Registration form for Acquisition of Certificate of Authorization (For Service Providers Category B only)
1. Exhibit A –Business Registration forms
2. Exhibit B – Valid SSNIT Clearance Certificate
3. Exhibit C – Signed Application Letter
4. Exhibit D – Proof of payment of application fees
5. Exhibit E – Tax Clearance Certificate
6. Exhibit F – Completed Application form
7. Exhibit G – JVC plan (For Joint Venture Companies Only)
EXHIBIT F- APPLICATION FORM FOR ACQUISITION OF CERTIFICATE OF AUTHORIZATION
(FOR SERVICE PROVIDERS CATEGORY B)
1.0 Company Profile
COMPANY DETAILS
Company Name
Postal Address
Telephone Number(s)
Website Address
Email Address
Town/City
Region
Digital Address
CONTACT PERSON ( This person should have the authority to endorse this document)
Name
Position
Phone Number
E-mail Address
2.0 Type of Service (Tick Where applicable)
Item
Service
1
Legal
2
Financial
Banking
Audit
Advisory
Insurance
Other, specify……………………
3
Engineering, Technical Consultancy, Maintenance
Engineering
Technical Consultancy
Maintenance
Other, specify………………………….
4
Research and Development
5
Allied
Transport or Vehicle Hire
Vehicle Maintenance
Catering
Janitorial
6
Ancillary Service
7
Fuel, Water and Lubricant
Fuel
Water
Lubricant
8
Any Other Service, please specify …………………………….
3.0 Scope of Service (Please indicate the specific service you provide)
……………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………
4.0 Local Participation - Current Ownership and Shareholding structure (Attach the company registration
Documents for proof of ownership as Exhibit H)
*For Non-Joint Venture Companies*
Total Number
of Shares
Total Value
of shares
Name of
Shareholders
Nationality of
Shareholders
Contact
details of
shareholder
Individual
shares
allotment
percentage
shareholding
*Fo *For Joint Venture Companies (JVCs)*
Total Number
of Shares
Total
Value of
shares
List of
entities
within JV
Nationality of
entities
Contact details
of shareholders
Individual
shares
allotment
percentage
shareholding
*For JVCs, attach the company registration documents of each JVC partner as Exhibit A.
5.0 Executive and Senior Management Positions
No.
Names
Nationality
Contact Details
(Email and
Phone
Number)
Position
Job Description
6.0
7.0 Other Positions within the Company
Total Number of Staff
No. of Ghanaians
No. of Non- Ghanaians
EXHIBIT G – JVC PLAN
For Joint Venture Companies
For Joint Venture Companies, please also include, as part of your application, the following:
1. Board resolution of the two companies approving the incorporation of the joint venture company.
2. A plan clearly stating:
o the roles and responsibilities of the joint venture parties in the joint venture company;
o Tech Transfer Plan - the strategy for the transfer of technology and know-how to the
indigenous Ghanaian company.
3. Regulations of the Company covering, among other things, the following:
o Shares structure and the shareholder’s rights (including classes of shares and voting rights).
o Reserved Matters
o Dividend policy
o Transfer of Shares & Pre-emptive Rights
o Obligatory Transfer Events
o Board of Directors (Executive & Non Executive)
o Deadlock Provisions
o Tug Along Rights
