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EBO_V1

COMPULSORY BENEFICIAL OWNERSHIP REGISTER (CIPC)

IN TERMS OF: (Section 55 of the General Laws Amendment Act, 22 of 2022,
read with the amendments to the Companies Act and Companies Act Regulations).

Companies and Intellectual Property Commission (CIPC) is to keep a register of beneficial ownership (BO)
for companies and close corporations for shareholders and members of close corporations (CC’s) and NPC’s
with more than 5% beneficial ownership.

Beneficial ownership in respect of a company means, an individual who, directly or indirectly, ultimately
owns that company or exercises effective control over that company
. (Section 55 of the General Laws
Amendment Act, 22 of 2022, read with the amendments to the Companies
Act and Companies Act Regulations).

For your convenience we will file this compulsory shareholder registration, to CIPC, on your behalf.

The deadline, for existing companies, to file their shareholder register is 30 September 2023.
Newly registered companies must submit their shareholder register within 10 days of company registration.

Cost R500.00 excluding VAT

If you want Shelf Company Warehouse to file your Company Share Register on your behalf, please
completed the shareholder details below.

Appoint Shelf Company Warehouse

Billing Information

Who must the invoice be made out to?
Only complete if applicable
Postal Address
Postal Address
City
Province
Postal Code

WE WILL CONFIRM RECEIPT OF YOUR APPLICATION AND WILL GIVE YOU A REFERENCE NUMBER. PLEASE INDICATE HOW YOU WANT US TO NOTIFY YOU. THIS REFERENCE NUMBER IS TO BE USED WHENEVER YOU MAKE ENQUIRIES.

List Company  and Shareholders

Add Shareholder1

DETAILS OF SHAREHOLDERS

Shareholder Interest Type

INDIVIDUAL SHAREHOLDER DETAILS

Please complete the details of each Shareholder.

WE NEED ALL THE INFORMATION TO BE ABLE TO PROCEED WITH THE REGISTRATION.

DETAILS OF SHAREHOLDING COMPANY – SHAREHOLDERS

Please complete the details of each Shareholder.

WE NEED ALL THE INFORMATION TO BE ABLE TO PROCEED WITH THE REGISTRATION.

DETAILS OF SHAREHOLDING CC – MEMBERS

Please complete the details of each Shareholder.

WE NEED ALL THE INFORMATION TO BE ABLE TO PROCEED WITH THE REGISTRATION.

%
%
%
Shareholder Name
Shareholder Name
Full Fornames
Surname
Shareholder Name (of the company who is the shareholder)
Shareholder Name (of the company who is the shareholder)
Full Fornames
Surname
Member Name (of CC who is the shareholder)
Member Name (of CC who is the shareholder)
Full Fornames
Surname
Date on which shares were purchased.
Date on which member obtained “Member interest”
%
%
%
Class of Shares (Select the class or classes shares the individual shareholder own)
If the Class of Share selected is “Other”, please describe “Other “Share Classs
Class of Shares (Select the class or classes shares the company own)
If the Class of Share selected is “Other”, please describe “Other “Share Classs
Class of Shares (Select the class or classes shares the CC own)
If the Class of Share selected is “Other”, please describe “Other “Share Classs
Class of Shares (Select the class or classes shares the Trust own)
If the Class of Share selected is “Other”, please describe “Other “Share Classs
Are you a South Africa Citizen?

Maximum file size: 10MB

Maximum file size: 10MB

NB. A copy of shareholder’s ID is required. If you have the new CARD ID, kindly make copies of both sides. Upload FRONT of ID card.

Maximum file size: 10MB

NB. A copy of shareholder’s ID is required. If you have the new CARD ID, kindly make copies of both sides. Upload BACK of ID card.
DAY / MONTH / YEAR

