Form 3 m4) fete} (Geaula ied dp ‘The Companies (Preseribed Forms) Regulations, (Section 12, 13 ant 93) APPLICATION FOR INCORPORATION PART A, CoMPany DETAILS Frat Capa Lime fy Shares xT od “Type of Company Private Compan Ltd i Ganrance meee Sttone pea Cooyeny by fe tne of company [feta cree Tcl Hank eae / Company Category satpeyefcemnsy Company Raine bse Business Activities | SE" wana wo 692/075 Bre bro RoR Powal Address {BOK | 0977722670 Tic Rel Aaron rexwellgdigmail.comPART BD. FIRST DIRECTORS foe Dect opt an vee fr aie oie compas. Th mae of rector revert I fed ifs tae eecosopconed PARTICULARS OF DIRECTOR Tinton vat cxonsiwa = ERE swan Gender MALE é e [FEMALE Dnt 18.03.1980 _| 04.08.1990 i ata 2ANDIAN znworan we we vty tuner (FRBTO7II/A | 299926/30/4 ve| REE [ss _loorrzazer0 | oov2ea950s pan [ine | Email Address Fexwellgd@gmail.com rexwellgd@gahoo}com Tee RATTLE | PE OTT WRTATE | tear | PBRGHANE ROAD | FEREEANT ROAD snysct [=| AREA SHHOSON | HAREN_SINOSON eevee Tour ‘LUSAKA . | LUSAKA omer A SAKA anand GAMBIA ZAMBIA ‘DEGTARATION FOR CONSENT 10 ACT AS DIRECTOR: We, whose name(s} and particula nentioned company: sienaurex pet pute 27.07.2023, appear above, consent to act as director(s) for the above sigan Re pu 27.07.2023 ‘Rete Pan Dia ad ae ak vectorsPART eplcae Part toad mare Shareholders suanewoLEns ps Mianstcans ov sxanmouwens ‘ Se ae mind ERE se ne Dac of ih 18.03.1980 | 04.08.1990 ee ZAMBIAN ZAMBIAN fa ena Tye Ferponganbaane xnc/Posspav | NRC me ‘Identity Number 722670/11/1 199926/10/1 fans inip Ege Se face iet Gea - ates o Soa ERR men emeee Pease | Soetoro and Country of 9 aut Incopratn f Body \=\) ee seem eal " ote | 0977722670 09 7pesa 852. fhe nee GmAiaca Fexwebigd@gnail.con | Fexwellga@yehop-con array | PHOT NO-FEST/ —| PLOT WOR6E7/R/3/b/47872 Cia” [Rayo a/ars sre [pepxans ROAD | PEREKANT ROAD nen [HE [MAREN SINOSON | MAKEN STHOSON eee fom ‘LUSAKA. LUSAKA femen” _| LUSAKA LUSAKA. = cnr | zameza, ZaBIA 14,250 750 —- [tea || Class of Shares ORDINARY SHARES| ORDINARY Si Signature:y ga? Date: 27/07/2023 22) signature: Gage Date; 27/07/2023PART D. | | BENEFICIAL ownERSHIP PARTICULARS OF BENEFICIAL OWNERSHIP [FirstName MAXWELL GEORGINA oo JERE BWALYA Gender MALE FEMALE | Date of Birth 18.03.1980 __| 04.08.1990 Z Nationatey ZAMBIAN ZAMBIAN Petia he NRC NRC ae entity Number 722670/11/1 | 199926/10/2 ‘Occupation DIRECTOR DIRECTOR ‘Name of Body Corporate Ur py Bly Corporate ‘Nature of Body Corporate Thee ppc pal teehee cme isn Compo, Co 3, | Sean, ast Sey Be Registration Number, Dale and Country of Incorporation of Body Corporate wow | 9977722670 _|_ 0972839545 Phone Number TmilAden Fexwelligdégmail.con | rexwellgd@yahoo {con Tartine? ¥68 | tiene” layt/b/4/asa [PLOT NO P687/A/14b/4/A/4 swe [PEREKANI ROAD |PEREKANI ROAD _| Proscal, [rasa |MAKENT_STMOSON| MAKENT STHOSON Office Address ee ee a a [LUSAKA LUSAKA frence |LUSAKA. LUSAKA. 1 coy __|gamprn | ampza DIRECTOR/ TRUSTEE OF HODY CORPORATE We First Name! ‘entity Number: Physical Address Date Appa mal Pat Haber: Natoma 24, Date of BirtSUIAREHOLDER/SETTLER OF HODY CORPORATE ms Ro [Rast Mentity | Physical tumber of [Class of | _Mumber of Paid tome | mnter | Addess | "Shares: | Shares ‘tp Shares: ssuname: | Gonder “ec Phone tambo: National Date of Bvt a5] eeupation ok : 7 4 i z = 2 a E ‘BENEFICIAL OWNER/BENEFICIARY OF BODY CORPORATE To] Fast ane “ety Huber Physical Address | aare of ierest ‘Surname ‘Gondor “Ent hore turbo: tonality Date of Bethe 26. | “erat 7 g = z 7 | — [Rumer of Shares prany)—| 14,250. Tso, Classof Shares any] | ORDINARY “ORDINARY SHARES Nature of Bet Ownership LEGAL . LEGAL eppepne nef OWNER OWNER : a eee eae Bate when bench pievatonaccguned | 27-07-23, if beneficial owners politically exposed person | NIL xr f {Pen as dened in the Financial ateliganee Act ‘ No 46 of 2010, provide |__| eta fg: poston he | DEcLARanoN oF DenEricint owns ‘We whose mesa avila appear sve, desae that a he Dene ome a nated above 1 ue 27.07.2023 Sigtuce> pag sie By bute 27.07.2023