1 Sheet No.

of

Token No. \ New Registration (for Income Tax, Sales Tax, Federal Excise, I.T W/H Agent or S.T W.H Agent ST or FED Registration, who already have NTN change in Particulars Small Company

N Current NTN

Apply for

Duplicate Certificate Trust Unit Trust Modarba

3 Category

Company

Company type

pvt

Public Ltd

Individual AOP 4 Status Registry 5 CNIC/PP No 6 Reg./Inc No. 7 Name Resident AOP Type =>

NGO HUF

Society Firm

Any other (pl specify)

INVESTMENT FUND (NOT HAVING PE IN PAKISTAN) Body of persons formed under a foreign law

Artificial Juridical Person

Non-Resident

Country of Non Resident

(for Individula only Non-Residents to write Passpost No.)
(for company & Registered AOP only)

Gender

Male

Female

Birth / Inc. Date

Name of Registered Person (Company Individual or AOP Name)

8 Address

Registered Office Address for Company and Mailing / Business Address for Individual & AOP, for all correspondence

Office / Shop / House / Flat / Plot No

Street / Lane / Plaza / Floor / Village

Block / Mohala / Sector / Road/ Post Office / etc

Province

District

City / Tehsil

Area / Town

Activity Code

Principal Activity

10 Register for 11 Rep. Type Representative / Authorized Rep. CNIC / NTN Address

Income Tax

Sales Tax

Federal Excise

Withholding agent for I/Tax

Withholding Agent for S/Tax

Revision N

Representative u/s 172 40-00-0804825-8

Authorized Rep. u/s 223 Name

In Capacity as A. F. FERGUSON & CO

CHARTERED ACCOUNTANTS

STATE LIFE BUILDING 1-B,

Office/Shop/House/Flat/Plot No

I.I. CHUNDRIGAR ROAD

Street/Lane/Plaza/Floor/Village Block/Mohala/Sector/Road/Post Office/etc

SINDH
Province

KARACHI
District City/Tehsil

KARACHI
Area/Town

12 Phone

(9221)
Area Code

32426682-6
Number

Mobile

0322
Area Code

2752250
Number

Fax

(9221)
Area Code

32415007
Number

13 E-Mail Directors/Shareholders/Partner

aff.t2@pk.pwc.com
Please provide information about top-10 Directors / Shareholders /Partners

(e-Mail address for all correspondence)

14 Total Director/Shareholder/Partner 15 Type NTN/CNIC/Passport No.

Total Capital Action

Name of Director / Shareholder/Partner

Share Capital

Share %

(Add/Remove)

NOT APPLICABLE

16 Other Activities 17 Activity Code

All Other Shareholders / Directors / Partners (in addition to 10) Other Business Activities in addition to the Principal Activity given at Sr-9 above

Action (Add/Close)

18 Total business / branches 19 Bus/Br. Serial 20 Bus/Br. Type

1 Provide details of all business / branches / outlets / etc. use additional copies of this form if needed Action Requested Add Change Close

Business / Branch Name

HQ/Factory/Showroom/Godown/Sub Off./etc

Address Business /Branches

Office/Shop/House/Flat/Plot No. Street/Lane/Plaza/Floor/Village Block/Mohala/Sector/Road/Post Office/etc

Province

District

City/Tehsil

Area/Town

21 Nature of Premises Possession owned Rented Others Owner's CNIC / NTN / FTN Owner's Name

22 Electricity Ref. No

Gas Connection installed

Yes

No

Gas Consumer No.

23 Phone No. Area Code Number

Business / Branch Start Date

Buisness / Branch Close Date if applicable

24

Total Bank Accounts

Provide details of all bank accounts, use additional copies of this form if needed

Bank Accounts

25 Account Sr. 26 A/C No. 27 Bank Name

Action Requested A/C Title City (NBP, MCB, UBL, City, etc)

Change

Close Type

Branch

28 Employer

Account Star Date

Account Close Date, if close action is required

29 30

NTN / FTN Address

Name

Not applicable City

Declaration

31 I, the undersigned solemnly declare that to the best of my knowledge and belief the information given above is correct and ocmplete. It is further declared that any notice sent on the e-mail address or the address given in the registry portion will be accepted as legal notice served under the law. 32 Date Passport No. Name of Applicant Signature