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TCC 001
TAX CLEARANCE
Application for a Tax Clearance Certificate
Purpose Tenders
Select the applicable option
Good standing
If “Good standing”, please state the purpose of this application
Particulars of applicant Name/Legal name (Initials & Surname or registered name)
Trading name (if applicable)
Company/Close Corp. registered no
ID/Passport no Income Tax ref no VAT registration no
4
Customs code Telephone no
C O D E
N U M B E R
Fax no
PAYE ref no
7
SDL ref no
L
UIF ref no
U
C O D E
N U M B E R
E-mail address Physical address
Postal address
Particulars of representative (Public Officer/Trustee/Partner) Surname First names Income Tax ref no
ID/Passport no Telephone no
C O D E
N U M B E R
E-mail address Physical address
Page 1 of 2
Fax no
C O D E
N U M B E R
Particulars of tender (If applicable) Tender number Estimated Tender amount Expected duration of the tender
,
R year(s)
Particulars of the 3 largest contracts previously awarded Date started
Date finalised
Contact person
Principal
Amount
Telephone number
Audit Are you currently aware of any Audit investigation against you/the company? If “YES” provide details
YES
NO
Appointment of representative/agent (Power of Attorney) I the undersigned confirm that I require a Tax Clearance Certificate in respect of I hereby authorise and instruct SARS the applicable Tax Clearance Certificate on my/our behalf.
Tenders
or
Goodstanding.
to apply to and receive from
M M
C C Y Y
D D
Date
Signature of representative/agent Name of representative/ agent
Declaration I declare that the information furnished in this application as well as any supporting documents is true and correct in every respect.
M M
C C Y Y
D D
Date
Signature of applicant/Public Officer Name of applicant/ Public Officer
Notes: 1. It is a serious offence to make a false declaration. 2. Section 75 of the Income Tax Act, 1962, states: Any person who (a)
fails or neglects to furnish, file or submit any return or document as and when required by or under this Act; or
(b)
without just cause shown by him, refuses or neglects to(i)
furnish, produce or make available any information, documents or things;
(ii)
reply to or answer truly and fully, any questions put to him ...
As and when required in terms of this Act ... shall be guilty of an offence ... 3. SARS will, under no circumstances, issue a Tax Clearance Certificate unless this form is completed in full. 4. Your Tax Clearance Certificate will only be issued on presentation of your South African Identity Document or Passport (Foreigners only) as applicable. Page 2 of 2