Required upload size: 5MB – 15MB

Gender: are you
Demographic- are you:
Disability
Business Address of Shareholder
Business Address of Shareholder
Street / Building Number
Street Name
City / Town or Suburb
Province/State
Postal Code
Country
Business Address of CC Member
Business Address of CC Member
Street / Building Number
Street Name
City / Town or Suburb
Province/State
Postal Code
Country
Residential Address of Shareholder
Residential Address of Shareholder
Street / Building Number
Street Name
City / Town or Suburb
Province/State
Postal Code
Country
Residential Address of CC Member
Residential Address of CC Member
Street / Building Number
Street Name
City / Town or Suburb
Province/State
Postal Code
Country
Postal Address of Shareholder
Postal Address of Shareholder
If your Postal address is not the street address above, please provide us with your postal address i.e. P.O. Box, or Private Bag number.
City / Town or Suburb
Province/State
Postal Code
Country
Postal Address of CC Member
Postal Address of CC Member
If your Postal address is not the street address above, please provide us with your postal address i.e. P.O. Box, or Private Bag number.
City / Town or Suburb
Province/State
Postal Code
Country

To ensure approval of your shareholder listing by the Companies and Intellectual Property Commission (CIPC), it is crucial to provide the correct and unique cell phone numbers and email addresses for each shareholder.

CIPC will reject the listing if any cell phone numbers or email addresses are identical.

To ensure approval of your shareholder listing by the Companies and Intellectual Property Commission (CIPC), it is crucial to provide the correct and unique cell phone numbers and email addresses for each member.

CIPC will reject the listing if any cell phone numbers or email addresses are identical.

The cellphone number of each shareholder must be the shareholder’s own cell number.
The cellphone number of each memberr must be the members’s own cell number.
The email address of each shareholder must be the shareholder’s own email address.
The email address of each member must be the members’s own email address.
2nd Shareholder add

DETAILS OF SHAREHOLDER 2

Shareholder Interest Type

INDIVIDUAL SHAREHOLDER DETAILS

Please complete the details of each Shareholder.

WE NEED ALL THE INFORMATION TO BE ABLE TO PROCEED WITH THE REGISTRATION.

DETAILS OF SHAREHOLDING COMPANY – SHAREHOLDERS

Please complete the details of each Shareholder.

WE NEED ALL THE INFORMATION TO BE ABLE TO PROCEED WITH THE REGISTRATION.

DETAILS OF SHAREHOLDING CC – MEMBERS

Please complete the details of each Shareholder.

WE NEED ALL THE INFORMATION TO BE ABLE TO PROCEED WITH THE REGISTRATION.

%
%
%
Shareholder Name
Shareholder Name
Full Fornames
Surname
Shareholder Name (of the company who is the shareholder)
Shareholder Name (of the company who is the shareholder)
Full Fornames
Surname
Member Name (of CC who is the shareholder)
Member Name (of CC who is the shareholder)
Full Fornames
Surname
Date on which shares were purchased.
Date on which member obtained “Member interest”
%
%
%
Class of Shares (Select the class or classes shares the individual shareholder own)
If the Class of Share selected is “Other”, please describe “Other “Share Classs
Class of Shares (Select the class or classes shares the company own)
If the Class of Share selected is “Other”, please describe “Other “Share Classs
Class of Shares (Select the class or classes shares the CC own)
If the Class of Share selected is “Other”, please describe “Other “Share Classs
Class of Shares (Select the class or classes shares the Trust own)
If the Class of Share selected is “Other”, please describe “Other “Share Classs
Are you a South Africa Citizen?

Maximum file size: 10MB

Maximum file size: 10MB

NB. A copy of shareholder’s ID is required. If you have the new CARD ID, kindly make copies of both sides. Upload FRONT of ID card.

Maximum file size: 10MB

NB. A copy of shareholder’s ID is required. If you have the new CARD ID, kindly make copies of both sides. Upload BACK of ID card.
DAY / MONTH / YEAR

Required upload size: 5MB – 15MB

Gender: are you
Demographic- are you:
Disability
Business Address of Shareholder
Business Address of Shareholder
Street / Building Number
Street Name
City / Town or Suburb
Province/State
Postal Code
Country
Business Address of CC Member
Business Address of CC Member
Street / Building Number
Street Name
City / Town or Suburb
Province/State
Postal Code
Country
Residential Address of Shareholder
Residential Address of Shareholder
Street / Building Number
Street Name
City / Town or Suburb
Province/State
Postal Code
Country
Residential Address of CC Member
Residential Address of CC Member
Street / Building Number
Street Name
City / Town or Suburb
Province/State
Postal Code
Country
Postal Address of Shareholder
Postal Address of Shareholder
If your Postal address is not the street address above, please provide us with your postal address i.e. P.O. Box, or Private Bag number.
City / Town or Suburb
Province/State
Postal Code
Country
Postal Address of CC Member
Postal Address of CC Member
If your Postal address is not the street address above, please provide us with your postal address i.e. P.O. Box, or Private Bag number.
City / Town or Suburb
Province/State
Postal Code
Country

To ensure approval of your shareholder listing by the Companies and Intellectual Property Commission (CIPC), it is crucial to provide the correct and unique cell phone numbers and email addresses for each shareholder.

