Sworn Statement

I, First name and Surname: ________________________________________________________

Identity No.: ___________________________________, Sex: ___________________________

Occupation: ____________________, Company address: _______________________________

____________________________Telephone: _________________________________________

State under oath that the information below is the information of the (Name of business)

______________________________________________________________________________

UIF/ CK number (CK for companies without UIF

reference number)
Sector/ Industry classification
(Please see classification list attached)
Number of employees currently employed

Total Annual Turnover

Total Gross asset value (Excluding Fixed Assets)

I know and understand the contents of this statement. I have no objection to taking the
prescribed oath. I consider the prescribed oath to be binding on my conscience.

I swear that the contents of this statement are true.

_____________________ ______________
Signature of the deponent Date

COMMISSIONER OF OATHS
I certify that the deponent has acknowledged that he knows and understands the contents of this
statement. This statement was sworn before me and the deponent’s signature was placed hereon
in my presence at ___________________ on_________________________________________

Full name and Surname__________________________________________________________

Designation ___________________________________________________________________

Address ______________________________________________________________________

Tel/Cell no_____________________________________________________________________

______________________________ __________________
Signature of commissioner of Oaths Date
INDUSTRY APPROVED INDUSTRY SECTORS The total full Total Turnover Total gross
SECTOR ON time equivalent asset value
SIYAYA of paid (fixed property
employees excluded)

Agriculture Agriculture 100 R5m R5m

Taxi Industry Transport, Storage and 200 R26m R6m
Communications
Retail and Motor Trade and Repair
Services
Fishing Agriculture 100 R5m R5m
Mining Mining and Quarrying 200 R39m R23m
Building Construction 200 R26m R5m
Food Wholesale, Trade, Commercial 200 R64m R10m
Agents and Repair Services
Textiles Manufacturing 200 R51m R19m
Wood Industry Manufacturing 200 R51m R19m
Printing and Manufacturing 200 R51m R19m
Paper Industry
Rubber Manufacturing 200 R51m R19m
Leather Manufacturing 200 R51m R19m
Industry
Glass Manufacturing 200 R51m R19m
Iron Manufacturing 200 R51m R19m
Jewellers Manufacturing 200 R51m R19m
Trade Wholesale, Trade, Commercial 200 R64m R10m
Agents and Repair Services
Banking Finance and business services 200 R26m R5m
Air Transport 200 R26m R6m
Local Community, Social and Personal 200 R13m R6m
Authorities Services
Personal Community, Social and Personal 200 R13m R6m
Services Services
Entertainment Community, Social and Personal 200 R13m R6m
Services
Medical Community, Social and Personal 200 R13m R6m
Services Services
Professional Finance and Business Services 200 R26m R5m
Services
Educational Community, Social and Personal 200 R13m R6m
Services Services
Charitable Community, social and Personal 200 R13m R6m
Services
Private Community, Social and Personal 200 R13m R6m
Household Services

Compliance Directorate