You are on page 1of 8

Form 18

(Regulation 19)
(In typescript and completed in duplicate)

THE PATENTS AND COMPANIES REGISTRATION AGENCY

The Companies Act, 2017


(Act No. 10 of 2017)
____________

The Companies (Prescribed Forms) Regulations, 2018


(Section 188)
Available at www.pacra.org.zm

NOTICE OF TRANSFER OF SHARES

PART A
COMPANY DETAILS
1. Company Number
Indicate the 12 digit registration 120210012997
number
2. Company Name
Indicate the name as captured on the NIPPON HEALTH AND BEAUTY CARE LIMITED
certificate of incorporation
Phone Number Mobile +260976887666
3. Include the international
code (e.g. +260 for Landlin
Zambia) e
4.
Email Address nipponhealthofficial@gmail.com
PART B
TRANSFEROR
(Person Transferring Shares)
PARTICULARS OF SHAREHOLDER
5. First Name N/A
Surname N/A
Gender N/A
Date of Birth N/A
Nationality N/A
Identity Type
For Zambians: NRC
N/A
For non-Zambians: NRC/Passport/
Driver’s Licence/Resident Permit
Identity Number N/A
Name of Body Corporate NIPPON HEALTH AND BEAUTY CARE LIMITED
Where applicant is a Body Corporate
Nature of Body Corporate
Where applicant is a Body
Corporate, indicate whether Private Limited Company
applicant is a Company, Co-
operative, Trust, Society, Etc.
Registration Number, Date 120230046776
and Country of 24/02/2023
Incorporation of Body ZAMBIA
Corporate
Where applicant is a Body Corporate
Mobile +260976887666
Phone Number
Landline

Email Address nipponhealthofficial@gmail.com


Plot/House/
Village Plot No. 369A
Street Off Makeni Road
Physical Area Makeni
Address Town Lusaka
Province Lusaka
Country Zambia
Shares held
before 10000
transfer
6. Number of Shares
10000
Shares transferred
Shares held
after 0
transfer
7.
Class of Shares Ordinary

8. Numbering of Shares
Indicate numbering of shares as in From 10000 To 0
the Company Register of Shares

9.
Date of Resolution 20/11/2023
10. Consideration for the
10,000 ZMW
Shares

DECLARATION

I, whose names appear on this form, declare that I have transferred shares indicated on this form
11. and that the beneficial ownership information provided is true and accurate.

Signature: Date: 20/11/2023

PARTICULARS OF BENEFICIAL OWNERSHIP


12. First Name N/A
Surname N/A
Gender N/A
Date of Birth N/A
Nationality N/A
Identity Type
For Zambians: NRC
N/A
For non-Zambians: NRC/Passport/
Driver’s Licence/Resident Permit
Identity Number N/A
Occupation N/A
Name of Body Corporate NIPPON HEALTH AND BEAUTY CARE LIMITED
Where applicant is a Body Corporate
Nature of Body Corporate
Where applicant is a Body
Corporate, indicate whether Private Limited Company
applicant is a Company,
Co-operative, Trust, Society, Etc.
Registration Number, Date 120230046776
and Country of 24/02/2023
Incorporation of Body
Corporate ZAMBIA
Where applicant is a Body Corporate
Mobile +260976887666
Phone Number
Landline

