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EXPORT MARKETING AND

INVESTMENT ASSISTANCE
GROUP OUTWARD INVESTMENT &
OUTWARD SELLING TRADE
MISSIONS
APPLICATION FORM FOR
MANUFACTURING ENTITIES
All correspondence to EMIA should be sent to one of the following addresses:
POSTAL ADDRESS
(Registered Mai!
t"e dti Ca#$%s
EMIA& Di'isi()
*%idi)g A& Gr(%)d F((r
Pri'ate *ag X+,
Pret(ria
---.
P/0SICAL ADDRESS
(/a)d1C(%rier Deei'eries!
t"e dti Ca#$%s
EMIA& Di'isi()
*%idi)g A& Gr(%)d F((r
22 Mei)t3ies Street
S%))4side Pret(ria
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E66e7ti'e . O7t(8er 5-.9
Warning:
Under no circumstances should any application form andor the claim form be
altered! Amended applicationclaim forms will not be considered for
e"aluation!
#orrespondence that has not been properly addressed to t"e dti can be
incorrectly forwarded to other departments!
t"e dti does not accept responsibility for mail that has not been properly
addressed
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Se7ti() A : Parti7%ars (6 Missi() Parti7i$a)ts
%ame of the #ompany
Entity type &Please #ross ' Applicable(
&Pty( )td #lose #orp! *ole Prop! Partnership )imited +i"ision ,ther: Please specify
Address Fa7t(r4 1 /ead O66i7e
#ity
Pro"ince
Postal #ode
-elephone %umber
.acsimile
Mobile %umber
Web site address
Email address
#ontact Person +esignation:
#E,M+,wner
E/ports In"estment
Proposed -ra"eller
GROUP OUTWARD MISSIONS&
APPLICATION FORM FOR MANUFACTURING ENTITIES
T"is a$$i7ati() 6(r# #%st 8e s%8#itted t(get"er ;it" t"e 6((;i)g d(7%#e)ts&

(a! A 'aid< (rigi)a Ta= Ceara)7e Certi6i7ate ;"e) EMIA is re>%ired t( #a?e %$6r()t $a4#e)ts
(8! A 7($4 (6 a) e=$(rter@s registrati() 7erti6i7ate 6r(# C%st(#s & E=7ise
(7! C($ies (6 t"e 7erti6i7ate (6 I)7(r$(rati() as ;e as (6 a )a#e 7"a)ges e66e7tedA I) t"e 7ase (6 a s(e $r($riet(r< $ease s%8#it a
7erti6ied 7($4 (6 a S(%t" A6ri7a) ide)tit4 d(7%#e)tA
(d! A 7($4 (6 a 'aid $ass$(rt 6(r t"e $r($(sed tra'eerA
(e! C(#$re"e)si'e 7((%r 1 7(r$(rate 8r(7"%re (r CD ROM (6 t"e $r(d%7ts #a)%6a7t%red a)d 1 (r #ar?eted 84 t"e 7(#$a)4A (Fa=ed
7($ies ;i )(t 8e a77e$tedA!
(6! Latest a%dited Fi)a)7ia State#e)tsA Pease 7()s%t t"e G%idei)es 6(r s$e7i6i7 re>%ire#e)tsA
(g! I6 4(% are a C(##issi() Age)t< $ease s%8#it 7($ies (6 t"e age)74 agree#e)ts 6r(# #a)%6a7t%ri)g e)tities ;"i7" 4(% re$rese)tA
("! I6 4(% are a) E=$(rt Tradi)g /(%se $ease s%$$4 detais< 8r(7"%res a)d etters (6 $er#issi() 6r(# at east 9 #a)%6a7t%ri)g e)tities
t"at 4(% re$rese)tA
Purpose of participation
&.or I-I 0s only(
Application for:
&%ame of Mission and dates(
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Se7ti() *
%umber of Employees -urno"er last financial year
-otal assets &E/cluding fi/ed property( 2alue of fi/ed property
Indicate whether the entity is a:
Manufacturer 0ES %,
E/port -rading 3ouse 0ES %,
#ommission Agent44 0ES %,
,utsource Manufacturer 0ES %,
Pease i)di7ate t"e $er7e)tage (B! (6 (;)ers"i$ i) 4(%r e)tit4
*a7? O;)ed E)tit4
B
*a7? W(#a) O;)ed E)tit4
B
W"ite W(#a) O;)ed E)tit4
B
Disa8ed E)it4
B
%ame of related party *hort description of the relationship
*tate the number of products which can be manufactured per month and which are a"ailable for e/port
+escription 3s5#ode 6uantity Unit Price 7and 2alue )ocal #ontent
Detais (6 $r(d%7ts e=$(rted ('er t"e $ast t;( 4ears
+escription 3s5#ode 6uantity Unit Price 7and 2alue #ountry
E"ent Mission %ame +ate #ountry
4*ubmit letters of confirmation of representation
44*ubmit copies of agency agreements
Please consult the guidelines
+isclose information on related parties where the one party can e/ercise significant insignificant substantial insubstantial influence o"er another party
in ma8ing financial and operating decisions or can e/ercise control or 9oint control o"er the other party! Please refer to the EMIA guidelines: effecti"e 1
,ctober $;11
Se7ti() C : Pr(d%7t Ca$a7it4 (O%t;ard Sei)g Missi()s ()4!
Se7ti() D : Pre'i(%s Fi)a)7ia Assista)7e& Did 4(% re7ei'e a)4 6i)a)7ia assista)7e 6r(# EMIA d%ri)g t"e ast 9 4earsC (T"is i)7%des 8(t"
t"e I)di'id%a a)d Gr(%$ (66eri)gs s%7" as IE< PMR 1 FDI< NP< Gr(%$ Missi()s a)d ITI@s!A I6 4es< $ease 7(#$ete t"e i)6(r#ati() 8e(;
EMIA assistance recei"ed i!e! IE: %P: <roup
Mission or I-I
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Detais (6 ;"et"er $re'i(%s $arti7i$ati() res%ted i) a)4 e=$(rts 1 i)'est#e)ts&
I#$(rta)t I)6(r#ati()
Tra'e Arra)ge#e)ts
Pre6erred Ser'i7e Pr('ider& Dis7ai#er
AUT/ORISED OFFICIAL OF T/E ENTIT0
I:
In my capacity as
of
Desig)ati()
Na#e i) Pri)t
Date
-he +epartment of -rade and Industry &t"e dti( has appointed Preferred *er"ice Pro"iders: to the EMIA *cheme: for the pro"ision of -ra"el ser"ices!

