Taxpayer Details Update Form

Part A – Taxpayer information

2001547693
TPIN……………………………………………………………………………………………..
Emmanuel Mwansa
Full name……………………………………………………………………………………………………………………………………………….
Business Trading name………………………………………………………………………………………………………………………….
P.O. Box ……………………………………………………………………………………..
+260966993925
Cell Phone No……………………………………………………………………………..
Land lines……………………………………………………………………………………
emmanuelmwansa733@gmail.com
E-mail………………………………………………………………………………………….

Part B – Bank details

Name of bank:
Bank 1……………………….………………Account No ……………..……………Branch…….……..……………
Bank 2……………………….………………Account No ……………..……………Branch…….……..……………
Bank 3……………………….………………Account No ……………..……………Branch…….……..……………

Part C – Current physical address

81
Plot No. ……………………………………………………………………….……
Magam
Street…………………………………………………………………………..……
South Kalengwa Kalulushi
Area………………………………………Town………………………………….
Copperbelt
Province…………………………………………………………….……………..

Part D – Current contact address

Principal Contact Person’s Name ………………………………………………………….……………………………………………….
Contact Numbers………………………………………………………………………..………..……………………………………………….
E-mail…………………………………………………………….………………………………………………………………………………………

Part E – Declaration:
Emmanuel Mwansa
I ………………………………………………………………… declare that the information given in this form is true and
complete.
22/05/2024
Signature: …………………………………….………………………… Date: …………………………………………………..………………
Taxpayer
Capacity of signatory…………………………………………..……………………………………………………….………………………..

Part F – Official use:

Details updated on the system

by: .…………………………………………………………………….…
Sign: …………………………………………………………….………
Date: ………………………………………………………………….