Registration Fee.Shs.

24,000

THE REPUBLIC OF UGANDA

Statement of Particulars required to be given pursuant to the Business

Name Registration Act IN CASE OF A FIRM

This form must be signed either (a) by all the individuals who are partners (or if one or more of the partners is a
corporation, by a director or secretary thereof) or (b) by one individual who is a partner in the firm, or (c) by a director or
secretary of a corporation which is a partner in the firm; but in cases (b) and (c), a statutory declaration as to the truth of the
particulars contained in the form must be made as per reverse. (Vide sec. 6 of the Act).

1 – Business name to be registered.

Where a business is carried on under two or more business ………………………………………………………………………………….
Name, each of these business names must be stated.

2- General nature of the business. …...............................................................................................

3- Principal place of business. ……………………………………………………………………………….

Plot, Street and Postal Address.
………………………………………………………………………………..

4.- Present Christian name (or names), surname and age of each
of the individuals who are partners. ………………………………………………………………………………….
If any of the individuals who are partners are of non-European origin,
Such individual or individuals (as the case may be) must also state the ………………………………………………………………………………………….
Christian name (or names) or surname if his, her or their fathers respectively
…………………………………………………………………………………

5- Former Christian name ( or names), and surname (if any) of each

of the individuals who are partners. ……………………………………………………………………………….

……………………………………………………………………………….

6- Nationality of each of the individuals who are partners

If the Nationality stated is not the nationality or origin, such nationality ……………………………………………………………………………….
of origin must in any case be stated.
.……………………………………………………………………………....

7- Usual place of residence of each of the individuals who are partners. ………………………………………………………………………………..
Plot, Street and Postal Address.
……………………………………………………………………………….

………………………………………………………………………………..

8 – Other business occupation (if any) of each of the individuals

who are partners. ….…………………………………………………………………………………..……..

……………………………………………………………………………………………..

9- Date of commencement of business

The date need only be stated where the business was commenced after …………………………………………………………………………………
The 15th day of October 1918.
…………………………………………………………………………………………….

10- Corporate name of each corporation which is a partner.

…………………………………………………………………………………

11 – Registered or principal office of each corporation which is

a partner. ………………………………………………………………………………...

Dated this…………………………………..day of ……………………………………………………………..20.......

Signed: …..…………………………………………
……………………………………………..
……………………………………………..
 STATUTORY DECLARATION

I, …………………………………………………………………………………………………………………………………

of…………………………………………………………………………………………………………………………Uganda

DO SOLEMNLY AND SINCERELY declare that the particulars hereon are true and correct AND I make this
solemn declaration conscientiously believing the same to be true and by virtue of the Oaths Act.

DECLARED at ………………………………………..in this …………………………………………………….District

Of……………………………………………this…………………………….day of…………………………20…………

BEFORE ME,

…………………………………………………..
Magistrate/Commissioner for Oaths.