It is the responsibility of the customer to ma8e the arrangements for air5tic8ets!-his includes the boo8ing: issue: payment and deli"ery stages!
EMIA will only consider claims in respect of tra"elling e/penses where t"e dti Preferred *er"ice Pro"iders or the respecti"e airline were utili=ed!
&Please refer to the guidelines pertaining to <roup Missions for full details on boo8ings through the rele"ant airline!(
Upon return from the e"ent: the originalcertified copy of the tic8ete5tic8et together with proof of payment &originalcertified copies of ban8 statements(:
original certified copies of all the boarding passes and certified copies of your passport should be submitted to t"e dti for reimbursement!
Please note that EMIA does not accept any liability relating to the non5performance or ser"ice deli"ery of the appointed Preferred *er"ice Pro"iders
pertaining to the transport of samples of air and tra"el arrangements!
Se7ti() E : De7arati() &-o be completed by all applicants(
am aware of the fact that the information which I ha"e submitted will ha"e a material bearing on the ad9udication of the application and if it: therefore:
subse>uently transpires that any information in the application and addenda was incorrect: or that certain information was omitted: -he +epartment of
-rade and Industry shall be entitled to withdraw or amend its appro"al and without pre9udice to its rights: reco"er any amounts already paid or to withhold
further payments due! I further underta8e to furnish follow5up reports on the successes achie"ed by the "isit no later than si/ months after my return!
(Fai%re t( s%8#it t"e 6((; %$ re$(rts 7a) res%t i) 4(%r e)tit4 8ei)g e=7%ded 6r(# 6%t%re assista)7e %)der t"e EMIA s7"e#eA!
This application (with any addenda), if successful, will form part of your contract with The Department of Trade and Industry. Please Note: Cessions of
the incentives ranted are not allowed unless consented to in writin !y the dti. "ny cessions of these #$I" incentives or part thereof invalidate the
contract from the date such cession is effected. The dti reserves the riht to cede or transfer its rihts to any other %overnment "ency.
I)de#)it4&
-he organiser participants indemnify and shall hold harmless t"e dti against any claims: damages: e/penses and costs &including those asserted by
third parties( directly or indirectly related to this -rade Mission and the E/port Mar8eting and In"estment Assistance pro"ided to the mission participants
by t"e dti: in delict: for breach of statutory duty or otherwise!
Sig)ed &Authorised ,fficial of Entity(
D(7%#e)t C"e7?ist (O%t;ard I)'est#e)t & Sei)g Missi()s!
&d( A "alid current ,riginal -a/ #learance #ertificate when EMIA ma8es upfront payments for logistics
&e( A copy of an e/porter0s registration certificate from #ustoms ? E/cise!
&g( A copy of the proposed tra"eller0s passport!
&i( )atest audited .inancial *tatements in the case of a company! Please consult the <uidelines for specific re>uirements!
&9( If you are a #ommission Agent: please submit copies of agency agreements from manufacturing entities which you represent!
@indly ensure that all the re>uired documentation is attached to the application in the following order! Please tic8 in the last column the
documentation submitted!
7efer to
Mission
<uidelines for
details
&a( A detailed moti"ation and mar8et research information for the mission to be submitted by t"e Missi() Orga)iserA Please refer to
the Mission Moti"ation -emplate for details to be co"ered: such as:
&1( Arief bac8ground and o"er"iew
&$( Purpose of the mission: including clear: measurable ob9ecti"es and outcomes
&1( +uration of the mission and mission plan
&4( 3ow will the mission support the mandate
of sustainable *MME support and 3+I de"elopment
&b( A detailed mission plan for each of the participants by t"e Missi() Orga)iser containing information on the companies targeted!
&%ote: wee8ends and public holidays are e/cluded!(
&c( A detailed business plan (O)4 a$$i7a8e t( O%t;ard I)'est#e)t Missi()sA!
&f( #opies of the certificate of Incorporation as well as of all name changes effected! In the case of a sole proprietor: please submit a
certified copy of a *outh African identity document!
&h( #omprehensi"e colour corporate brochure or #+ 7,M of the products &or ser"ices( manufactured and or mar8eted by the
company &.a/ed copies will not be accepted(
&8( If you are an E/port -rading 3ouse please supply details: brochures and letters of permission of manufacturing entities which you
represent!