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EMP101e
EMPLOYEES’ TAX
SKILLS DEVELOPMENT LEVY
UNEMPLOYMENT INSURANCE FUND CONTRIBUTION
Application for registration
2009/07/01 SP V2.003

www.sars.gov.za
 EMP101e

FOR OFFICE USE Office date stamp

PAYE Reference number 7

SDL Reference number L
UIF Reference number U
Area code

Magisterial district

Please refer to the Guide for completion of Employer Registration application. (Your registration may be
delayed if you do not complete this application fully)

1. Particulars of person applying / liable for registration

PLEASE USE BLOCK LETTERS
Nature of person (Select applicable nature of person) C
A. Individual D. Public authority / Municipality G. Club
B. Partnership / Body of persons E. Association not for gain H. Welfare organisation
C. Company / CC / Shareblock F. Estate / Liquidation I. Trust

Initials (Only if nature of person is individual)

Legal name (In the case of an U N I T E D A F R I CA T O BA C CO MA N U F A C T UR I NG

individual, only the surname, and in the case
of a partnership, company, etc. name of
partnership, company, etc.) ( P T Y ) L T D
Trading or other name U N I T E D A F R I CA T O BA C CO MA N U F A C T UR I NG
( P T Y ) L T D
Preferred language English Afrikaans

Income tax reference number 9 4 3 6 5 7 1 1 6 1 VAT number 4 3 6 0 2 5 4 4 7 0

Date of birth C C Y Y M M D D Identity number

Registration number of Company / CC / Trust / Fund 2 0 0 8 / 0 2 5 2 4 0 / 0 7

Registration number of Co-operative / / /
If not South African resident state country of residence

Passport number FOR OFFICE USE Reason code

2. Particulars of business
Residential address if
individual

Postal code

Home telephone number (for Individuals) CODE T E L

Physical address of 3 3 7 - 3 3 8 NOR T H L A ND S B US I N E S S PA R K

the business
N EW MA R K E T ROA D NOR T H R I D I NG
RA ND B URG Postal code 2 1 6 9
Business telephone number 0 1 1
Facsimile number 0 1 1
Cellular phone number
 E-mail address u a t m a c c o u n t s@ f a s t m a i l . f m
Website address

Postal address 3 3 7 - 3 3 8 NOR T H L A ND S B US I N E S S PA R K

N EW MA R K E T ROA D NOR T H R I D I NG
RA ND B URG Postal code 2 1 6 9
State main activity MA N U F A C T UR I NG A ND D I S T R I B UT I O N O F
C I GA R E T T E S
Major division
Trade classification codes
(Refer to brochure - VAT / PAYE 403 available on the SARS website: www.sars.gov.za)
Activity within major division

3. Particulars of other branches / divisions

State the number of branches / divisions if separate branches / divisions that also exist
in the RSA

State the number of branches / divisions for which separate registration is required.

Furnish the trading or other name and / or VAT number of ALL branches / divisions
including those for which an application for separate registration will be made on an EMP102 form:

Name

VAT no 4

Name

VAT no 4

Name

VAT no 4

Name

VAT no 4

Name

VAT no 4

4. Liability particulars
Date on which the business commenced / will commence 2 0 10 - 0 3 - 0 1
Date on which the employer became / will become liable for registration for PAYE / UIF

Date on which the employer became / will become liable for registration for SDL / UIF 2 0 10 - 0 8 - 0 1

Information for Skills Development Levy purposes

State main sector and activity F O O D & B E V E R A G E S M A N U F A C T U R I N G
SETA classification codes (Refer to Guide for SDL) SETA code 0 9 Chamber / SIC code 3 0 6 0 0
Payroll information
R 1,440,000
Estimated payroll for the following 12 month period ,
Number of employees on which estimated payroll is based 13

Particulars of Exemptions (where applicable)

Employers who fall within the categories mentioned below are not liable for the payment of the levy in terms of section 1 of the Skills
Development Levies Act, but must however still register in terms of section 5(6) of the aforementioned Act.
Kindly mark a block with an “X” if applicable).

