PAYROLL TAXES Application for registration

1 For registrationEMP101ePAYROLL TAXESEMP101eFOR OFFICE USEArea codeMagisterial districtLOffice date stampPAYE Reference number7 SDL Reference numberUUIF Reference numberA. IndividualB. PartnershipC. Company/CC/Co-operative(CIPRO reg. entity)D. Government/Public or Local authorityE. Association not for gainG. ClubH. Welfare OrganisationI. TrustK. Foreign IndividualL. Foreign Governmental (foreign embassies)M. Unincorporated Body of PersonsN. Retirement FundsO. Section Title Entity (Sectional Titles Act no.)

2 95 of 1986 - non CIPRO Body Corporate)Nature of person (select applicable nature of person)Initials (only if nature of person is individual) Surname or registered name (in the case of an individual, only the surname, and in the case of a partnership, company, etc. name of partnership, company, etc.) FOR OFFICE USE: Reason codeRegistration number of CO/CC /Trust/FundID of birth (DDMMCCYY)Income tax not South African resident state country of residencePassport refer to the Guide for completion of Employer registration Application .

3 Your registration may be delayed if you do not complete this Application fully. PLEASE USE BLOCK LETTERSR egistration number of co-operativeResidential address if individual and Registered address for other entity typesPostal codeHome tel no. (for individuals)Bus tel of issue( South Africa = ZAF)Purpose of registration :PAYE/UIFSDL/UIFUnit (if applicable)Street/ name of farmSuburb/ DistrictCity/ Town1. Business Information2. Residential/Registered AddressVAT emailPage 1 of 4 Fax on which the business commenced/will commence (DDMMCCYY)Date on which the employer became/will become liable for registration for PAYE/UIF (DDMMCCYY)Date on which the employer became/will become liable for registration for SDL/UIF (DDMMCCYY)Preferred languageAfrikaansEnglish3.

4 Particulars of Two Main PartnersInitials (only if nature of person is individual) Surname/Company/Close Corporation or other nameRegistration number of CO CC /Trust/FundIdentity of birth (DDMMCCYY)Income tax reference numberIf not South African resident state country of residencePassport of issue( South Africa = ZAF)Nature of person (select applicable nature of person) registration number of co-operative4. Liability ParticularsPage 2 of 4 Number of partners in partnershipA. IndividualB. PartnershipC.

5 Company/CC/Co-operative(CIPRO reg. entity)D. Government/Public or Local authorityE. Association not for gainG. ClubH. Welfare OrganisationI. TrustK. Foreign IndividualL. Foreign Governmental (foreign embassies)M. Unincorporated Body of PersonsN. Retirement FundsO. Section Title Entity (Sectional Titles Act no. 95 of 1986 - non CIPRO Body Corporate)Initials (only if nature of person is individual) Surname/Company/Close Corporation or other nameRegistration number of CO CC /Trust/FundID of birth (DDMMCCYY)Income tax reference numberIf not South African resident state country of residencePassport of issue( South Africa = ZAF)Nature of person (select applicable nature of person)

6 registration number of co-operativeFOR OFFICE USE Reason codeInitialsThe representative employer is a natural person residing in South Africa who is, according to paragraph 16 of the Fourth Schedule to the Income Tax Act 58 of 1962, responsible for performing the duties of the employer as required by the said schedule. Not applicable to individuals except if the individual is not a SA Particulars of Representative EmployerSurnameFOR OFFICE USE Reason codePayroll Information:Estimated PAYROLL for the following 12 month periodNumber of employees on which estimated PAYROLL is basedR,Trade classification codes (refer to brochure - VAT/PAYE 403 available on the SARS website: )Activity within major divisionMajor divisionWebsite addressState main activityPostal address: 6.

7 Particulars of Business (continue)Trading or other namePhysical address of the businessPostal codeBus tel (if applicable)Street/ name of farmSuburb/ DistrictCity/TownContact emailPostal codeChamber/SIC codeSETA classification codes (refer to Guide for SDL)SETA CodePage 3 of 4 Same as above: Capacity:PartnerTreasurerPublic OfficerTrustee/Curator/Liquidator/Execut or/Administrator/Judicial managerOfficer for Municipality/Public Authority/Manager/Secretary/Council/Boar dRepresentative employers must ensure that they are familiar with the provisions of the Fourth Schedule to the Income Tax ActPhysical address in South Africa (not postal box number)Passport the representative EmployerPostal codeTel (if applicable)

8 Street/ name of farmSuburb/ DistrictCity/ TownContact emailID of Issue( South Africa = ZAF)Employers who fall within the categories mentioned below are not liable for the payment of the levy in terms of section 1 of the Skills Development Levies Act, but must however still register in terms of section 5(6) of the aforementioned mark a block with an X if applicable).Any National/Provincial public service employerPublic Benefit OrganisationsNational/Provincial public entity, if more than 80% of your expenditure is defrayed from funds voted by ParliamentMunicipalities to whom a certificate of exemption has been grantedFOR OFFICE USE 7.

9 Particulars of Exemptions (where applicable)Account holder nameType of account:Branch Particulars of other branches/divisions9 Banking particulars (Must be a registered bank in South Africa)State the number of branches/divisions if separate branches/divisions also exist in the RSAPage 4 of 4 Account holder relationship:In name of businessThird partyI declare that:(I) I am the representative employer and that the information furnished herein is true and correct and that all required documents are attached and,(ii) I am fully aware of my duties and responsibilities as per the fourth schedule to the Income Tax Act 58 of 1962.

10 name Signature Capacity of Representative Employer DateDDMMCCYY1. Please read Guide for Employers iro Employees Tax for more information regarding Employees Tax. The guide is available on the SARS website: An employer is deemed not to have applied for registration until the Application form has been completed in full and all the required information and documentation has been furnished.