CIPC will reject the listing if any cell phone numbers or email addresses are identical.

To ensure approval of your shareholder listing by the Companies and Intellectual Property Commission (CIPC), it is crucial to provide the correct and unique cell phone numbers and email addresses for each member.

CIPC will reject the listing if any cell phone numbers or email addresses are identical.

The cellphone number of each shareholder must be the shareholder’s own cell number.
The cellphone number of each memberr must be the members’s own cell number.
The email address of each shareholder must be the shareholder’s own email address.
The email address of each member must be the members’s own email address.
3rd Shareholder add

DETAILS OF SHAREHOLDER 3

Shareholder Interest Type

INDIVIDUAL SHAREHOLDER DETAILS

Please complete the details of each Shareholder.

WE NEED ALL THE INFORMATION TO BE ABLE TO PROCEED WITH THE REGISTRATION.

DETAILS OF SHAREHOLDING COMPANY – SHAREHOLDERS

Please complete the details of each Shareholder.

WE NEED ALL THE INFORMATION TO BE ABLE TO PROCEED WITH THE REGISTRATION.

DETAILS OF SHAREHOLDING CC – MEMBERS

Please complete the details of each Shareholder.

WE NEED ALL THE INFORMATION TO BE ABLE TO PROCEED WITH THE REGISTRATION.

%
%
%
Shareholder Name
Shareholder Name
Full Fornames
Surname
Shareholder Name (of the company who is the shareholder)
Shareholder Name (of the company who is the shareholder)
Full Fornames
Surname
Member Name (of CC who is the shareholder)
Member Name (of CC who is the shareholder)
Full Fornames
Surname
Date on which shares were purchased.
Date on which member obtained “Member interest”
%
%
%
Class of Shares (Select the class or classes shares the individual shareholder own)
If the Class of Share selected is “Other”, please describe “Other “Share Classs
Class of Shares (Select the class or classes shares the company own)
If the Class of Share selected is “Other”, please describe “Other “Share Classs
Class of Shares (Select the class or classes shares the CC own)
If the Class of Share selected is “Other”, please describe “Other “Share Classs
Class of Shares (Select the class or classes shares the Trust own)
If the Class of Share selected is “Other”, please describe “Other “Share Classs
Are you a South Africa Citizen?

Maximum file size: 10MB

Maximum file size: 10MB

NB. A copy of shareholder’s ID is required. If you have the new CARD ID, kindly make copies of both sides. Upload FRONT of ID card.

Maximum file size: 10MB

NB. A copy of shareholder’s ID is required. If you have the new CARD ID, kindly make copies of both sides. Upload BACK of ID card.
DAY / MONTH / YEAR

Required upload size: 5MB – 15MB

Gender: are you
Demographic- are you:
Disability
Business Address of Shareholder
Business Address of Shareholder
Street / Building Number
Street Name
City / Town or Suburb
Province/State
Postal Code
Country
Business Address of CC Member
Business Address of CC Member
Street / Building Number
Street Name
City / Town or Suburb
Province/State
Postal Code
Country
Residential Address of Shareholder
Residential Address of Shareholder
Street / Building Number
Street Name
City / Town or Suburb
Province/State
Postal Code
Country
Residential Address of CC Member
Residential Address of CC Member
Street / Building Number
Street Name
City / Town or Suburb
Province/State
Postal Code
Country
Postal Address of Shareholder
Postal Address of Shareholder
If your Postal address is not the street address above, please provide us with your postal address i.e. P.O. Box, or Private Bag number.
City / Town or Suburb
Province/State
Postal Code
Country
Postal Address of CC Member
Postal Address of CC Member
If your Postal address is not the street address above, please provide us with your postal address i.e. P.O. Box, or Private Bag number.
City / Town or Suburb
Province/State
Postal Code
Country

To ensure approval of your shareholder listing by the Companies and Intellectual Property Commission (CIPC), it is crucial to provide the correct and unique cell phone numbers and email addresses for each shareholder.

