KENYA INVESTMENT AUTHORITY

INVESTMENT APPLICATION FORM
(Full and accurate completion of this form will speed up the project approval process)
PART I
A. DETAILS OF THE APPLICANT
(i)

Name of Company / Business ___________________________________________

(ii)

Contact Person _______________________________________________________

(iii)

Address of Contact Person _______________________________________________
Tel _________________________________ Fax _____________________________
E-mail: _______________________________________________________________

(iv)

Type of business Entity ___________________________________________________
(Limited Company, Partnership, Etc.)

(v)

Country of Incorporation __________________________________________________

(v)

Date of Incorporation ____________________________________________________

(vi)

Indicate whether the Company is:(a) New

[ ]

(b) Operating [ ]
(vii)

Indicate whether to Manufacture Under Bond (MUB is manufacturing for export only)
Yes __________________

No __________________

B. PROPOSED LOCATION OF BUSINESS
(i)

Land Registration Number (L.R.No.) _______________________________

1

000) Year YR 1 YR 2 YR 3 YR 4 YR 5 Investment Growth (Kshs 000) 2 .(ii) (iii) Street/ Road ______________________Town ________________________ District _______________________________________________________ C. COMPANY DIRECTORS Name of Director Nationality Address PART II (i) Nature of activity _____________________________________________________________ Describe the nature of activity (Project Description) ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ (ii) Give 5 years projected Investment growth (Kshs.

PART III (A) EMPLOYMENT DETAILS KENYAN EMPLOYEES NUMBER Management _____________________________ Technical/ Professional _____________________________ Skilled _____________________________ Others Total EXPATRIATE EMPLOYEES _____________________________ NUMBER Management ________________________________________ Technical / Professional Total (i) ________________________________________ Explain need for expatriate employee(s) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ PART IV: INVESTMENT AND FINANCING PROGRAMME A. CAPITAL COSTS (ESTIMATED) FIXED COSTS Land & Land Development Plant and Machinery Working Capital Others TOTAL B. AMOUNT FINANCING PLAN Type of Financing Equity Loan TOTAL Foreign Local 3 .

Certificate of Incorporation in Kenya.com FOR OFFICIAL USE ONLY 1.O. Others____________________________ To be submitted to: MANAGING DIRECTOR KENYA INVESTMENT AUTHORITY P.O. 2. Mobile: 0722-205424 / 0733-601184 Fax: +254 20 2243862 Email: info@investmentkenya. P.investmentkenya.com Website: www. REF NO.PART V: DECLARATION I hereby certify that the foregoing particulars are correct to the best of my knowledge.Box 55704-00200 NAIROBI Tel: 2221401-4. DATE RECEIVED --------------------------------------------------------------------------------------------------------------------------------------------- 3. Kenya Tel: +254 20 2221401-4| Mobile Phones: +254 722 205424/722 209902| +254 733 601184 Fax: +254 20 2243862 Email: info@investmentkenya. 2. Memorandum and Articles of Association 3. Name _____________________________________________________________________________ Signature ___________________________________________________________________________ Date ______________________________________________________________________________ Indicate Enclosures: 1.com|Website: www. RECEIVING OFFICER ----------------------------------------------------------------------KENYA INVESTMENT AUTHORITY Kenya Railways Headquaters| Block D 3TH FLOOR.com Representative Offices: JKIA|Eldoret|Kisumu|Mombasa 4 .investmentkenya. BOX 55704-00200 Nairobi. Off Haile Sellasie Ave.