CC1 Application for registration of a Close Corporation SAMPLE
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REPUBLIC OF NAMIBIA CC 1
BUSINESS AND INTELLECTUAL PROPERTY AUTHORITY - BIPA
CLOSE CORPORATIONS ACT, 1988
(Sections 12, 13, 14, 24, 27, 29, 47 and 60)
(Regulations 2, 3 and 13)
Founding Statement
Before filling in the form, first see notes on page 2.
REGISTRATION NUMBER OF CORPORATION DATE OF RECEIPT
Full name of corporation ABC CONSTRUCTION CC Commented [LM1]: Please note, before submitting
an application for a CC to be registered, a client
should first obtain an approved name through the
submission of an application for a name reservation
Literal translation of name (if applicable) on Form CC8.
Shortened form of name (if applicable) Commented [LM2]: Only complete this space if
the shortened name has been approved. The
shortened name must be 7 characters long and
TO CONSTRUCT, AND RENOVATE PROPERTIES AND ALL RELATED derived from the full name of the corporation. An
Description of principal business ACTIVITIES. application for the reservation of a shortened
name can be submitted on form CC 8, the
Date of end of financial year LAST DAY OF MARCH EACH YEAR associated fee of N$75.00 is payable.
Postal address P O BOX 0000, WINDHOEK, NAMIBIA Commented [LM3]: Principal business on the form
CC1 must be the same as was provided with the
Address of registered office (not post office box)
approved name, if any activities are being added
NUMBER 000, WXYZ SUITES, LMK STREET, these must relate to the name as provided. Also
note regulated activities cannot be added after a
WINDHOEK, NAMIBIA name has been approved.
Email address: doeprop@xxxxmail.com.na Commented [LM4]: **Please note: in addition to the
requirements of the CC Act and Regulations, any
Name and address of accounting officer JOHN DOE additional information requested is in terms of
Section 4 of the Financial Intelligence Act, 2012 (Act
P O BOX 00000 No. 13 of 2012), as well as the Regulations
thereunder.
WINDHOEK
Commented [LM5]: In terms of Section 59(1) of the
Close Corporations Act; “Every corporation shall
appoint an accounting officer who has in writing
consented thereto”.
(Attach written consent to appointment)
Full name of association or body of which accounting officer is a member
NAMIBIA INSTITUTE OF PUBLIC ACCOUNTANTS (NIPA)
Membership/Practice No. NIPA XXXX
Signature of Accounting Officer ______________________________________________________________________ Commented [LM6]: In addition to issuing a
consent letter, a CC application must be signed
by the Accounting Officer to confirm and
authenticate the appointment.
-2- CC 1
NOTES
1. Form CC 1 must be written in block capitals or be typewritten, lithographed or printed in legible characters with deep
permanent black ink, and lodged in triplicate.
2. Where a person signs on behalf of a member, a power of attorney must be attached.
3. Minor children and other persons under legal disability must be assisted by their parents, guardians or representatives,
as the case may be, and the capacity must be stated.
4. If no identity document has been issued, a written statement to this effect must be attached.
5. Form CC 1 which does not comply with the requirements of the Act, regulations or these notes, will be rejected.
6. Particulars to be furnished under the heading “MEMBERS”.
(a) Full names and surname. (if juristic person, mention name and capacity and if trustee, also mention name and
particulars of testamentary trust).
(b) Identity number ((i) if no identity document has been issued, state date of birth and see par. 4 above.) ((ii) If
juristic person, mention registration number).
(c) Size of interest expressed as a percentage.
(d) Particulars of interest and fair value thereof.
(e) Residential address
(f) Postal address.
(g) Signature of member or representative (where applicable).
-3- CC 1
NAME OF CORPORATION
ABC CONSTRUCTION CC
REGISTRATION NUMBER
PART C
MEMBERS (ONE) 1
Full names and surname JANE DOE
Year Month Day
Identity number or date of birth (i) 7 0 0 4 2 0 0 0 0 0 0
Registration number (ii)
Percentage of interest 100% Particulars of contribution N$100.00 Commented [LM7]: Where a cc has more than 1
member, each member’s percentage share must
Residential address NUMBER 1234, DEF STREET, OLYMPIA, WINDHOEK, NAMIBIA be expressed as a percentage of 100 (the total
percentage of a corporation), otherwise express
as 100% if the cc has only 1 member.
Postal address P O BOX 0000, WINDHOEK, NAMIBIA
Email address: janedoe@xxxxmail.com.na Commented [LM8]: **Please note: in addition to the
requirements of the CC Act and Regulations, any
Signature of member or representative X additional information requested is in terms of
Section 4 of the Financial Intelligence Act, 2012 (Act
No. 13 of 2012), as well as the Regulations
thereunder.
Full names and surname
Commented [LM9]: NB. Each CC must be signed
by a member of representative and where a
representative sign the additional requirements
as expressed in Paragraphs 2 and 3 in the
Year Month Day guiding notes on page 2 must be provided in
Identity number or date of birth (i) addition to submitting the CC and the rest of the
required documentation.
Registration number (ii)
Percentage of interest Particulars of contribution
Residential address
Postal address
Email address:
Signature of member or representative
Witness Signature Date of signature Commented [LM10]: The signature and date of
Full names JOHN DOE signature of the witness must be reflected at all
times.
Residential address NUMBER 6247, KLM STREET, WINDHOE-WEST, WINDHOEK, NAMIBIA
Business address NUMBER 6247, KLM STREET, WINDHOE-WEST, WINDHOEK, NAMIBIA
Postal address P O BOX 000, EROS, WINDOEK
Commented [LM11]: **Please note: in addition to
the requirements of the CC Act and Regulations,
Email address: johndoe@xxxxmail.com.na any additional information requested is in terms of
Section 4 of the Financial Intelligence Act, 2012 (Act
No. 13 of 2012), as well as the Regulations
thereunder.
