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REGISTRATION OF BUSINESS NAME - SOLE PROPRIETORSHIP
REGISTRATION OF BUSINESS NAMES ACT, 1962 (Act 151)
*Business Name:
*General Nature of
Business:
(A)
Mining/Oil and Gas
Finance/Insurance/Real Estate
Services
Farming/Fisheries
Health/Pharmacy
Information Communication Technology (ICT)
Manufacturing
Commerce
Construction/Civil Engineering
Transportation
Others
*Principal Activity:
REGISTRATION OF BUSINESS NAMES ACT, 1962 (ACT 151)
REGISTRATION OF BUSINESS NAME - SOLE PROPRIETORSHIP
INSTRUCTIONS: COMPLETE FORM WITH BLACK INK AND IN BLOCK LETTERS
PLEASE SPELL OUT ALL WORDS –NO ABBREVIATIONS
*INDICATES MANDATORY FIELD
FORM A
(B) Business Address Information
Principal Place of Business
*House/Building/Flat
(Name or House No.
etc.) /LMB:
*Street:
*City:
*District:
*Region:
( C)
*TIN
*First Name:
Proprietor/Proprietress
Date of
Commencement:
Middle Name:
Form A: Registration of Business Name - Sole Proprietorship Page 1 of 5
(Section 2)
Form A: Registration of Business Name - Sole Proprietorship Page 2 of 5
d d / m m / y y y y
Any Former
Forename or Surname:
Residential Address of Proprietor or Proprietress(D)
*House/Building/Flat
(Name or House No.
etc.) /LMB:
*Street:
*City:
*District:
*Region:
Other Place(s) of Business(E)
Address:
*House/Building/Flat
(Name or House No.
etc.) /LMB:
*Street:
*City:
*District:
*P. O. Box:
PMB/DTD
*Region:
(F) Postal Address
*C/O
*Postal Type:
(Tick as applicable) P. O. Box PMB DTD
*Postal Number: Prefix Number
*Surname:
*City:
*Town:
Gender:
(please tick
appropriate box)
Male UnmarriedMarriedMarital Status:Female
Date of Birth:
Occupation:
Nationality:
Form A: Registration of Business Name - Sole Proprietorship Page 3 of 5
Date of Submission of Document:
Transaction ID Number Allocated:
International Standard Industrial
Classification (ISIC) Code:
Office Description:
(For instructions as to signing etc., see Notes on subsequent pages)
(dd/mm/yyyy)
For Official Use Only
(G) Contact
Phone No:
*Mobile No:
Fax:
E-mail Address:
Website:
(H) SME Details
(I) Declaration
I, declare that the information given
(Full name of Applicant) is correct and complete.
Signature
N/B: I of (address) hereby
declare that I have read over the contents of this document to the Applicant in the
language and the Applicant appeared to understand same before
thumb printing.
(signature)
THUMB PRINT
OF THE
APPLICANT
Date:
d d / m m / y y y y
(J) Declaration
(for an Applicant who cannot read or write)
Date:
d d / m m / y y y y
*Region:
No. of Employees
Envisaged
Revenue Envisaged
This Form must be signed by the applicant and sent by post to the Registrar of Business Names, P. O.
Box118,Accra,beelectronicallydeliveredorhanddeliveredtotheOfficesoftheRegistrar-General's
Department within twenty eight days after any change in any of the particulars registered. If the
individual cannot sign, his or her mark must be affixed and witnessed. The name and address of
witnessmustbestated.
Apersonwho,withoutreasonablecause,failstofurnishtheRegistrarwiththerequiredstatementof
any change in the particulars registered within twenty eight days is liable to a fine of one hundred
penaltyunitsforeachdayduringwhichthedefaultcontinues.
Apersonwhowillfullymakesafalsestatementonthisdocumentandknowsittobefalsecommitsan
offence and is liable on conviction to imprisonment for a term of not more than six months or to a
fineofnotmorethantwohundredpenaltyunitsortoboththeimprisonmentandthefine.
