409x Filetype XLS File size 0.28 MB Source: www.thedtic.gov.za
Sheet 1: Sheet1
| i | |||||||||||||
| HOW DID YOU FIND OUT ABOUT THE SCHEME? | |||||||||||||
| Road show/Exhibition/Presentation | the dti Group | the dti Website | NAACAM | ||||||||||
| the dti Regional Office | Private Sector Consultant | Network Facilitator | |||||||||||
| Advertisement: TV, Radio, Print | the dti Customer Contact Centre | NAAMSA | |||||||||||
| Please return completed forms by registed mail or by courier / hand delivery to: | |||||||||||||
| Postal Address | Physical Address | Courier address | Web address | ||||||||||
| www.thedti.gov.za | |||||||||||||
| Private Bag X84 | 77 Meintjies Street | 1 Esselen Street (Ground Floor) | |||||||||||
| Pretoria | Sunnyside | Shared Service Centre | Customer Contact Centre | ||||||||||
| 0001 | Pretoria | Sunnyside, Pretoria | 0861 843 384 +27(0)12 394 9500 |
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| 0002 | 0002 | ||||||||||||
| SECTION 1 | GENERAL INFORMATION | |||||||
| 1.1 SUPPORT APPLIED FOR | Component Manufacturer | Deemed Component Manufacturer | Tooling Company | |||||
| Bus Body Manufacturer | Truck Body Manufacturer | |||||||
| 1.2 ASSISTANCE APPLIED FOR (Application Type) | ||||||||
| New Component Manufacturer | Exisiting Component Manufacturer | |||||||
| 1.2 ASSISTANCE APPLIED FOR | ||||||||
| Capital Investment | Competitiveness Improvement | |||||||
| 1.3 TOTAL INVESTMENT IN ASSETS(rand value) | Year 1 | Year 2 | Year 3 | TOTAL | ||||
| 1.4 LIST OF ADDITIONAL INFORMATION | ||||||||
| - Incorporation documentation | ||||||||
| - Documents that prove funding of the required project value and/ or Board approval for the project | ||||||||
| - Business Plan (Overview of the entity and/or the project, detailed marketing, sales, production and cost benefit analysis) | ||||||||
| - Audited annual financial statements for the last three years (where applicable) | ||||||||
| - Letter of Intent / Purchase agreements | ||||||||
| SECTION A | APPLICANT INFORMATION | |||||||
| 2. ENTITY TYPE | Close corporation | Other | ||||||
| 3. ITAC REGISTRATION CERTIFICATE | ||||||||
| If Yes Certicate No | ||||||||
| 4. NAME OF APPLICANT | ||||||||
| 5.INCORPORATION NO | INCORPORATION DATE | |||||||
| 6. TRADING NAME | ||||||||
| 7. POSTAL ADDRESS | ||||||||
| POSTAL CODE | ||||||||
| 8. CONTACT PERSON | ||||||||
| Title | Mr | Prof | Sir | |||||
| 9. CONTACT DETAILS | (with area codes) | |||||||
| Fax | e.g. +(0)12 394 1234 | |||||||
| Mobile | e.g. +(0)83 394 1234 | |||||||
| Work | e.g. +(0)12 394 1234 | |||||||
| 10. NAME OF CONSULTANT COMPANY | ||||||||
| Name of contact person | ||||||||
| Fax | e.g. +(0)12 394 1234 | |||||||
| Mobile | e.g. +(0)83 394 1234 | |||||||
| Work | e.g. +(0)12 394 1234 | |||||||
| 11. FINANCIAL YEAR-END | e.g. February | |||||||
| 12. ASSISTANCE ENJOYED UNDER THE FOLLOWING PROGRAMMES | ||||||||
| PROGRAMME | APPROVED ENTITY NAME | APPROVED ENTITY NUMBER | PERIOD OF BENEFIT | |||||
| Enterprise Investment Programme (EIP) | ||||||||
| Small Medium Enterprise Development (SMEDP) | ||||||||
| Production Asset Allowance (PAA) | ||||||||
| Strategic investment project (SIP) | ||||||||
| National Industrial Participation Programme | ||||||||
| OTHER | ||||||||
| 13. TAX OFFICE | ||||||||
| VAT Number | TAX Number | |||||||
| TAX Clearance Certificate Number | TAX Clearance end date | |||||||
| 14. LITIGATION | Provide details of ongoing litigation | |||||||
| 15. BROAD-BASED BLACK ECONOMIC EMPOWERMENT BEE (For Statistical Use only) | Provide details of BEE scoring in terms of the B-BBEE Code of Good Practice | |||||||
| Level 8 contributor (>/=30 < 40) | Level 5 contibutor (>/=55 < 65) | Non-compliant/not verified | ||||||
| Level 7 contributor (>/=40 < 45) | Level 4 contibutor (>/=65 < 75) | BEE Score | ||||||
| Level 6 contributor (>/=45 < 55) | Above level 4 contributor (>/=75) | |||||||
| 15.1: If not B-BBEE compliant (below level 4), please provide plans towards achieving B-BBEE compliance during the incentive period | ||||||||
| SECTION A1 | INVESTMENT IN OTHER MANUFACTURING ENTERPRISES (where shareholding > 25%) | ||||||
| 16. ENTERPRISE NAME | |||||||
| INCORPORATION No. | INCORPORATION No. | ||||||
| 16.1 ENTERPRISE NAME | |||||||
| INCORPORATION No. | INCORPORATION No. | ||||||
| 16.2 ENTERPRISE NAME | |||||||
| INCORPORATION No. | INCORPORATION No. | ||||||
| 16.3 ENTERPRISE NAME | |||||||
| INCORPORATION No. | INCORPORATION No. | ||||||
| 16.4 ENTERPRISE NAME | |||||||
| INCORPORATION No. | INCORPORATION No. | ||||||
| 16.5 ENTERPRISE NAME | |||||||
| INCORPORATION No. | INCORPORATION No. | ||||||
| 16.6 ENTERPRISE NAME | |||||||
| INCORPORATION No. | INCORPORATION No. | ||||||
| 16.7 ENTERPRISE NAME | |||||||
| INCORPORATION No. | INCORPORATION No. | ||||||
| 16.8 ENTERPRISE NAME | |||||||
| INCORPORATION No. | INCORPORATION No. | ||||||
| 16.9 ENTERPRISE NAME | |||||||
| INCORPORATION No. | INCORPORATION No. | ||||||
| 16.10 ENTERPRISE NAME | |||||||
| INCORPORATION No. | INCORPORATION No. | ||||||
| Please make copies of section A1 if more businesses must be indicated | |||||||
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