CIPC will reject the listing if any cell phone numbers or email addresses are identical.

To ensure approval of your shareholder listing by the Companies and Intellectual Property Commission (CIPC), it is crucial to provide the correct and unique cell phone numbers and email addresses for each member.

CIPC will reject the listing if any cell phone numbers or email addresses are identical.

The cellphone number of each shareholder must be the shareholder’s own cell number.
The cellphone number of each memberr must be the members’s own cell number.
The email address of each shareholder must be the shareholder’s own email address.
The email address of each member must be the members’s own email address.
4th Shareholder add

DETAILS OF SHAREHOLDER 4

Shareholder Interest Type

INDIVIDUAL SHAREHOLDER DETAILS

Please complete the details of each Shareholder.

WE NEED ALL THE INFORMATION TO BE ABLE TO PROCEED WITH THE REGISTRATION.

DETAILS OF SHAREHOLDING COMPANY – SHAREHOLDERS

Please complete the details of each Shareholder.

WE NEED ALL THE INFORMATION TO BE ABLE TO PROCEED WITH THE REGISTRATION.

DETAILS OF SHAREHOLDING CC – MEMBERS

Please complete the details of each Shareholder.

WE NEED ALL THE INFORMATION TO BE ABLE TO PROCEED WITH THE REGISTRATION.

%
%
%
Shareholder Name
Shareholder Name
Full Fornames
Surname
Shareholder Name (of the company who is the shareholder)
Shareholder Name (of the company who is the shareholder)
Full Fornames
Surname
Member Name (of CC who is the shareholder)
Member Name (of CC who is the shareholder)
Full Fornames
Surname
Date on which shares were purchased.
Date on which member obtained “Member interest”
%
%
%
Class of Shares (Select the class or classes shares the individual shareholder own)
If the Class of Share selected is “Other”, please describe “Other “Share Classs
Class of Shares (Select the class or classes shares the company own)
If the Class of Share selected is “Other”, please describe “Other “Share Classs
Class of Shares (Select the class or classes shares the CC own)
If the Class of Share selected is “Other”, please describe “Other “Share Classs
Class of Shares (Select the class or classes shares the Trust own)
If the Class of Share selected is “Other”, please describe “Other “Share Classs
Are you a South Africa Citizen?

Maximum file size: 10MB

Maximum file size: 10MB

NB. A copy of shareholder’s ID is required. If you have the new CARD ID, kindly make copies of both sides. Upload FRONT of ID card.

Maximum file size: 10MB

NB. A copy of shareholder’s ID is required. If you have the new CARD ID, kindly make copies of both sides. Upload BACK of ID card.
DAY / MONTH / YEAR

Required upload size: 5MB – 15MB

Gender: are you
Demographic- are you:
Disability
Business Address of Shareholder
Business Address of Shareholder
Street / Building Number
Street Name
City / Town or Suburb
Province/State
Postal Code
Country
Business Address of CC Member
Business Address of CC Member
Street / Building Number
Street Name
City / Town or Suburb
Province/State
Postal Code
Country
Residential Address of Shareholder
Residential Address of Shareholder
Street / Building Number
Street Name
City / Town or Suburb
Province/State
Postal Code
Country
Residential Address of CC Member
Residential Address of CC Member
Street / Building Number
Street Name
City / Town or Suburb
Province/State
Postal Code
Country
Postal Address of Shareholder
Postal Address of Shareholder
If your Postal address is not the street address above, please provide us with your postal address i.e. P.O. Box, or Private Bag number.
City / Town or Suburb
Province/State
Postal Code
Country
Postal Address of CC Member
Postal Address of CC Member
If your Postal address is not the street address above, please provide us with your postal address i.e. P.O. Box, or Private Bag number.
City / Town or Suburb
Province/State
Postal Code
Country

To ensure approval of your shareholder listing by the Companies and Intellectual Property Commission (CIPC), it is crucial to provide the correct and unique cell phone numbers and email addresses for each shareholder.

CIPC will reject the listing if any cell phone numbers or email addresses are identical.

To ensure approval of your shareholder listing by the Companies and Intellectual Property Commission (CIPC), it is crucial to provide the correct and unique cell phone numbers and email addresses for each member.

