turnover
No of Employees
Business Address:
House No.
Building Name
Street Name
Town / City
Location / Area
Country
Region
District
Ghana Digital Address
Section to be filled out by all Proprietors / Proprietresses (regardless of whether they have a TIN or not)
Mobile Number 1: |
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Mobile Number 2: |
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Phone Number 1: |
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Phone Number 2: |
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Fax: |
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E-mail Address: |
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Preferred Contact |
Mobile |
Email |
Letter |
Postal Address |
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Form A Registration of Business Name – Sole Proprietorship Page 3 of 8
Care of: |
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Postal Type |
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P O Box |
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PMB |
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DTD |
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Postal No |
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Postal Region |
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Postal Town |
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(D) |
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Residential Address of Proprietor or Proprietress |
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House No. |
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Building Name |
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Street: |
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Town / City: |
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Location / Area |
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Country: |
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Region: |
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District: |
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Ghana Digital Address |
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Ownership of Premises |
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Rented |
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Owner Occupied |
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Free Use |
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If Owner Occupied is it part rented? |
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Yes |
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No |
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If Yes provide details of Landlord |
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Landlords Name |
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(E) |
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Other Place(s) of Business |
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*House/Building/Flat |
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(Name or House No. |
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etc.) /LMB: |
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*Street: |
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*City: |
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*District: |
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*Region: |
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*Digital Address: |
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Ownership of Premises |
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Rented |
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Owner Occupied |
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Free Use |
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Form A Registration of Business Name – Sole Proprietorship Page 4 of 8
If Owner Occupied is it part rented? |
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Yes |
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No |
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If Yes provide details of Landlord |
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Landlords Name |
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(F) |
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Postal Address |
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Care of: |
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Postal Type |
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P O Box |
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PMB |
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DTD |
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Postal No |
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Postal Region |
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Postal Town |
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(G) |
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Contact |
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Phone No. 1: |
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Mobile No. 1: |
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Mobile No. 2: |
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Fax: |
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E-mail Address: |
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Website: |
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(H) |
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SME Details |
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No. of Employees Envisaged: |
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Revenue Envisaged: |
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(I) |
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Business Operating Permit (BOP) Request |
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Apply for BOP Now |
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Apply for BOP Later |
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Already have a BOP* |
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*Provide BOP Reference No. |
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(J) |
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Declaration |
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I, …………………………………………………………………………………………………………………….. declare that the information given
(Full name of Applicant) |
is correct and complete. |
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(Signature) |
Date (d d / m m / y y y y) |
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Form A Registration of Business Name – Sole Proprietorship Page 5 of 8 |
(K) |
Declaration (for an Applicant who cannot read or write) |
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N/B: I…………………………………………………..of………………………………………………………. (address) |
THUMB PRINT |
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hereby declare that I have read over the contents of this document to the Applicant in the |
OF THE |
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………………………. language and the Applicant appeared to understand same before thumb |
APPLICANT |
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printing. |
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………………………………………….. |
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(Signature) |
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Date (d |
d / m m / y |
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y |
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y |
y) |
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For Official Use Only |
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Date of Submission of Document: |
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D |
D |
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M |
M |
Y |
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Y |
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Y |
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Y |
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Transaction ID Number Allocated |
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ISIC Code |
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Office Description |
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(For instructions as to signing etc., see Notes on subsequent pages)
NOTES
This Form must be signed by the Applicant and sent by post, e-mail or electronically delivered to the Registrar of Business Names, P. O. Box 118, Accra, within 28 days after any change in any of the particulars registered. If the applicant cannot read/sign, his or her mark must be made and witnessed. The Witness must write his / her name clearly and give sufficient address.
If the change is in respect of the place of business, the applicant has to state the house number and street (if any) of the new place of business or adequate description of the principal place of business.
Failure, without reasonable excuse, to furnish the Registrar with the required statement of any change in the particulars registered within 28 days of such change will entail liability on conviction to a fine not exceeding GHC
10.00for every day during which the default continues and any statement which contains any false information signed by any applicant knowingly will entail liability and on conviction to imprisonment for a term not exceeding six months or to a fine not exceeding GHC 500.00 or to both such imprisonment and fine.
INSTRUCTIONS TO FILL SOLE PROPRIETOR FORM
Section A:
(i)Business Name: Here state the full name of the business (Name cannot imply ownership of more than 2 people for eg. &, and etc)
(ii)General Nature of Business: please tick (√) the appropriate column/columns applicable to your line of business
(iii)Principal Activity: Out of the above classification selected by you, kindly mention you principal business activity here.
(iv)Date of Commencement: Write here the commencement date of your business in the given format of (dd/mm/yyYY). The business must have commenced within 14 days before registration.
