Legal Entity SPENN Agent Application Zambia
Enter your Full Name (as it appears on ID)
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First Name
Middle Name
Last Name
Enter your Phone Number
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Area Code
Phone Number
Nationality
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ID Number
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Gender
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Male
Female
N/A
Date of Birth
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Day
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Month
Year
2 digit day, 2 digit month, 4 digit year
Date
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Your Position In the Company
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Registered Business Name
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Business Registration Number
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Description of Commercial Activities
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Source of Funds for Agency Business
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Contact details of Director's / Company owners
Rows
Name
Email address
1
2
3
4
Business Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Upload Tax Payers Identification Certificate
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Business Registration Certificate
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PACRA Form
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Valid Business License
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Proof of Current Business Address (if different from TPIN)
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We hereby declare that: i. Our registered business has obtained the necessary consent of the regulatory authority and/or oversight body that we are subject to.ii. The agent’s financial activities do not contravene any of our business’ written law, parent statute, memorandum and articles of association or other constitutive documents or objects of our registered entity. iii. The above details statements provided in this form including the supporting documentations are true and correct in every aspect and that SPENN may rely on it.
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Tick to Confirm you Agree to the above Declaration
Please tick to confirm you have read, understood and agree to Terms & Conditions - https://www.spenn.com/t-c-for-direct-agent-zambia/
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I agree to Terms & Conditions
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