APPLICATION FOR APPROVAL AS AN APPROVED INSPECTION AUTHORITY FOR ELECTRICAL MACHINERY

SURNAME: ...................................................................................................…..

FIRST NAMES: ................................................................................................…

ID NO.: .............................................................................................................

TRADING NAME: ...............................................................................................

State whether the business is a SOLE PROPRIETORSHIP/PARTNERSHIP/COMPANY/ CLOSE CORPORATION (delete whichever is not applicable).

BUSINESS CK NO.: ............................................................................................

PROVINCE IN WHICH BUSINESS IS SITUATED: ....................................................

PHYSICAL ADDRESS: .........................................................................................

........................................................................................................................

....................……............................................. POSTAL CODE: ...........................

POSTAL ADDRESS: ............................................................................................

......................................................................... POSTAL CODE: ........................

TEL NO.: ........................................ CELL. NO.: ..................................................

FAX NO.: ..........................................     EMAIL: .................................................

SANAS REGISTRATION NUMBER: .......................................................................

SCOPE OF ACCREDITATION: ..............................................................................

1)         A certified copy of the business registration number (indicate CK No.);

2)        A certified copy of the accreditation certificate from the accreditation authority.

I hereby declare that the above particulars are, to the best of my knowledge and belief, correct.

Signature of applicant: ......................................... Date: .............................................

FOR OFFICE USE ONLY :

Application: APPROVED/NOT APPROVED

Reason/s for declining: .........................................................................................……

..................................................................................................................................

Registration No: ...............................................…………

Date: ...........................................................................