Sworn Affidavit - B-Bbee Exempted Micro Enterprise - General Form printable pdf download

Sworn Affidavit - B-Bbee Exempted Micro Enterprise - General Form

SWORN AFFIDAVIT – B-BBEE EXEMPTED MICRO ENTERPRISE - GENERAL

I, the undersigned,

Full name & Surname

Identity number

Hereby declare under oath as follows:

1. The contents of this statement are to the best of my knowledge a true reflection of the facts.

2. I am a Member / Director / Owner of the following enterprise and am duly authorised to act on

its behalf:

Enterprise Name:

Trading Name (If

Applicable):

Registration Number:

Enterprise Physical

Address:

Type of Entity (CC, (Pty)

Ltd, Sole Prop etc.):

Nature of Business:

Definition of “Black

As per the Broad-Based Black Economic Empowerment Act 53 of 2003 as

People”

Amended by Act No 46 of 2013 “Black People” is a generic term which

means Africans, Coloureds and Indians –

(a) Who are citizens of the Republic of South Africa by birth or descent;

(b) Who became citizens of the Republic of South Africa by

naturalization-

Before 27 April 1994; or

ii.

On or after 27 April 1994 and who would have been

entitled to acquire citizenship by naturalization prior to that

date

3. I hereby declare under Oath that:



The Enterprise is ______________% Black Owned as per Amended Code Series 100 of the

Amended Codes of Good Practice issued under section 9 (1) of B-BBEE Act No 53 of 2003 as

Amended by Act No 46 of 2013,



The Enterprise is ______________% Black Woman Owned as per Amended Code Series 100

of the Amended Codes of Good Practice issued under section 9 (1) of B-BBEE Act No 53 of

2003 as Amended by Act No 46 of 2013,



The Enterprise is ______________% Black Designated Group Owned as per Amended Code

Series 100 of the Amended Codes of Good Practice issued under section 9 (1) of B-BBEE Act

No 53 of 2003 as Amended by Act No 46 of 2013,



Based on the Financial Statements/Management Accounts and other information available on

the latest financial year-end of _____________, the annual Total Revenue was

R10,000,000.00 (Ten Million Rands) or less

Sworn Affidavit - B-Bbee Exempted Micro Enterprise - General Form

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