Application for registration as a Taxpayer or Changing of Registered Particulars: Company IT77C Taxpayer Information TPINF01 Taxpayer ref. no. · Area code · Where registered details have changed, the applicant must only fill in the taxpayer reference number and the details that have changed Use capital letters and where applicable, mark with an “X” Company Details Registered Name Trading Name Registration No. Registration date (CCYYMMDD) Bus Tel No. Turnover Fax No. , R Cell No. Email address Nature of Business Voluntary Disclosure Programme Registered Address Unit No. Complex Is this registration made in respect of a VDP agreement with SARS? Street No. Street / Farm name VDP Application No. (if applicable) Suburb / District Y N Declaration City / Town Country code (e.g. South Africa = ZA) Postal Code I declare that the information furnished in this application is true, correct and complete. Postal Address Mark here with an “X” if same as above or complete your Postal Address XXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXX Please ensure you sign over the 2 lines of “X”s above Date (CCYYMMDD) Country code (e.g. South Africa = ZA) For enquiries go to www.sars.gov.za or call 0800 00 SARS (7277) Postal Code IT77C Version: v2013.0.4 Page 1 of 6 Updated on: 4/28/2015 Public Officer Details PODIF01 Surname Initials First two names Taxpayer ref. no. Date of Birth (CCYYMMDD) ID No. Passport No. Passport Country (e.g. South Africa = ZAF) Home tel no. Bus tel no. Passport issue date (CCYYMMDD) Cell no. Fax no. Date of Appointment (CCYYMMDD) Email Address Physical Address Unit No. Complex Street No. Street / Farm name (if applicable) Suburb / District City / Town Country code (e.g. South Africa = ZA) Postal Code Tax Practitioner Details (if applicable) Surname / Registered name Registration No. TPDIF01 Initials (if applicable) Tel No. Contact Email Trading Details Is the Company trading? TDINF01 Y N Financial year end (MM) If ‘No’, provide reason(s): IT77C Version: v2013.0.4 Page 2 of 6 Updated on: 4/28/2015 Three Main Partners Details (Only in case of partnership) MPDIF01 Number One Taxpayer ref no. Surname Initials ID No. Passport Country (e.g. South Africa = ZAF) Passport No. Number Two Taxpayer ref no. Surname Initials ID No. Passport Country (e.g. South Africa = ZAF) Passport No. Number Three Taxpayer ref no. Surname Initials ID No. Passport No. Passport Country (e.g. South Africa = ZAF) IT77C Version: v2013.0.4 Page 3 of 6 Updated on: 4/28/2015 Three Main Directors / Shareholders / Members Details MNDIF01 Number One Initials Surname Taxpayer ref. no Registered Name ID No. Date of Birth (CCYYMMDD) Passport No. Passport Country (e.g. South Africa = ZAF) Passport issue date (CCYYMMDD) Registration No. Number Two Initials Surname Taxpayer ref. no Registered Name ID No. Date of Birth (CCYYMMDD) Passport No. Passport Country (e.g. South Africa = ZAF) Passport issue date (CCYYMMDD) Registration No. Number Three Initials Surname Taxpayer ref. no Registered Name ID No. Date of Birth (CCYYMMDD) Passport No. Passport Country (e.g. South Africa = ZAF) Passport issue date (CCYYMMDD) Registration No. IT77C Version: v2013.0.4 Page 4 of 6 Updated on: 4/28/2015 Estate Details ESTIF01 Type of Estate Effective Date (CCYYMMDD) Meeting Dates for Company in Liquidation First meeting CCYYMMDD Voluntary liquidation Second meeting (CCYYMMDD) Special meeting (CCYYMMDD) Involuntary liquidation Other: Specify Representative Taxpayer Details Surname Initials First two names Taxpayer ref. no. Date of Birth (CCYYMMDD) ID No. Passport No. Passport Country (e.g. South Africa = ZAF) Home tel no. Bus tel no. Passport issue date (CCYYMMDD) Cell no. Fax no. Date of Appointment (CCYYMMDD) Email Address Physical Address Contact Numbers Unit No. Complex Tel No. Street No. Street / Farm name Cell No. (if applicable) Suburb / District Fax No. City / Town Country code (e.g. South Africa = ZA) Postal Code Capacity of Representative Postal Address Mark here with an “X” if same as above or complete your Postal Address Liquidator Administrator Other (Specify) Country code (e.g. South Africa = ZA) Postal Code IT77C Version: v2013.0.4 Page 5 of 6 Updated on: 4/28/2015 Information Required for Registration / Change of Registered Particulars RQINF01 The following information is required in order for SARS to process your application. Your application may be rejected where the required information has not been submitted. Documents required for company/cc/co-operatives/welfare organisations/association not for gain/other Copy of certificate of incorporation with a company/cc/co-operative (CR10 form) registration number Copy of the signed constitution Proof of Address General accounts: Municipal/business residential account/utility account i.e. rates and taxes/ water or electricity account/student fee account/medical aid statement/mortgage statement from mortgage lender/ All telephone network accounts/eToll account/Major retail accounts Government documents: Motor vehicle licence documentation/court order/subpoena/traffic fine/UIF payout document/pension payout document Insurance and investment documents: Life assurance document/short-term insurance document/health insurance document/funeral policy document/investment statement from share, portfolio or unit trust CRA01 form: Where the place of residence is in the name of a third party, a ‘Confirmation of Entity Residential / Business Address (CRA01) form must be completed by the third party. Legal document: Any statutory body, local government or any other legal document that bear the residential address of the taxpayer. Lease agreement: A valid lease agreement signed by the lessor. Bank Details Original letter from bank not older than one month confirming the account holder’s legal name; account number, account type; branch code and the date reflecting the date on which the account was opened Recent bank statement with original bank stamp ABSA bank eStamped statement Internet statement with or without an original bank stamp. A clear bank statement drawn from an ATM machine containing all the information such as the account holder's legal name, account number, account type, branch code and the date on which the bank account was opened. Representative taxpayer Copy of identity document/driving licence/passport//temporary identity document/asylum seekers certificate/permit Power of attorney (POA)/letter of authority authorising the practitioner/representative/public officer to act on behalf of the taxpayer For Office Use Only Initial year of liability Current financial year end (MM) FOINF01 Taxpayer Sub-Category Taxpayer Type Normal Mining Non-Provisional Assurance Exempt Provisional Suspense Code Suspense Effective Date (CCYYMMDD) Dormant IT77C Version: v2013.0.4 Page 6 of 6 Updated on: 4/28/2015