CC1 – Founding statement
Download CC1 Founding statement.doc
The form is always available to download and submit on paper.
Founding Statement
Before filling in the form, first see notes on page 2.
REGISTRATION NUMBER OF CORPORATION
DATE OF RECEIPT
Full name of corporation
Literal translation of name (if applicable)
Shortened form of name (if applicable)
Description of principal business
Date of end of financial year
Postal address
Address of registered office (not post office box)
Email address:
Name and address of accounting officer
(Attach written consent to appointment)
Full name of association or body of which accounting officer is a member
Membership/Practice No.
Signature of Accounting Officer ______________________________________________________________________
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CC 1
NOTES
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.
Where a person signs on behalf of a member, a power of attorney must be attached.
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.
If no identity document has been issued, a written statement to this effect must be attached.
Form CC 1 which does not comply with the requirements of the Act, regulations or these notes, will be rejected.
Particulars to be furnished under the heading “MEMBERS”.
Full names and surname. (if juristic person, mention name and capacity and if trustee, also mention name and particulars of testamentary trust).
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).
Size of interest expressed as a percentage.
Particulars of interest and fair value thereof.
Residential address
Postal address.
Signature of member or representative (where applicable).
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CC 1
NAME OF CORPORATION
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:
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CC1
NAME OF CORPORATION
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:
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CC 1
NAME OF CORPORATION
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
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
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
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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
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.
)
Signed at Windhoek this
Day of
Two Thousand and
REGISTRAR OF CLOSE CORPORATIONS
- (Delete if not applicable)
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CC 1
NAME OF CORPORATION
REGISTRATION NUMBER
The above-named corporation has been converted from company:
Reg. No.
)
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.
Name
Land-line number of applicant (if available);
Mobile number (compulsory);
Fax Number (if available);
E-mail Address (if available);
Name
Land-line number of applicant (if available);
Mobile number (compulsory);
Fax Number (if available);
E-mail Address (if available);
Name
Land-line number of applicant (if available);
Mobile number (compulsory);
Fax Number (if available);
E-mail Address (if available);
Name
Land-line number of applicant (if available);
Mobile number (compulsory);
Fax Number (if available);
E-mail Address (if available);
Name
Land-line number of applicant (if available);
Mobile number (compulsory);
Fax Number (if available);
E-mail Address (if available);
Name
Land-line number of applicant (if available);
Mobile number (compulsory);
Fax Number (if available);
E-mail Address (if available);
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)
N$ 150,00 fee payable in terms of the Act and as set out in the regulations
FOR OFFICE USE
Founding Statement registered
Registrar of Close Corporations
Date
Data Processing
Classification
Recorded
Signature and date