MEMBERSHIP APPLICATION FORM

Transcription

1 Company Name MEMBERSHIP APPLICATION FORM (Please fill up all the details below) Postal Address Physical Address Telephone No(s) Fax No(s) Contact person Directors: (Names) 1) 2) 3) 4) 5) Please attach copies of: *Certificate of Incorporation * Business License *Tin or VAT Certificate *For Sole Proprietorships (TIN Certificate must be attached) *List of products to be barcoded For Official Use Only: Application Approved by Nature of business Company Prefix Number Membership No. Date of Issue No of bar codes issued 1.Registration fee 2. Annual Subscription Amount Invoice No. Amount 3. Other Charges Amount Receipt No

2 Membership Fees Annual Turnover Amount Registration Fee (Paid only Once) Annual License Fee Category 1: Category 2: Start up to Tshs 5M 100,000/= 80,000/= Tshs 5.1M to Tshs 10M 100,000/= 100,000/= Category 3: Tshs 10.1M to Tshs 40M 100,000/= 200,000/= Category 4: Tshs 40.1M to Tshs 80M 100,000/= 400,000/= Category 5: Tshs 80.1M to Tshs 200M 100,000/= 1,300,000/= Category 6: Tshs 200.1M to Tshs 500M 100,000/= 2,000,000/= Category 7: Tshs and above 100,000/= 2,640,000/= Service providers 100,000/= 2,640,000/= Note: All cheques must be paid out to GS1 (TZ) National Ltd CRDB Bank account number Please indicate by placing a tick ( ) in the appropriate box for number of Items you have [ ] [ ] [ ] [ ] [ ] [ ] GS1 (TZ) National Ltd license Terms and Conditions are attached hereto and form an integral part of your application. 1. I/We agree to abide by the Terms and Conditions of the GS1 (TZ) National Ltd License Agreement as set out in GS1 (TZ) National Ltd license Terms and Conditions 2. I/We hereby apply for membership of GS1 (TZ) National Ltd and agree to adhere to the GS1 specifications and guidelines, abide by the Rules of GS1 (TZ) National Ltd and to pay the appropriate annual license and subscription fees after each year from the date of registration. 3. Training on point of sale compliance for beginners is held every two weeks this is a foundation course. Make sure you attend the first course, which is mandatory for all new members. Company Stamp (Signature and position) Date...

3 Industry Category: Please indicate by ticking the appropriate codes for Your Company: MANUFACTURER ( ) RETAILER ( ) SERVICE PROVIDER ( ) IMPORTER ( ) PUBLISHER ( ) BAKER ( ) DAIRY ( ) FOOD PROCESSOR ( ) What is your major Business Activity.? FRESH PRODUCE ( ) MEAT AND FISH PRODUCE ( ) NON-PROFITABLE ORGANISATION ( ) PACKING ( ) PHARMACEUTICAL ( ) OTHER ( ). How did you find out about GS1 (TZ) National Ltd? Barcode Generation / Origination - Tshs. 5000/= per barcode for 1-5 barcodes - Tshs. 3000/= per barcode for 6 barcodes and above Bar code Verification All Prices are VAT Inclusive (18%) - Tshs. 3000/= each for over 5 product For Members - Tshs. 15,000/= per product for Non-Members Other Services that are soon going to be available to our esteemed members a. Access to a global network This provides each member with a unique identification number (barcode number) for retail products, trade and logistic units. Note that the numbers are correctly termed as Global Trade Item Numbers (GTINs) b. Support/Help Desk. We have a dedicated team that responds to all of your needs and provides assistance when required. This service is free for all of our members especially when one encounters a barcoding problem or simply need further help. c. GS1 Standards Magazine A quarterly publication to be distributed to all members that provide information about the use of the GS1 system nationally and internationally, updates on supply chain issues, business practices, industry requirements and technology. d. Bar code verification Service. In order to achieve and maintain barcode consistency and conformity to international standards, guidelines and specifications, verification is mandatory for the barcodes on any new products and repackages. A verification report would be issued for every product verified. e. Consultancy Service GS1 (TZ) National Ltd can provide extra assistance to help achieve maximum results from the GS1 standards and systems within your organization. Consultancy is available on a wide range of topics including supply chain management logistics, integrated management systems among others. f. Seminars, Conferences and in-house training. Training seminars including barcoding and point of sale compliance training, which is a quarterly foundation course that teaches the basics of the GS1 thus UCC system, allocation of barcode numbers to products and how to design and print technical reliable barcodes. A certificate of attendance is issued to participating individuals and companies. g. Global Location Numbers (GLNs) GLNs are globally unique identifiers for electronic identification of sites and organisations. It is used to

4 identify suppliers of products for tracing and tracking of products. Statement from Auditors Name of Auditors (Full Address) Name of Company Statement of Auditors We, hereby (Name of Auditor) Certify that (Name of Applicant) Has an Annual Turnover as indicated below: Category 1: Tshs. 5M and Below Category 2: Tshs. 5.1M to Tshs. 10M Category 3: Tshs. 10.1M to Tshs. 40 M Category 4: Tshs. 40.1M to Tshs. 80 M Category 5: Tshs. 80.1M to Tshs. 200M Category 6: Tshs M to 500M Category 7: Tshs M and Above Please tick ( ) as appropriate Auditors signature and stamp Date NEW COMPANIES In the event that the applicant is a newly established Company and the first Annual Accounts and Balance Sheet have yet to be produced, the need for an Auditor s Certificate is relinquished and the applicant s Chief Executive Officer should sign the certificate set out below. As a newly incorporated Company, we have yet to produce our Annual Accounts and Balance Sheet. We estimate that our Annual Turnover will be Tshs. Chief Executive Officer/Managing Director Date Bank Details CRDB BANK: Account No: Vijana Branch Mpesa No Tigo Pesa No

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