Business and Intellectual Property Authority
Namibia Business Register

Forms & documents

CM 12 Statement of Payment of Commission on shares

Type
Statutory form
Form
CM12
Category
Company documents

Download CM 12 Statement of Payment of commision on shares.doc

The form is always available to download and submit on paper.

Form CM 12

REPUBLIC OF NAMIBIA

BUSINESS AND INTELLECTUAL PROPERTY AUTHORITY - BIPA

COMPANIES ACT 2004

(Section 86(2)) (Regulation 25(1))

STATEMENT OF PAYMENT OF COMMISSION ON SHARES

N.B. - To be lodged with the Registrar of Business before commission is paid

Name of Company

Authorised capital N$ ………………………

Authorised no par value shares

Number

Class

Nominal value per share

Number

Class

ISSUED SHARE CAPITAL

Amount of share capital of par value N$………………….

Stated capital N$ ……………………

Number

Class

Total amount paid

Number

Class

Issue price per share

SHARE CAPITAL TO BE ISSUED

Amount N$ ....................................

Number of no par value shares N$ ..............................

Number

Class

Issue price per share

Number

Class

Issue price per share

COMMISSION PAID ON SHARES ISSUED WITHIN THE TWO YEARS PRIOR TO THE DATE OF THIS STATEMENT

Date

Number

Class

Issue price, par

value shares

Issue price, no par

value shares

Rate of commission

paid

Total amount of

commission paid

COMMISSION TO BE PAID ON THE SHARES TO BE ISSUED IN TERMS OF THIS STATEMENT

Number

Class

Rate of commission

to be paid

Amount of com-

mission to be paid

Name, business and postal address of person to whom commission will be paid

Article of association authorising commission .......................................................................................................................

Reason for the payment of commission .................................................................................................................................

.................................................................................................................................................................................................

________________________________________________________________________________________________________________________________________________________________

Date ................................................................... .........................................................................................

Rubber stamp of company, if any, or of secretaries. Signature of Director/Manager/Secretary

Perforated

(To be completed by company)

Date of registration

____________________________________________________

The statement of payment of commission on shares in respect of the company

mentioned below has been registered on this day.

Name of company

Postal address

Registrar of Business

Date stamp of Business

Email address

Registration Office

Copyright: Business and Intellectual Property Authority, Namibia

Registration Number of Company

N$ 20,00 fee payable in terms of the Act and as set out in the regulations