Section A-C
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Section D-E
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Section F-H
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Schedule 1-4
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SCHEDULE
5-6
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Application for Taxpayer Identification Number
For All Individuals
(This Form may be used by all individuals who are applying for a TIN. Individuals who are ONLY employed, or
Registering/ transfering a Motor Vehicle or carrying out a Land transfer are not required to complete section D and
Schedule 3 of this form.)
Section A - Name and Address
1) Title (Optional)
Others(specify)
2) Surname/ Maiden Name*
3) First Name*
4) Middle Name
5) Acquired Name (if different from Surname)
6) Family/Father's Surname (if different from
Surname)
7) Mother's Maiden Name*
8) Marital Status Of Applicant*
9) Have you previously applied for or been issued a
TIN?* (Select YES/NO. If “YES” provide details
below)
a) Enter existing number*
b) Approximate Date of Previous Application*
c) Was your previous TIN obtained under a
different Name?* (Select YES/No. If YES then
complete Schedule 4)
10) Postal address where notices and correspondence should be sent
a) Post Office Box number/Private Bag
b) District/city where box is located*
11) Home address in Uganda (This must be a permanent physical address. Complete all boxes a
through h that apply)
a) Plot Number
b) Street Name
c) Building Name
d) Trading Center*
e) District/City*
f) County/Municipality*
g) Sub-County/Town Council/Division*
h) Parish*
i) Village*
12) Mobile Phone Number*
13) Landline Number
14) Email Address*
Section B - Birth and Citizenship and Purpose of Registration
1) Country of Birth*
2) Place of Birth (As Appropriate)
District*
City*
State* (If Country of Birth is not Uganda)
Sub-County*
Parish*
Village*
3) Sex*
4) Date of Birth (DD/MM/YYYY)*
5) Citizenship (Select only if you are not a citizen of
Uganda)*
6) Are you Minor?* (Select YES/NO. If YES then
complete Schedule 1*)
7) Have you been known by another name other than
the Maiden Name listed in A-2 above?* (Select
YES/NO. If YES then complete Schedule 2*)
8) Why do you need a TIN? (Indicate YES/NO, as applicable for each tax type) NOTE: For
VAT,LED,Gaming Tax you must attach another form. See instructions starting on page 3 for more
information.
a) Income Tax
b) VAT (Complete Form DT-1011)
c) Stamp Duty
d) Imports/Exports
e) Local Excise (Complete Form DT-1012)
f) Gaming Tax Registration (Complete Form DT-
1013)
g) Motor Vehicle Registration/Transfer
h) Oil and Gas (Complete Form DT-1017)
Section C - Identification Documents
Indicate the identification you have by selecting YES/NO. If YES, enter the reference number of the
form of identification you have. You MUST attach to this application either a copy of a National ID or
copies of any other two identification documents. (NSSF Card, Passport, Employee’s ID or Voter’s
Card)
1) National ID
2) NSSF Card
3) Passport
4) Employees ID
5) Voters Card
6) Drivers Permit
7) Work Permit
8) Village Identity Card
9) Current Bank Statement (Past 90 days)
10) Visa
11) Diplomatic Foreign Affairs ID
12) Financial Card
13) Refugee ID
Form DT-1001
Toll Free Number 0800117000
Reference Number (If YES)*
Section D - Partnership, Corporate an
Indicate below your additional business interests/ investments in any partnerships, companies or trust
Entity Type*
Section E - Sources of Income and Type of Business Activity
Select all income sources that apply. If the business address required in item 4 is the same as the home
provided in Section A, Item 11, provide YES in 4-III below
1) Employment (Select YES/NO)
a) Principal Employer's Name*
b) Is Employer Uganda Resident ?*
i) Employer's TIN*
2) Property Income (Royalties, interest dividends
annuity, gifts, Winnings from Gaming and any other
income other than from business, rental or
employment(Select YES/NO))
3) Rental Income (Select YES/NO)
4) Business Income from a Sole Proprietorship or
Family Run Business (Select YES/NO)
Business name*
I) Business Registration Certificate Number*
II) Date Business Started (DD/MM/YYYY)*
III) Is your business address the same as your
home address? If YES, leave boxes "a" through "i"
blank.*
a) Plot Number
b) Street Name
c) Building Name
d) Trading Center*
e) District/City*
f) County/Municipality*
g) Sub-County/Town Council/Division*
h) Parish*
i) Village*
5) Description of Activity*
6) Activity Code *
a) Division *
b) Class *
7) Do you have additional places of business? If YES
then complete Form DT-1014 (Application for
Additonal Places of Business i.e. Branch Annexure)
and attach copy.*
8) Do you qualify to withhold tax from employees or
suppliers or Winnings from Gaming provide YES
and complete Schedule 3 to register for Withholding
Tax. You will thereafter be required to submit
monthly schedules of tax withheld.*
Section D - Partnership, Corporate and Trusts Information
nterests/ investments in any partnerships, companies or trust
b) Business Name of Partnership, Corporation or Trust *
s of Income and Type of Business Activity
e business address required in item 4 is the same as the home address
ES in 4-III below
nd Trusts Information
Registration Number* TIN*
Section F - Alternate Contact
If we should contact someone other than you
to discuss the issuance of this TIN, Enter
information about that person below. Is
alternate contact detail same as provided in
Section A?
