BARRICK - Supplier Pre-Registration

Applicant Details

Name of Company or Individual*

Trading Name*

Company Registration Number*

Country Of Registration*

Type of Supplier*

Exporters Code (for SA Suppliers Only)*

Is your company VAT/GST registered?*

VAT/GST Registration Number*

If NO, please explain*

TIN Number*

Business/Postal Address (for Communication Purposes)

Street*

City*

Region*

Country*

Postal Code*

Physical Address

Street*

City*

Region*

Country*

Postal Code*

Are you an Original Equipment Manufacturer (OEM)?*

Contact Details for Orders

Name*

Designation*

Phone (inc. Country and Area Code) eg. +27000000000*

Fax (inc. Country and Area Code) eg. +27000000000

Mobile eg. +27000000000*

Company/Generic Email Address

Business Information

Please describe your primary lines of business and the products/services you offer*

One Hundred Percent (100%) of Non-Managerial and other positions occupied by Tanzanians?*

Ownership

Type of Company*

b. If privately owned, please list names, shareholdings, and nationalities of all directors and any other individuals. If more than five individuals, please attach their details separately.*

Name

Shareholdings

Nationality

Share Holding Type

Does the Company have at least fifty-one percent (51%) of its equity owned by a citizen or citizens of Tanzania?*

Does the Company have Eighty percent (80%) of the Executive and Senior Management positions held by Tanzanian citizens?*

Please identify all subsidiary, parent, and affiliate entities to be involved in activities for Barrick:*