Section A
(I) Business Name: State the full name of the business (Name cannot imply ownership of more
thantwopeopleforeg.&,andetc)
(ii) General Nature of Business: please tick (✓) the appropriate column/columns applicable to
yourlineofbusiness
(iii)Principal Activity: Out of the above classification selected by you, kindly provide your
principalplaceofbusinessactivity.
(iv) Date of Commencement: Provide the commencement date of your business in the given
format of (dd/mm/yy). The business must have commenced within fourteen days before
registration.
Section B:
Principal Place of Business
(i) State House/Building/Flat (Name or House No. etc.) LandMark of Building (LMB) in which
thebusinessissituated.
(ii) StatetheStreetinwhichthebusinessissituated.
(iii) StatetheCityinwhichthebusinessissituated.
(iv) StatetheDistrictinwhichthebusinessissituated.
(v) StatetheRegioninwhichthebusinessissituated.
Section C:
Proprietor or Proprietress Information
(I) Provide accurate Taxpayer Identification Number (TIN) of the Proprietor or Proprietress.
(ii) Please provide First Name, Middle Name and Surname of the Proprietor or Proprietress.
(iii) Provide any Former Forename or Surname of Proprietor or Proprietress.
(iv) State the Date of Birth of the Proprietor or Proprietress in the given format of
(dd/mm/yyyy).
(v) State the Occupation of the Proprietor or Proprietress.
(vii) Tick appropriate Gender and Marital Status of the Proprietor or Proprietress.
INSTRUCTIONS TO FILL IN SOLE PROPRIETORSHIP FORM
NOTES
Form A: Registration of Business Name - Sole Proprietorship Page 4 of 5
Section D:
Residential Address of Person Registering
(I) State House/Building/Flat (Name or House No. etc.) LandMark of Building (LMB) in which the
applicantisresiding.
(ii) StatetheStreetinwhichtheApplicantisresiding.
(iii) StatetheCityinwhichtheApplicantisresiding.
(iv) StatetheP.O.Box,PrivateMailBag(PMB)/DoorToDoor(DTD)inwhichtheapplicantisresiding.
(v) StatetheDistrictinwhichtheApplicantisresiding.
(vi) StatetheRegioninwhichtheApplicantisresiding.
Section E:
Other Places of Business
Eachofthethreeaddressesofthissectionshouldbefilledinlinewiththefollowingguidelines:
(i) State House/Building/Flat (Name or House No. etc.) LMB where branch of your business is
situated.
(ii) StatetheStreetwherebranchofthebusinessissituated.
(iii) StateCitywherebranchofthebusinessissituated.
(iv) StateP.O.Box,PrivateMailBag(PMB)/DoorToDoor(DTD)wherebranchofthebusinessis
situated.
(v) StatetheDistrictwherebranchofthebusinessissituated.
(vi) StatetheRegionwherebranchofthebusinessissituated.
SectionF:
Postal Address
(i) SpecificallyindicatetheC/Oagainstaspecificpersonorcompanyisapplicable.
(ii) StatethePostalTypebyticking(✓)theappropriatecolumnfromtheoptionsprovided.
(iii) StatethecompletePostalNumberincludingPrefixandNumberinwhichthebusinessissituated.
(iv) StatetheTowninwhichthebusinessissituated.
(v) StatetheCityinwhichthebusinessissituated.
(vi) StatetheRegioninwhichthebusinessissituated.
Section G:
Contacts
(I) OneMobileNumberoftheapplicant ismandatory.
(ii) PleaseprovidePhoneNo., Fax,EmailAddressandWebsitewhereapplicable.
Section H:
SME Details
Please provide the Total Number of Employees and Revenue Envisaged for your business in the
spaces provided.
SectionI:
Declaration
(i) ProvidetheFullNameoftheApplicant.
(ii) ProvideSignature oftheApplicantanddate.
SectionJ:
PLEASE FILL WHERE APPLICANT CANNOT READ OR WRITE
(i) ProvidetheFullNameoftheWitness.
(ii) StatetheResidentialAddressoftheWitness.
(iii) Provide theLanguageinwhichthecontentoftheformisreadoverbythewitness(forilliterate
Applicants.)
