Precious Metals Act, 2005 (Act No. 37 of 2005)Precious Metals RegulationsAnnexuresAnnexure C : FormsForm PMJ(i) : Application for Renewal of Jeweller’s Permit |
FORM PMJ(i)
Permit number:_____________
South African Diamonds and Precious Metals Regulator
South African Diamond Centre, Cnr Main and Phillip Streets,
Johannesburg. PO Box 16001, Doornfontein, 2028
APPLICATION FOR RENEWAL OF JEWELLER’S PERMIT
[In terms of section 9(6) of the Precious Metals Act, 2005 (Act 37 of 2005)]
Instructions:
1. | For any enquiries, contact the office of the Regulator during office hours. |
2. | Complete the form in block letters and in black pen. |
3. | Where options are given mark the appropriate block. |
4. | Complete the form in English and do not use abbreviations. |
5. | Although the application forms are made available in electronic format, only a signed original hard copy shall be acceptable. |
6. | Ensure that all the required documentation accompanies the application. |
7. | The application must be submitted to the operational business premises of the Regulator. |
Part A : Particulars of applicant
1a) | In the case of a natural person, please provide the following: |
i) | Surname: |
_________________________________________________
ii) | First name(s): |
_________________________________________________
iii) | Identity number: |
_________________________________________________
*(A certified copy of the identity document must be attached.)
iv) | Has the applicant ever been convicted of any criminal offence in terms of the Act or any other law? (Yes/No) If yes, furnish particulars on a separate sheet of paper. |
b) | In the case of a person other than a natural person, please indicate: |
CC.____________Partnership/Joint venture _____________
Co. ____________Other (specify) _____________________
i) | Name of company, close corporation, partnership or joint venture: |
_________________________________________________________
ii) | Registration number of Co. or CC: |
_________________________________________________________
iii) | Full names and identity number of managing director or member: |
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
iv) | An indication of the metals/alloys/solders to be manufactured to jewellery: |
_________________________________________________________
_________________________________________________________
_________________________________________________________
v) | Source from which precious metals/alloys/solders will be obtained: |
_________________________________________________________
_________________________________________________________
_________________________________________________________
vi) | Reasons why renewal is required: |
_________________________________________________________
_________________________________________________________
_________________________________________________________
vii) | Description of the applicant’s manufacturing ability. |
_________________________________________________________
_________________________________________________________
_________________________________________________________
*(In the case of a company or close corporation, a certified copy of a certificate of incorporation must be attached.)
PART B: CORRESPONDENCE ADDRESS FOR THIS APPLICATION
2a) | Business address: |
i) | Building name: |
ii) | Building number: |
iii) | Street number: |
iv) | Street name: |
v) | Suburb: |
vi) | Town/City: |
vii) | Postal code: |
viii) | Province: |
ix) | Country: |
x) | Telephone number: |
xi) | Fax No: |
xii) | Cellphone No: |
xiii) | Email address: |
2b) | Relevant postal address: |
i) | Postal address:_________________________________ |
______________________________
ii) | Town/City:_____________________________________ |
iii) | Postal code:____________________________________ |
(Attach documentary proof of the registered business premises.)
THE APPLICATION MUST BE ACCOMPANIED BY THE FOLLOWING:
1. | A certified copy of the applicant's identity document, if applicable. |
2. | A certified copy of the certificate of incorporation and articles of association or founding statement, if applicable. |
3. | The applicant’s curriculum vitae or a brief description of the applicant’s manufacturing ability. |
4. | A copy of the relevant resolution, if acting in a representative capacity. |
5. | Documentary proof of the applicant's registered business premises |
6. | A description of the applicant's intended business activities, together with an indication of measures to comply with the broad-based socio-economic empowerment charter developed in terms of section 100 of the Mineral and Petroleum Resources Development Act (Act 28 of 2002), where applicable. |
7. | A non-refundable prescribed application fee. |
PART C: DECLARATION
I, the applicant,___________________________________________________, hereby declare that the contents of this application are true and correct.
Capacity: _
Signed at________________________________on the_________day of_________________
_______________________________________________________
SIGNATURE OF APPLICANT/REPRESENTATIVE (IF APPLICABLE)