Email Address nipponhealthofficial@gmail.com


Plot/House/
Village Plot No. 369A

Physical/ Street Off Makeni Road


Registered Area Makeni
Office Address Town Lusaka
Province Lusaka
Country Zambia
DIRECTOR/TRUSTEE OF BODY CORPORATE
N First Name: Surname: Identity Number: Date Appointed:
o
1 Lona Banda 194165/10/1
13.
2 Parmender Singh 913732/10/2
3
4
SHAREHOLDER/SETTLER OF BODY CORPORATE
N First Surname: Identity Number: Number of Class of Number of Paid Up
o Name: Shares: Shares: Shares:
1
14.
2
3
4
BENEFICIAL OWNER/BENEFICIARY OF BODY CORPORATE
N First Name: Surname: Identity Number: Nature of Interest
o
1
15.
2
3
4
Shares held
before
transfer
16. Number of Shares
Shares (if any) transferred
Shares held
after
transfer
17.
Class of Shares (if any)
Nature of Beneficial
Ownership
18. Briefly explain the nature of
beneficial ownership (whether trust,
legal arrangement etc.) including
how ownership control or economic
interest is maintained
19. If beneficial owner is
politically exposed person
(PEP) as defined in the
Financial Intelligence Act
No. 46 of 2010, provide
details (e.g. position held)
PART C
TRANSFEREE
(Person Acquiring Shares)
PARTICULARS OF SHAREHOLDER
First Name
Surname
Gender
Date of Birth
Nationality
Identity Type
For Zambians: NRC
For non-Zambians: NRC/Passport/
Driver’s Licence/Resident Permit
Identity Number
Name of Body Corporate
Where applicant is a Body Corporate
Nature of Body Corporate
Where applicant is a Body
Corporate, indicate whether
applicant is a Company,
20. Co-operative, Trust, Society, Etc.
Registration Number, Date
and Country of
Incorporation of Body
Corporate
Where applicant is a Body Corporate
Mobile
Phone Number
Landline

Email Address
Plot/House/
Village
Street

Physical Area
Address Town
Province
Country
Shares held
before being
acquired
21. Number of Shares
Shares acquired
Shares held
after
transfer
22.
Class of Shares

23. Numbering of Shares


Indicate numbering of shares as in From To
the Company Register of Shares

24.
Date of Resolution
25. Consideration for the
Shares
26. DECLARATION
I, whose names appear on this form, declare that I have acquired shares indicated on this form and
that the beneficial ownership information provided is true and accurate.

Signature: Date:

PARTICULARS OF BENEFICIAL OWNERSHIP


First Name
Surname
Gender
Date of Birth
Nationality
Identity Type
For Zambians: NRC
For non-Zambians: NRC/Passport/
Driver’s Licence/Resident Permit
Identity Number
Occupation
Name of Body Corporate
Where applicant is a Body Corporate
Nature of Body Corporate
Where applicant is a Body
Corporate, indicate whether
27. applicant is a Company,
Co-operative, Trust, Society, Etc.
Registration Number, Date
and Country of
Incorporation of Body
Corporate
Where applicant is a Body Corporate
Mobile
Phone Number
Landline

Email Address
Plot/House/
Village
Street
Physical/
Registered Area
Office Address Town
Province
Country

DIRECTOR/TRUSTEE OF BODY CORPORATE


N First Name: Surname: Identity Number: Date Appointed:
o
1
28.
2
3
4
SHAREHOLDER/SETTLER OF BODY CORPORATE
29. N First Surname: Identity Number: Number of Class of Number of Paid Up
o Name: Shares: Shares: Shares:
1
2
3
4
BENEFICIAL OWNER/BENEFICIARY OF BODY CORPORATE
N First Name: Surname: Identity Number: Nature of Interest
o
1
30.
2
3
4

PARTICULARS OF BENEFICIAL OWNERSHIP


Shares held
before being
acquired
31. Number of Shares
Shares (if any) acquired
Shares held
after
transfer
32.
Class of Shares (if any)
Nature of Beneficial
Ownership
33. Briefly explain the nature of
beneficial ownership (whether trust,
legal arrangement etc.) including
how ownership control or economic
interest is maintained
If beneficial owner is
politically exposed person
34. (PEP) as defined in the
Financial Intelligence Act
No. 46 of 2010, provide
details (e.g. position held)
PART C
PARTICULARS OF PERSON LODGING NOTICE
35.
First Name
36.
Surname
37.
Gender
38.
Date of Birth
39.
Nationality
Identity Type
40. For Zambians: NRC
For non-Zambians: NRC/Passport/
Driver’s Licence/Resident Permit
41.
Identity Number

42. Mobile
Phone Number
Landline
43.
Email Address
44. Physical Plot/House/
Village
Address
Street
Area
Town
Province
Country

45.
Signature: Date:
Also note that property transfer tax clearance certificate must be attached together with copies of identifcation documents for both the
transferor and transferee.

You might also like