(iv) A personwhois literateshouldendorsetheThumbPrintoftheApplicantwhoisilliterate.
Form A: Registration of Business Name - Sole Proprietorship Page 5 of 5

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E form a sp-registration

  • 1. REGISTRATION OF BUSINESS NAME - SOLE PROPRIETORSHIP REGISTRATION OF BUSINESS NAMES ACT, 1962 (Act 151)
  • 2. *Business Name: *General Nature of Business: (A) Mining/Oil and Gas Finance/Insurance/Real Estate Services Farming/Fisheries Health/Pharmacy Information Communication Technology (ICT) Manufacturing Commerce Construction/Civil Engineering Transportation Others *Principal Activity: REGISTRATION OF BUSINESS NAMES ACT, 1962 (ACT 151) REGISTRATION OF BUSINESS NAME - SOLE PROPRIETORSHIP INSTRUCTIONS: COMPLETE FORM WITH BLACK INK AND IN BLOCK LETTERS PLEASE SPELL OUT ALL WORDS –NO ABBREVIATIONS *INDICATES MANDATORY FIELD FORM A (B) Business Address Information Principal Place of Business *House/Building/Flat (Name or House No. etc.) /LMB: *Street: *City: *District: *Region: ( C) *TIN *First Name: Proprietor/Proprietress Date of Commencement: Middle Name: Form A: Registration of Business Name - Sole Proprietorship Page 1 of 5 (Section 2)
  • 3. Form A: Registration of Business Name - Sole Proprietorship Page 2 of 5 d d / m m / y y y y Any Former Forename or Surname: Residential Address of Proprietor or Proprietress(D) *House/Building/Flat (Name or House No. etc.) /LMB: *Street: *City: *District: *Region: Other Place(s) of Business(E) Address: *House/Building/Flat (Name or House No. etc.) /LMB: *Street: *City: *District: *P. O. Box: PMB/DTD *Region: (F) Postal Address *C/O *Postal Type: (Tick as applicable) P. O. Box PMB DTD *Postal Number: Prefix Number *Surname: *City: *Town: Gender: (please tick appropriate box) Male UnmarriedMarriedMarital Status:Female Date of Birth: Occupation: Nationality:
  • 4. Form A: Registration of Business Name - Sole Proprietorship Page 3 of 5 Date of Submission of Document: Transaction ID Number Allocated: International Standard Industrial Classification (ISIC) Code: Office Description: (For instructions as to signing etc., see Notes on subsequent pages) (dd/mm/yyyy) For Official Use Only (G) Contact Phone No: *Mobile No: Fax: E-mail Address: Website: (H) SME Details (I) Declaration I, declare that the information given (Full name of Applicant) is correct and complete. Signature N/B: I of (address) hereby declare that I have read over the contents of this document to the Applicant in the language and the Applicant appeared to understand same before thumb printing. (signature) THUMB PRINT OF THE APPLICANT Date: d d / m m / y y y y (J) Declaration (for an Applicant who cannot read or write) Date: d d / m m / y y y y *Region: No. of Employees Envisaged Revenue Envisaged
  • 5. This Form must be signed by the applicant and sent by post to the Registrar of Business Names, P. O. Box118,Accra,beelectronicallydeliveredorhanddeliveredtotheOfficesoftheRegistrar-General's Department within twenty eight days after any change in any of the particulars registered. If the individual cannot sign, his or her mark must be affixed and witnessed. The name and address of witnessmustbestated. Apersonwho,withoutreasonablecause,failstofurnishtheRegistrarwiththerequiredstatementof any change in the particulars registered within twenty eight days is liable to a fine of one hundred penaltyunitsforeachdayduringwhichthedefaultcontinues. Apersonwhowillfullymakesafalsestatementonthisdocumentandknowsittobefalsecommitsan offence and is liable on conviction to imprisonment for a term of not more than six months or to a fineofnotmorethantwohundredpenaltyunitsortoboththeimprisonmentandthefine. Section A (I) Business Name: State the full name of the business (Name cannot imply ownership of more thantwopeopleforeg.