FORM 3 SUPPLEMENTARY
THE COMPANIES ACT 1963 (ACT 179)
RETURNS OF PARTICULARS OF A COMPANY LIMITED BY SHARES UNDER
SECTIONS 27(1) AND 335A (1) (C) OF THE COMPANIES ACT, 1963 (ACT 179) ON INCORPORATION
SUPPLEMENTARY FORM FOR DIRECTOR
(Sections 27(1) and 335 A(1)(C))
INSTRUCTIONS: COMPLETE FORM WITH BLACK INK AND IN BLOCK LETTERS
PLEASE SPELL OUT ALL WORDS –NO ABBREVIATIONS
*INDICATES MANDATORY FIELD
(A) Director:
Title Mr Mrs Miss Ms Dr
First Name
Middle Name
Last Name
Gender Male Female
Date of Birth D D M M Y Y Y Y
Any Former Name
Nationality
Does the Director Have a Tax Identification Number (TIN?) Yes No
Section to be filled out by Directors who have a TIN
TIN
Section to be filled out by Directors who do not have a TIN
Type of Identification Used Voters Card National ID Driver’s License
Date of Issue D D M M Y Y Y Y
Date of Expiry D D M M Y Y Y Y
Country of Issue
Place of Issue
ID Number
Mothers Maiden Last Name
Mothers Maiden First Name
Marital Status Single Married Divorced
Separated Widowed Widower
Town of Birth
Country of Birth
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Region of Birth
District of Birth
Resident Yes No
Other Information Importer Exporter Tax Consultant Not Applicable
cial Security No.
Current Tax Office
Old TIN
Employment Type Self Employed Employee Employee of a Foreign Mission
Other (Specify)
Employers Name
Main Occupation
Section to be filled out if Director Does Not have a TIN and is Self-employed
Nature of Business
Annual Turnover
No of Employees
Business Address:
House No.
Building Name
Street Name
Town / City
Location / Area
Country
Region
District
Ghana Digital Address
Section to be filled out by All Directors (regardless of whether they have a TIN or not)
Mobile Number 1:
Mobile Number 2:
Phone Number 1:
Phone Number 2:
Fax:
E-mail Address:
Preferred Contact Mobile Email Letter
Form 3 Company Limited by Shares (Supplementary Registration Form) Page 2 of 3
Residential Address
House No.
Building Name
Street:
Town / City:
Location / Area
Country:
Region:
District:
Ghana Digital Address
Postal Address
Care of:
Postal Type P O Box PMB DTD
Postal No
Postal Region
Postal Town
Particulars of other
Directorships:
Director’s Signature Date:
( d d / m m / y y y y)
(B) Declaration (for a Director who cannot read or write)
N/B: I…………………………………………………..of………………………………………………………. (address) THUMB PRINT
hereby declare that I have read over the contents of this document to the Director in the OF DIRECTOR
………………………. language and the Director appeared to understand same before
thumb printing.
…………………………………………..
(Signature) Date (d d / m m / y y y y)
Form 3 Company Limited by Shares (Supplementary Registration Form) Page 3 of 3