Sworn Affidavit - B-Bbee Exempted Micro Enterprise - General Form Page 2



Please Confirm on the below table the B-BBEE Level Contributor, by ticking the applicable

box.

100% Black Owned

Level One (135% B-BBEE procurement recognition

level)

At least 51% Black

Level Two (125% B-BBEE procurement

Owned

recognition level)

Less than 51% Black

Level Four (100% B-BBEE procurement recognition

Owned

level)

4. I know and understand the contents of this affidavit and I have no objection to take the

prescribed oath and consider the oath binding on my conscience and on the Owners of the

Enterprise which I represent in this matter.

5. The sworn affidavit will be valid for a period of 12 months from the date signed by

commissioner.

Deponent Signature:

Date:

Commissioner of Oaths

Signature & stamp

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