CIPC will reject the listing if any cell phone numbers or email addresses are identical.

The cellphone number of each shareholder must be the shareholder’s own cell number.
The cellphone number of each memberr must be the members’s own cell number.
The email address of each shareholder must be the shareholder’s own email address.
The email address of each member must be the members’s own email address.
5th Shareholder add

DETAILS OF SHAREHOLDER

Shareholder Interest Type

INDIVIDUAL SHAREHOLDER DETAILS

Please complete the details of each Shareholder.

WE NEED ALL THE INFORMATION TO BE ABLE TO PROCEED WITH THE REGISTRATION.

DETAILS OF SHAREHOLDING COMPANY – SHAREHOLDERS

Please complete the details of each Shareholder.

WE NEED ALL THE INFORMATION TO BE ABLE TO PROCEED WITH THE REGISTRATION.

DETAILS OF SHAREHOLDING CC – MEMBERS

Please complete the details of each Shareholder.

WE NEED ALL THE INFORMATION TO BE ABLE TO PROCEED WITH THE REGISTRATION.

%
%
%
Shareholder Name
Shareholder Name
Full Fornames
Surname
Shareholder Name (of the company who is the shareholder)
Shareholder Name (of the company who is the shareholder)
Full Fornames
Surname
Member Name (of CC who is the shareholder)
Member Name (of CC who is the shareholder)
Full Fornames
Surname
Date on which shares were purchased.
Date on which member obtained “Member interest”
%
%
%
Class of Shares (Select the class or classes shares the individual shareholder own)
If the Class of Share selected is “Other”, please describe “Other “Share Classs
Class of Shares (Select the class or classes shares the company own)
If the Class of Share selected is “Other”, please describe “Other “Share Classs
Class of Shares (Select the class or classes shares the CC own)
If the Class of Share selected is “Other”, please describe “Other “Share Classs
Class of Shares (Select the class or classes shares the Trust own)
If the Class of Share selected is “Other”, please describe “Other “Share Classs
Are you a South Africa Citizen?

Maximum file size: 10MB

Maximum file size: 10MB

NB. A copy of shareholder’s ID is required. If you have the new CARD ID, kindly make copies of both sides. Upload FRONT of ID card.

Maximum file size: 10MB

NB. A copy of shareholder’s ID is required. If you have the new CARD ID, kindly make copies of both sides. Upload BACK of ID card.
DAY / MONTH / YEAR

Required upload size: 5MB – 15MB

Gender: are you
Demographic- are you:
Disability
Business Address of Shareholder
Business Address of Shareholder
Street / Building Number
Street Name
City / Town or Suburb
Province/State
Postal Code
Country
Business Address of CC Member
Business Address of CC Member
Street / Building Number
Street Name
City / Town or Suburb
Province/State
Postal Code
Country
Residential Address of Shareholder
Residential Address of Shareholder
Street / Building Number
Street Name
City / Town or Suburb
Province/State
Postal Code
Country
Residential Address of CC Member
Residential Address of CC Member
Street / Building Number
Street Name
City / Town or Suburb
Province/State
Postal Code
Country
Postal Address of Shareholder
Postal Address of Shareholder
If your Postal address is not the street address above, please provide us with your postal address i.e. P.O. Box, or Private Bag number.
City / Town or Suburb
Province/State
Postal Code
Country
Postal Address of CC Member
Postal Address of CC Member
If your Postal address is not the street address above, please provide us with your postal address i.e. P.O. Box, or Private Bag number.
City / Town or Suburb
Province/State
Postal Code
Country

To ensure approval of your shareholder listing by the Companies and Intellectual Property Commission (CIPC), it is crucial to provide the correct and unique cell phone numbers and email addresses for each shareholder.

CIPC will reject the listing if any cell phone numbers or email addresses are identical.

To ensure approval of your shareholder listing by the Companies and Intellectual Property Commission (CIPC), it is crucial to provide the correct and unique cell phone numbers and email addresses for each member.

CIPC will reject the listing if any cell phone numbers or email addresses are identical.

The cellphone number of each shareholder must be the shareholder’s own cell number.
The cellphone number of each memberr must be the members’s own cell number.
The email address of each shareholder must be the shareholder’s own email address.
The email address of each member must be the members’s own email address.
5th Shareholder add

Trust Beneficiaries details

Trust add shareholder