WCA Registration Form

SKMC

ACCOUNTING □ TAXATION □ BUSINESS CONSULTING

FAX: 086 692 4048

INFO@SKMC.CO.ZA

SKYPE: SKMC.HEINIE

ACCOUNTING:

INSURANCE:

Multi Prof Insurance Brokers

USEFUL LINKS:

Contact Us

WCA Registration Form

Please complete the following form. Note that all fields marked with * is compulsory.

Entity Type Of Employer	*
Date On Which First Employee Was Employed	*
Trading Name Of Business	*
Postal Address Of Business	*
Physical Address / Name(s) of Farm(s)	*
Magisterial District Of Business	*
Name of Owner / Partnership / Company / CC	*
(In case of Sole Proprietor/Partnership, copies of *ID Documents* must be faxed to *086 617 0890*
and Companies / Close Corporations, copies of *CM1 & CM29 / CK1 or CK2* must be faxed to *0866170890*
If a Limited Company or CC, state names, ID Numbers & addresses of directors or members.
Describe the nature of goods manufactured / services rendered	*
Materials used in the *manufacturing* of goods (if applicable)
Nature and extent of *construction / erection* undertaken (if applicable)
In the case of farming, indicate the nature thereof		livestock farming tillage Mixed: % livestock % tillage
Do you use any tractors and/or power driven saws?	*
Contact person name & surname	*
Telephone Number	*
Fax Number
Cell Phone Number
E-Mail Address
RESPONSIBLE PERSON / DIRECTOR / MEMBER OR PARTNER OF BUSINESS
Initials & surname	*
ID Number	*
Capacity	*
Residential Address	*
Is the business registered at the offices of the Compensation Commissioner?	*	Reg. No
Is the business registered for UIF?	*	Reg. No
If the business has changed ownership, furnish the following details:
Previous trading name of business / farm
Name of previous owner
Present residential address of previous owner
Date of take-over
Number of employees currently employed
Estimated particulars of your employees as from the date the 1st employee was employed up to the end of February the next year
Average number of employees expected to be employed during above-mentioned period	*
Estimated total earnings up to a maximum of R 149 136 per person per year
Total cash earnings of employees	*
Total cash value of food and lodging provided free by employer	*
Cash value of other in-kind benefits	*
Earnings of working directors / members	*

ADDITIONAL INFORMATION IN RESPECT OF HEAD OFFICE AND / OR FILLIALS / BRANCHES
Furnish the trading name and postal address of the Head Office and/or filials / branches and if already registered, the registration number allocated by the UIF and/or the Compensation Commissioner

Bank name	*
Details if other
Name of account holder	*
Type of bank account	*
Account number	*
Branch name	*
Branch code	*

No material may be published or reproduced in any form whatsoever without prior written permission from the Web Master.

Reliance on the information contained in this site is at your own risk.