-4- CC1
NAME OF CORPORATION
ABC CONSTRUCTION CC
REGISTRATION NUMBER
PART C
MEMBERS
Full names and surname
Year Month Day
Identity number or date of birth (i)
Registration number (ii)
Percentage of interest Particulars of contribution
Residential address
Postal address
Email address:
Signature of member or representative
Full names and surname
Year Month Day
Identity number or date of birth (i)
Registration number (ii)
Percentage of interest Particulars of contribution
Residential address
Postal address
Email address:
Signature of member or representative
Witness Signature Date of signature
Full names
Residential address
Business address
Postal address
Email address:
-5- CC 1
NAME OF CORPORATION
ABC CONSTRUCTION CC
REGISTRATION NUMBER
PART C
MEMBERS
Full names and surname
Year Month Day
Identity number or date of birth (i)
Registration number (ii)
Percentage of interest Particulars of contribution
Residential address
Postal address
Email Address:
Signature of member or representative
Full names and surname
Year Month Day
Identity number or date of birth (i)
Registration number (ii)
Percentage of interest Particulars of contribution
Residential address
Postal address
Email address
Signature of member or representative
Witness Signature Date of signature
Full names
Residential address
Business address
Postal address
Email Address:
-6- CC 1
NAME OF CORPORATION ABC CONSTRUCTION CC
REGISTRATION NUMBER
PART C
MEMBERS
Full names and surname
Year Month Day
Identity number or date of birth (i)
Registration number (ii)
Percentage of interest Particulars of contribution
Residential address
Postal address
Email Address
Signature of member or representative
Full names and surname
Year Month Day
Identity number or date of birth (i)
Registration number (ii)
Percentage of interest Particulars of contribution
Residential address
Postal address
Email address
Signature of member or representative
Witness Signature Date of signature
Full names
Residential address
Business address
Postal address
Email address
-7- CC1
NAME OF CORPORATION
ABC CONSTRUCTION CC
REGISTRATION NUMBER
PART C
MEMBERS
Full names and surname
Year Month Day
Identity number or date of birth (i)
Registration number (ii)
Percentage of interest Particulars of contribution
Residential address
Postal address
Email address
Signature of member or representative
Full names and surname
Year Month Day
Identity number or date of birth (i)
Registration number (ii)
Percentage of interest Particulars of contribution
Residential address
Postal address
Email address
Signature of member or representative
Witness Signature Date of signature
Full names
Residential address
Business address
Postal address
Email address
-8- CC 1
REPUBLIC OF NAMIBIA
BUSINESS AND INTELLECTUAL PROPERTY AUTHORITY - BIPA
CLOSE CORPORATIONS ACT, 1988
(Section 13, 14, 27 and 60)
(Regulations 3, 10 and 13)
(To be lodged in triplicate together with the Founding Statement)
Certificate of Incorporation
REGISTRATION NUMBER OF CORPORATION
CC /
This is to certify that the Founding Statement (CC 1) of
ABC CONSTRUCTION CC
Has been registered and the above-named close corporation was this day incorporated in terms of the Close Corporation
Act, 1988
- The above-named corporation has been converted from a company:
(Reg. No. )
Day
Signed at Windhoek this of
Two Thousand and
REGISTRAR OF CLOSE CORPORATIONS
- (Delete if not applicable)
-9- CC 1
NAME OF CORPORATION
ABC CONSTRUCTION CC
REGISTRATION NUMBER
The above-named corporation has been converted from company:
Reg. No. )
FOR OFFICE USE
Founding Statement registered
Commented [LM12]: Please note that each
Registrar of Close Corporations application for the registration of a CC must be
N$ 150,00 fee payable submitted together with proof of payment of the
in terms of the Act and associated registration fee of N$150.00 an
Date as set out in the application not submitted with proof of payment is
regulations deemed incomplete. When making payment please
use the approved CC name as payment reference.
Data Processing
Classification
Recorded
Signature and
date
MEMBER (S) / WITNESS CONTACT DETAILS
**Please note: in addition to the requirements of the CC Act and Regulations, any additional information requested is requested in
terms of Section 4 Financial Intelligence Act (Act 13 of 2012), as well as the Regulations thereunder.
1. Name JANE DOE (MEMBER)
2. Land-line number of applicant (if available);
061 - 000000
3. Mobile number (compulsory);
08112000000
4. Fax Number (if available);
N/A
5. E-mail Address (if available);
j Jjanedoe@xxxxmail.com.na
1. Name JOHN DOE (WITNESS)
2. Land-line number of applicant (if available);
061 - 000000
3. Mobile number (compulsory);
08112000000
4. Fax Number (if available);
N/A
5. E-mail Address (if available);
j Jjohndoe@xxxxmail.com.na Commented [LM13]: **Please note: in addition to
the requirements of the CC Act and Regulations,
1. Name any additional information requested is in terms of
1. Land-line number of applicant (if available); Section 4 of the Financial Intelligence Act, 2012 (Act
No. 13 of 2012), as well as the Regulations
2. Mobile number (compulsory); thereunder.
3. Fax Number (if available);
4. E-mail Address (if available);
1. Name
2. Land-line number of applicant (if available);
3. Mobile number (compulsory);
4. Fax Number (if available);
5. E-mail Address (if available);
1. Name
2. Land-line number of applicant (if available);
3. Mobile number (compulsory);
4. Fax Number (if available);
5. E-mail Address (if available);
1. Name
2. Land-line number of applicant (if available);
3. Mobile number (compulsory);
4. Fax Number (if available);
5. E-mail Address (if available);