Application for Investment license renewal

1. Page 1
2. Page 2

Order Number

Investment License Renewal Form

Issued under Section 22(5) of the Investment Code Act, 2019.The provision of the Investment Code Act, 2019 and Guidelines and Procedures brought into effect under it shall apply for Business Enterprise:

Investment License Number *

1. Applying on behalf of *

Myself

Entity
2. First Name *

3. Middle Name

4. Surname *

5. Nationality e.g. Ugandan *

6. ID Type *

Ordinary Passport

Diplomatic Passport

National ID
7. ID Number *

8. Gender *

Female

Male
9. Date of Birth *

10. Phone Number *

11. Email *

12. Tax ID number (TIN) *

13. Relationship with Entity/Company *

Director
Employee
Consultant/Agent
Corporation Secretary

14. Entity Type *

Company

Partnership
15. Entity Legal name *

16. Business Registration Number *

17. Date of Incorporation/Registration *

18. Tax Identification Number (TIN) *

19. Company Phone *

20. Company Email *

21. Entity Physical Address e.g. Plot 1 Baskerville, Kololo *

22.Business Activity Sector *

A – Agriculture, Forestry & Fishing
B- Minning & Quarrying
C – Manufacturing
D- Electricity, gas, Steam and air conditioning Supply
E-Water supply; sewerage, waste management and remediation activities
F -Construction
G- Wholesale & retail trade; repair of motor-vehicles & motorcycles
H – Transport & Storage
I – Accommodation and food service activities
J- Information & Communication
K – Financial and Insurance activities
L- Real Estate actives
M – Professional, Scientific & Technical Activities
N -Administrative & Support Service activities
O – Public administration & defence; Compulsory social security
P- Education
Q- Human Health & Social work activities
R – Arts, Entertainment & Recreation
S – Other Service Activities
T – Activities of households as employers; undifferentiated goods- and services-producing activities of households for own use
U – Activities of extraterritorial organizations and bodies
23. Describe business/project activity ? *

24. Location of the project e.g. E.g. Plot 1, Baskerville Avenue, Kololo, Kampala *

Geo Latitude

Geo Longitude

Located within Industrial Park

Yes

No
If yes, name of the Park

Project Implementation Status *

Operational

Implementation

Pre-Implementation

Closed

Abandoned
If closed/ abandoned, select the Project Close or Abandon Date

25. Share capital/Liability amount (USD)

26.Number of shares

27.Value per share (USD)

28. Please select the number of shareholders *
OneTwoThreeFourFiveSix

Shareholder One

29. Shareholder Type *

Individual

Entity
30. First Name *

31. Middle Name

32. Surname *

33.Nationality *

34. Gender *

Male

Female
35.Date of Birth *

36. ID Type *

Ordinary Passport

Diplomatic Passport

National ID
37. ID Number *

38. Tax Identification Number

39. Phone number *

40.Email Address *

41. Business Registration Number *

42. Percentage Shareholding *

43. Number of Shares *

44. Shareholder Address *

Shareholder Two

45. Shareholder Type

Individual

Entity
46. First Name

47. Middle Name

48. Surname

49.Nationality

50. Gender

Male

Female
51. Date of Birth

52. ID Type

Ordinary Passport

Diplomatic Passport

National ID
53. ID Number

54. ID Number

55. Tax Identification Number

56. Phone number

57.Email Address

58. Business Registration Number

59. Percentage Shareholding

60. Number of Shares

61. Shareholder Address

Shareholder Three

62. Shareholder Type

Individual

Entity
63. First Name

64. Middle Name

65. Surname

66.Nationality

67 Gender

Male

Female
68.Date of Birth

69. ID Type

Ordinary Passport

Diplomatic Passport

National ID
70. ID Number

71. Tax Identification Number

72. Phone number

73.Email Address

74. Business Registration Number

75. Percentage Shareholding

76. Number of Shares

77. Shareholder Address

Shareholder Four

78. Shareholder Type

Individual

Entity
79. First Name

80. Middle Name

81. Surname

82.Nationality

83. Gender

Male

Female
84.Date of Birth

85. ID Type

Ordinary Passport

Diplomatic Passport

National ID
86. ID Number

87. Tax Identification Number

88. Phone number

89. Email Address

90. Business Registration Number

91. Percentage Shareholding

92. Number of Shares

93. Shareholder Address

Shareholder Five

94. Shareholder Type

Individual

Entity
95. First Name

96. Middle Name

97. Surname

98. Nationality

99. Gender

Male

Female
100. Date of Birth

101. ID Type

Ordinary Passport

Diplomatic Passport

National ID
102. ID Number

103. Tax Identification Number

104. Phone number

105.Email Address

106. Business Registration Number

107. Percentage Shareholding

108. Number of Shares

109. Shareholder Address

Shareholder Six

110. Shareholder Type

Individual

Entity
111. First Name

112. Middle Name

113. Surname

114.Nationality

115. Gender

Male

Female
116.Date of Birth

117. ID Type

Ordinary Passport

Diplomatic Passport

National ID
118. ID Number

119 Tax Identification Number

120. Phone number

121.Email Address

122. Business Registration Number

123. Percentage Shareholding

124. Number of Shares

125. Shareholder Address

125. Loan Capital (Foreign)

126. Share Capital / Equity (Foreign)

127. Other Sources (Foreign)

128. Total (Foreign)

129. Loan Capital (Domestic)

130 Share Capital / Equity (Domestic)

131. Other Sources (Domestic)

132. Total (Domestic)