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  • UIN APPLICATION FORM - New

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    This document is an application form for an Electronic Fiscal Device (EFD) User ID from the Tanzania Revenue Authority. It requests general information about the EFD supplier in Part A, including their name, TIN, VRN, license number, address and contact details. Part B requests similar identifying information about the EFD user/taxpayer applying for the ID. Part C asks for specifics about the EFD itself, including its type, model, serial number, SIM card and ICCID details. The applicant must sign a declaration that the information provided is true and complete.

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    UIN APPLICATION FORM- new

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    This document is an application form for an Electronic Fiscal Device (EFD) User ID from the Tanzania Revenue Authority. It requests general information about the EFD supplier in Part A, including their name, TIN, VRN, license number, address and contact details. Part B requests similar identifying information about the EFD user/taxpayer applying for the ID. Part C asks for specifics about the EFD itself, including its type, model, serial number, SIM card and ICCID details. The applicant must sign a declaration that the information provided is true and complete.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    4 views1 page

    UIN APPLICATION FORM - New

    Uploaded by

    humphrey benedict
    This document is an application form for an Electronic Fiscal Device (EFD) User ID from the Tanzania Revenue Authority. It requests general information about the EFD supplier in Part A, including their name, TIN, VRN, license number, address and contact details. Part B requests similar identifying information about the EFD user/taxpayer applying for the ID. Part C asks for specifics about the EFD itself, including its type, model, serial number, SIM card and ICCID details. The applicant must sign a declaration that the information provided is true and complete.

    Copyright:

    © All Rights Reserved
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    of 1

    ITX602.01.

    E Application for EFD User ID

    TANZANIA REVENUE AUTHORITY


    APPLICATION FOR ELECTRONIC FISCAL DEVICE USER IDENTIFICATION (ID) NUMBER

    Part A: General Particulars of EFD Supplier.


    Name of Supplier-------Pergamon Group Limited------------------------------------------------------------
    TIN-------------------------110-781-512--------------------------------------------------------------------------------
    VRN------------------------40-006908-G------------------------------------------------------------------------------
    License No----------------01133F-110781512---------------------------------------------------------------------
    Postal Address-----------31236 DAR ES SALAAM---------------------------------------------------------------
    Location--------------------MSASANI----------------------------------------------------------------------------------
    Street----MIKOCHENI----------Plot No-----101--------------------------House No--------101----------------
    E-mail No----info@pergamongroup.com--------------------------------------------------------------------------

    Part B: General Particulars of EFD User


    Name of taxpayer………………………………………………………………………………………….
    TIN…………………………………………………………………………………………………………..
    VRN…………………………………………………………………………………………………….......
    Postal Address…………………………………………………………………………………………….
    Street: ………………………Plot No:………………………………House No:………………………..
    Telephone……………………………………………E-mail…………..………………………………….
    Position/Title of Applicant………………………………National ID number………………………….
    Tax office………………………………………..EFD Registration ID…………………………………
    Business Type……………………… Building ……………………………..Floor…………………….

    PART C: EFD Particulars


    Type of the Device: ………………………………………………………………………………………
    Model of EFD: …………………………………………………………………………………………….
    S/N of EFD: ………………………………………………Manufacturing date..……….......................
    Sim Card No ……………………………………………………………………….................................
    ICCID No………………………………………………………………PROVIDER……………………
    Declaration

    I here by certify that the information contained in this form is true and complete

    Name …………………....................Signature………………………Date…………………………..

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