Form 20

(Regulation 21)
(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 21)
Available at www.pacra.org.zm

NOTICE OF CHANGES IN PARTICULARS IN SHAREHOLDING OR

BENEFICAL OWNERSHIP

PART A
COMPANY DETAILS
1. Company Number 1202490012997
Indicate the 12 digit registration number

2. Company Name NIPPON HEALTH AND BEAUTY CARE

Indicate the name as captured on the
certificate of incorporation LIMITED
PART B
CURRENT SHAREHOLDER DETAILS
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
3. 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 Area
Address Town
Province
Country
4.
Number of Shares
5.
Class of Shares
6.
Par Value of Shares

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

8. Consideration for the shares

Indicate payment received for shares
where applicable
PART C
NEW SHAREHOLDER DETAILS
(Complete only where details have changed)
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
9. 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 Area
Address Town
Province
Country
10.
Number of Shares
11.
Class of Shares
12.
Par Value of Shares

13. Numbering of Shares

Indicate Numbering Of Shares As In From To
The Company Register Of Shares

14. Consideration for the shares

Indicate payment received for shares
where applicable
DECLARATION:

I, whose names and particulars appear on this form, do hereby declare that
15. the particulars of shareholding relating to shares indicated on this form, are
correct and accurate to the best of my knowledge.

Signature: Date:
 PART D
BENEFICIAL OWNERSHIP DETAILS
PARTICULARS OF BENEFICIAL OWNERSHIP
First Name NADEEM
Surname SARMAD
Gender MALE
Date of Birth 03/11/1994
Nationality ZIMBABWEAN
Identity Type
For Zambians: NRC
Passport
For non-Zambians: NRC/Passport/
Driver’s Licence/Resident Permit
Identity Number FN907505
Occupation Businessman
Name of Body Corporate N/A
Where applicant is a Body Corporate
Nature of Body Corporate
Where applicant is a Body
Corporate, indicate whether N/A
16. applicant is a Company, Co-
operative, Trust, Society, Etc.
Registration Number, Date
and Country of
Incorporation of Body N/A
Corporate
Where applicant is a Body Corporate
Mobile +260976887666
Phone Number
Landline
Email Address Info.wandipa@gmail.com
Plot/House/
Village 369A
Physical/ Street Makeni
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
17.
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
18. 2

3
4

BENEFICIAL OWNER/BENEFICIARY OF BODY CORPORATE

N First Name: Surname: Identity Number: Nature of Interest
o
1
19.
2
3
4
20.
Number of Shares (if any) N/A
21.
Class of Shares (if any) N/A
Nature of Beneficial
Ownership
22. Briefly explain the nature of beneficial
ownership (whether trust, legal N/A
arrangement etc.) including how
ownership control or economic interest
is maintained
If beneficial owner is
politically exposed person
23. (PEP) as defined in the
N/A
Financial Intelligence Act No.
46 of 2010, provide details
(e.g. position held)
DECLARATION:

I, whose names and particulars appear on this form, do hereby declare that
24. the particulars of beneficial ownership relating to shares indicated on this
Form, are correct and accurate to the best of my knowledge.

Signature: Date: 27/11/2023

PART E
NEW BENEFICIAL OWNERSHIP DETAILS
(Complete only where details have changed)
PARTICULARS OF BENEFICIAL OWNERSHIP
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 DR JAVIAS MEDICAL CENTER LIMITED
Where applicant is a Body Corporate
Nature of Body Corporate
Where applicant is a Body
Corporate, indicate whether Private Limited Company
25. applicant is a Company, Co-
operative, Trust, Society, Etc.
Registration Number, Date
and Country of 120230046776
Incorporation of Body 24/02/2023
Corporate ZAMBIA
Where applicant is a Body Corporate
Mobile +260979328887
Phone Number
Landline
Email Address filtermykidney@gmail.com
Plot/House/
Village Plot No. 599
Physical/ Street Protea Road
Registered Area Fairview
Office Address Town Lusaka
Province Lusaka
Country Zambia
DIRECTOR/TRUSTEE OF BODY CORPORATE
26. N First Name: Surname: Identity Number: Date Appointed:
o
1 Bhavesh Javia RP223702/10-20 24/02/2023
 2 Pragna Javia RP265894/8-21 24/02/2023
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 Bhavesh Javia RP223702/10- 7,500 Ordinary 7,500
27. 20
2 Pragna Javia RP265894/8-21 7,500 Ordinary 7,500
3
4
BENEFICIAL OWNER/BENEFICIARY OF BODY CORPORATE
N First Name: Surname: Identity Number: Nature of Interest
o
1 Bhavesh Javia RP223702/10-20 Legal Owner
28.
2 Pragna Javia RP265894/8-21 Legal Owner
3
4
29.
Number of Shares (if any) 10000
30.
Class of Shares (if any) Ordinary
Nature of Beneficial
Ownership
The beneficial ownership has all the
31. Briefly explain the nature of beneficial
ownership (whether trust, legal control and all the economic and voting
arrangement etc.) including how rights of the shareholder
ownership control or economic interest
is maintained
If beneficial owner is
politically exposed person
32. (PEP) as defined in the
Beneficial owner is PEP
Financial Intelligence Act No.
46 of 2010, provide details
(e.g. position held)
DECLARATION:

I, whose names and particulars appear on this form, do hereby declare that
33. the particulars of beneficial ownership relating to shares indicated on this
Form, are correct and accurate to the best of my knowledge.

Signature: Date: 27/11/2023

PART F
PARTICULARS OF PERSON LODGING NOTICE
34.
First Name SIANGA
35.
Surname SIANGA
36.
Gender MALE
37.
Date of Birth 01/09/1990
38.
Nationality ZAMBIAN
39. Identity Type NRC
For Zambians: NRC
For non-Zambians: NRC/Passport/
 Driver’s Licence/Resident Permit
40.
Identity Number 413010/61/1
41. Mobile +260978893077
Phone Number
Landline
42.
Email Address siangasianga0109@gmail.com
Plot/House/
Village 09/31
Physical Street Dr Aggrey Road
43. Area Kabwata
Address
Town Lusaka
Province Lusaka
Country Zambia
44.
Signature: Date: 27/11/2023
To be completed only when there is a change in the registered particulars of shareholders or beneficial owners.