1) Surname/Maiden Name*
2) First Name*
3) Middle Name
4) If You Have An Existing TIN, Enter
Number
5) Acquired Name (if different from
Surname)..
6) Family/ father's Surname
7) Designation/ Relationship
8) Mobile Phone Number*
9) Land Line Number
10) Email..
Section G - Referee
This application must be referenced by a taxpayer whose TIN is active. Fill in the details
below.
1) Surname/Maiden Name .*
2) First Name.*
3) Middle Name.
4) Referee's TIN *
5) Acquired Name (if different from
Surname).
6) Family/ father's Surname.
7) Designation/ Relationship.
8) Mobile Phone Number.*
9) Land Line Number.
10) Email.
You DO NOT need to file this sheet with your registration unless you have completed one of the
four schedules below.
Schedule 1 - Guardian for Minor
If this application for a TIN is on behalf of a minor, please provide the following information
about the parent or guardian.
1) Surname/Maiden Name.*
2) First Name .*
3) Middle Name .*
4) If You Have An Existing TIN, Enter Number
here*
5) Acquired Name (If Different from Surname).*
6) Family/Father's Surname (if different from
Surname).*
7) Mother's Maiden Name* ..
Schedule 2 - Other Names Used
If you have ever been known by another name, please provide the following information
1) Title (Optional) .
You will Schedule 3 - Registration
need to register for
for Pay As You Pay(PAYE)
Earn As You Earn and Withholding
/ Withholding of Tax
Tax if you withhold amounts
from payments made to payees such as:
1) Employees for Salary and Wages* (Select
YES/NO)
2) Contractor or Sub-contractor under Agreement*
(Select YES/NO)
3) Suppliers* (Select YES/NO)
4) Foreign Payments* (Select YES/NO)
5) Gaming* (Select YES/NO)
6) What date will withholding Commence ? *
Schedule 4 - Name Used on Prior TIN Registration Applications
(Complete only if you ticked the box in Section A, Line 9c )
1) Title (Optional).
Others(specify).*
2) Surname/Maiden Name*
3) First Name.*
4) Middle Name.*
5) Acquired Name (If Different from Surname) .*
6) Family/Father's Surname (if different from
Surname) .*
7) Mother's Maiden Name.*
h your registration unless you have completed one of the
e 1 - Guardian for Minor
of a minor, please provide the following information
e 2 - Other Names Used
name, please provide the following information
Others(specify) 2) Surname/Maiden Name*
or Pay(PAYE)
Earn As You Earn and Withholding
/ Withholding of Tax
Tax if you withhold amounts
on Prior TIN Registration Applications
Section A, Line 9c )
3) First Name* 4) Middle Name
5) Acquired Name (If 6) Family/Father’s Surname Dates Used*
Different from Surname) (if different from Surname)
Schedule 5 - Mining Operations
(Complete this section if you are undertaking mining operations)
1)Do you have a license to undertake mining operations in relation
to mining and midstream operations ? (attach evidence)*
Total_Schedule_5_1
Total_Schedule_5_2
Schedule 6 - Midstream Operati
(Complete this section if you are undertaking mids
1)Do you have a license to undertake midstream operations in relation to mining and midstream
Total_Schedule_6
ule 6 - Midstream Operations
n if you are undertaking midstream operations)
tion to mining and midstream operations ? (attach evidence)*
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