APPLICATION FOR ADMISSION OF MEMBERSHIP - COMPANY

PINELANDS COMMUNITY IMPROVEMENT DISTRICT

Registration No.: 2023/828331/08
APPLICATION FOR ADMISSION OF MEMBERSHIP BY JURISTIC PERSON / OTHER BODY

To the Board of the Pinelands Community Improvement District NPC
Insert name of Juristic Person/Other Body*
hereby applies for membership and to be entered into the NPC's Membership Register.
General Note on Information

Under the Companies Act, the Members' Register must contain the following information in respect of each member: (a) name; (b) business, residential or postal address; (c) email address (unless person has declined to provide an email address); and (d) an identifying number unique to that person (e.g. in the case of a company, the company registration number or representatives ID number). However, the Pinelands Community Improvement District NPC will keep any email address provided confidential when any member or outside third party requests access to the Members' Register under the Companies Act, unless you give your written consent.
Details of Juristic Person / Other Body

Name of Company/ Close Corporation/ Trust/ Sectional Title Body Corporate/ Partnership/ Other Body (circle whichever is applicable):
Name of Company*
Registration no. (if any)
Physical Address*
Postal Address
NOTE: Where the body's physical address differs from its postal address, only its postal address will be recorded in the Members' Register.
Website address (if any)
Details of Representatives
Representative*
Designation*
ID number*
Contact Details of Representative:
Business tel.
Fax
Cell. No.*
Email address*
example@example.com
Notices and communication need to be addressed to the (tick appropriate box) :*

The physical addressThe postal addressThe email address
Details of Property

The aforesaid body is the registered owner/ co-owner (strike through whichever is not applicable), of the following property located within the Pinelands Community Improvement District.

	ERF	Physical Address	Unit Number (Apartment)
1
2
3
4
5

Warranty by Signatory

I am the authorised signatory of the abovementioned juristic person/ body (by resolution or letter of authorisation, a copy of which is attached hereto) , and warrant that I have the necessary authority to apply for membership of the Pinelands Community Improvement District NPC.
Name*

NameSurname
Email address*
example@example.com
ID number*
(Note: your identity number will be kept confidential and not disclosed to third parties, without your written consent).
Signature*

Clear
Signed at*
Date*

MonthDayYear
Date
Should be Empty:

PINELANDS COMMUNITY IMPROVEMENT DISTRICT

APPLICATION FOR ADMISSION OF MEMBERSHIP BY JURISTIC PERSON / OTHER BODY

General Note on Information

Details of Juristic Person / Other Body

Details of Representatives

Details of Property

Warranty by Signatory