&,andetc) (ii) General Nature of Business: please tick (✓) the appropriate column/columns applicable to yourlineofbusiness (iii)Principal Activity: Out of the above classification selected by you, kindly provide your principalplaceofbusinessactivity. (iv) Date of Commencement: Provide the commencement date of your business in the given format of (dd/mm/yy). The business must have commenced within fourteen days before registration. Section B: Principal Place of Business (i) State House/Building/Flat (Name or House No. etc.) LandMark of Building (LMB) in which thebusinessissituated. (ii) StatetheStreetinwhichthebusinessissituated. (iii) StatetheCityinwhichthebusinessissituated. (iv) StatetheDistrictinwhichthebusinessissituated. (v) StatetheRegioninwhichthebusinessissituated. Section C: Proprietor or Proprietress Information (I) Provide accurate Taxpayer Identification Number (TIN) of the Proprietor or Proprietress. (ii) Please provide First Name, Middle Name and Surname of the Proprietor or Proprietress. (iii) Provide any Former Forename or Surname of Proprietor or Proprietress. (iv) State the Date of Birth of the Proprietor or Proprietress in the given format of (dd/mm/yyyy). (v) State the Occupation of the Proprietor or Proprietress. (vii) Tick appropriate Gender and Marital Status of the Proprietor or Proprietress. INSTRUCTIONS TO FILL IN SOLE PROPRIETORSHIP FORM NOTES Form A: Registration of Business Name - Sole Proprietorship Page 4 of 5
  • 6. Section D: Residential Address of Person Registering (I) State House/Building/Flat (Name or House No. etc.) LandMark of Building (LMB) in which the applicantisresiding. (ii) StatetheStreetinwhichtheApplicantisresiding. (iii) StatetheCityinwhichtheApplicantisresiding. (iv) StatetheP.O.Box,PrivateMailBag(PMB)/DoorToDoor(DTD)inwhichtheapplicantisresiding. (v) StatetheDistrictinwhichtheApplicantisresiding. (vi) StatetheRegioninwhichtheApplicantisresiding. Section E: Other Places of Business Eachofthethreeaddressesofthissectionshouldbefilledinlinewiththefollowingguidelines: (i) State House/Building/Flat (Name or House No. etc.) LMB where branch of your business is situated. (ii) StatetheStreetwherebranchofthebusinessissituated. (iii) StateCitywherebranchofthebusinessissituated. (iv) StateP.O.Box,PrivateMailBag(PMB)/DoorToDoor(DTD)wherebranchofthebusinessis situated. (v) StatetheDistrictwherebranchofthebusinessissituated. (vi) StatetheRegionwherebranchofthebusinessissituated. SectionF: Postal Address (i) SpecificallyindicatetheC/Oagainstaspecificpersonorcompanyisapplicable. (ii) StatethePostalTypebyticking(✓)theappropriatecolumnfromtheoptionsprovided. (iii) StatethecompletePostalNumberincludingPrefixandNumberinwhichthebusinessissituated. (iv) StatetheTowninwhichthebusinessissituated. (v) StatetheCityinwhichthebusinessissituated. (vi) StatetheRegioninwhichthebusinessissituated. Section G: Contacts (I) OneMobileNumberoftheapplicant ismandatory. (ii) PleaseprovidePhoneNo., Fax,EmailAddressandWebsitewhereapplicable. Section H: SME Details Please provide the Total Number of Employees and Revenue Envisaged for your business in the spaces provided. SectionI: Declaration (i) ProvidetheFullNameoftheApplicant. (ii) ProvideSignature oftheApplicantanddate. SectionJ: PLEASE FILL WHERE APPLICANT CANNOT READ OR WRITE (i) ProvidetheFullNameoftheWitness. (ii) StatetheResidentialAddressoftheWitness. (iii) Provide theLanguageinwhichthecontentoftheformisreadoverbythewitness(forilliterate Applicants.) (iv) A personwhois literateshouldendorsetheThumbPrintoftheApplicantwhoisilliterate. Form A: Registration of Business Name - Sole Proprietorship Page 5 of 5