Any National / Provincial public service employer

Public Benefit Organisations

2009/07/01 SP V2.003

National / Provincial public entity, if more than 80% of your expenditure is defrayed from funds voted by Parliament

Municipalities to whom a certificate of exemption has been granted FOR OFFICE USE

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 5. Particulars for Employees’ Tax purposes
Method used (Indicate manual applicable format) Payroll name

Format in which the PAYE deduction tables are required (Mark only 1 block with an “X”)

B Guide for Employers iro Employees’ tax and manual tables

D1 SARSTax 2000 (Employees Tax Deduction Program) on CD

I Internet access to download manual tables and SARSTax 2000 updates

G None

If another computer program is used to calculate employees’ tax, program:

6. Particulars of 2 most senior partners / members / directors / shareholders / trustees

Initials E

Surname / Company / R U T A G A M I RWA

Close Corporation name

Income tax number Identity number

Registration number of Company / CC / Trust / Fund 2 0 0 8 / 0 2 5 2 4 0 / 0 7

Country of residence
Passport number
(non-resident) FOR OFFICE USE Reason code

Initials

Surname / Company /
Close Corporation name

Income tax number Identity number

Registration number of Company / CC / Trust / Fund

Country of residence
Passport number
(non-resident) FOR OFFICE USE Reason code

7. Particulars of representative Employer

The representative employer is a natural person residing in South Africa who is, in terms of paragraph 16 of the
Fourth Schedule of the Income Tax Act 58 of 1962 responsible for performing the duties of the employer as required
by the said Schedule. (Not applicable to individuals except if the individual is not a SA resident)

Initials A
Surname K A DA NGO

Trustee / Curator / Liquidator / Executor / Officer for Municipality / Public authority /

Capacity Public Officer Administrator / Judicial manager 3 Partner Treasurer Manager / Secretary / Council / Board

1 2 0 3 S P L E ND I D P L A C E
Physical address in South
Africa 1 1 8 P R I T C HA R D S T R E E T
(not postal box number)
J O HA N N E S B URG
Postal code 2 0 0 1
Contact telephone number 0C O1D E1 T E L

Cellular phone number

E-mail address u a t m a c c o u n t s@ f a s t m a i l . f m
ID / Passport number of the representative Employer
2009/07/01 SP V2.003

Representative employers’ must ensure that they are familiar with the provisions of the Fourth Schedule

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 8. Particulars of external auditor / bookkeeper / accountant / tax practioner (Where applicable)
Initials A
Surname / Company name K A DA NGO

Postal address 3 3 7 - 3 3 8 NOR T H L A ND S B US I N E S S PA R K

N EW MA R K E T ROA D NOR T H R I D I NG
RA ND B URG
Postal code 2 1 6 9
Practice number

Tax Practitioner registration number (section 67A) PR-

Contact telephone number 0C O1D E1 T E L

Cellular phone number

E-mail address u a t m a c c o u n t s@ f a s t m a i l . f m

9. Banking particulars (Must be a registered bank in South Africa)

Legal name of account holder
(must correspond to part 1)
U N I T E D A F R I CA T O BA C CO MA N U F A C T UR I NG

Type of account Current Savings 2 Transmission

Bank branch number (at least six numbers) 1 4 9 7 4 5 0 0

Account number 1 ,4 9 7 , 2 1 8 , 6 8 3

10. Attachments required of person applying for registration (Please tick blocks for the documents attached)
For office use
Individual Copy of the identity document of the individual

Partnership Copy of the identity documents of the 2 most senior partners of the partnership

Close Corporation / Company / Copy of the identity documents of the 2 most senior members / directors / shareholders / trustees
Trust / Fund
Close Corporation / Company / Copy of certificate of incorporation
Trust
Association not for Gain / Welfare Copy of constitution
Organisation / Club

Letter of Authority If application is presented by registered Tax practitioner

Documents to be submitted with all applications:

Original cancelled cheque or original letter from your banker

Copy of the identity document or copy of passport of the representative employer

Recent copy of the Business Municipal account or

Recent copy of the Residential Municipal account of individual, partner or representative employer

11. Declaration by representative Employer

I declare that:
(I) I am the representative employer and that the information furnished herein is true and correct and that all required documents are attached and,
(ii) I am fully aware of my duties and responsibilities as per the fourth schedule to the Income Tax Act 58 of 1962.

AARON KADANGO ACCOUNTANT C C Y Y M M D D

Name Signature Capacity of Representative Employer Date

12. Notes
1. Please read “Guide for Employers iro Employees’ Tax for more information regarding Employees’ Tax. Available on the SARS website:
2009/07/01 SP V2.003

www.sars.gov.za
2. An employer is deemed not to have applied for registration until the application form has been completed in full and all the required information and
documentation has been furnished.
3. A EMP 103 Registration Certificate confirming the registration number(s) will only be issued upon successful verification and validation.
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