(v)ISIC: State appropriate ISIC code for principal activity
Form A Registration of Business Name – Sole Proprietorship Page 6 of 8
Section B:
Principal Place of Business
(i)State the House/Building/Flat (Name or House No. etc.) Landmark of Building (LMB) in which the business is situated.
(ii)State the Street in which the business is situated.
(iii)State the City in which the business is situated.
(iv)State the District in which the business is situated.
(v)State the Region in which the business is situated.
(vi)Indicate the Ghana Digital Address of the business (www.ghanapostgps.com)
(vii)Please tick ( √ ) the appropriate column for options against ‘‘Ownership of Premises’’.
(viii)Please tick ( √ ) the appropriate column against ‘‘If Owner occupied, is part rented.’’
(ix)State the Landlord's Name in full if appropriate
Section C:
Owner Information
(i)Please provide the First Name, Middle Name and Last Name of the Owner
(ii)Please indicate whether the Owner already has a Taxpayer Identification Number (TIN).
(iii)If the Owner already has a TIN please provide it
(iv)If the Owner does not already have a TIN please provide the required details including a valid means of identification (Ghana Voters Card, National Identity Card or Driving License) – this will permit Registrar-
General’s Department to submit an application for TIN on his / her behalf.
(v)For all Owners (regardless of whether they have a TIN or not) please provide their Title, Employment Type, Employers Name, Main Occupation, Marital Status, Country of Birth, Region of Birth, Nationality, Resident Status, indication of whether Owner is an Importer, Exporter or Tax Consultant, the Tax Office at which the Owner is currently registered (if applicable), ‘Old’ TIN of Owner (if applicable), Mobile Phone No., Phone No., Fax No., email address, preferred contact mode,
(vi)If the Director is self-employed please also provide: the Nature of Business, Annual Turnover, No. of employees
Section D:
Residential Address of Person Registering
(i)State the House/Building/Flat (Name or House No. etc.) Landmark of Building (LMB) in which the applicant is residing.
(ii)State the Street in which the applicant is residing.
(iii)State the City in which the applicant is residing.
(iv)State the District in which the applicant is residing..
(v)State the Region in which the applicant is residing..
(vi)Indicate the Ghana Digital Address of where the applicant is residing (www.ghanapostgps.com)
(vii)Please tick ( √ ) the appropriate column for options against ‘‘Ownership of Premises’’.
(viii)Please tick ( √ ) the appropriate column against ‘‘If Owner occupied, is part rented.’’
(ix)State the Landlord's Name in full if appropriate
Section E:
Other Places of Business
Each of the two addresses of this section should be filled in under following guidelines:
(i)State the House/Building/Flat (Name or House No. etc.) Landmark of Building (LMB) where branch of business is situated
(ii)State the Street where branch of business is situated
(iii)State the City where branch of business is situated
(iv)State the District where branch of business is situated
(v)State the Region where branch of business is situated
(vi)Indicate the Ghana Digital Address where branch of business is situated (www.ghanapostgps.com)
(vii)Please tick ( √ ) the appropriate column for options against ‘‘Ownership of Premises’’.
(viii)Please tick ( √ ) the appropriate column against ‘‘If Owner occupied, is part rented.’’
Form A Registration of Business Name – Sole Proprietorship Page 7 of 8
(ix) State the Landlord's Name in full if appropriate
Section F:
Postal Address
(i)Specifically mention the C/O against a specific person/company.
(ii)State the Postal Type by ticking ( √ ) the appropriate column from provided options.
(iii)State the complete Postal Number including Prefix and Number.
(iv)State the City.
(v)State the District
(vi)State Region
Section G:
Contacts
(I)One Mobile is mandatory and therefore must be provided. (ii) Phone No. Fax No., Email and Website are optional.
Section H:
SME Details
This section is optional if you fill it then please provide the Total Number of Employees and Revenue Envisaged in the spaces provided
Section I:
Business Operating Permit (BOP) Request
(I)Tick the appropriate box to indicate if you wish to apply for a Business Operating Permit (BOP) Now, Later or whether you Already have a BOP.
(II)If you already have a Business Operating Permit (BOP) please provide the Reference Number
Section J:
Declaration
(i)Here provide the Full Name of the Applicant.
(ii)Provide Signature and date of the Applicant.
Section K:
Declaration
(i)Here provide the Full Name of the Witness.
(ii)State the Residential Address of the Witness.
(iii)Mention here the Language in which the content of the form is read over by the witness for illiterate Applicants.
(iv)A literate person should endorse the Thumb Print of an illiterate person
Form A Registration of Business Name – Sole Proprietorship Page 8 of 8