Ghana Revenue Authority Taxpayer Registration Form - Individual
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4GHANA REVENUE AUTHORITY
TAXPAYER REGISTRATION FORM - INDIVIDUAL
COMPLETE FORM IN BLOCK LETTERS WITH BLACK / BLUE INK ONLY
A B C D
SEE PAGES 3 AND 4 FOR INSTRUCTIONS
(THIS FORM IS NOT FOR SALE)
PLEASE SPELL OUT ALL WORDS - NO ABBREVIATIONS
SECTION 1: PRIOR REGISTRATION
YES
NO
WERE YOU REGISTERED AS A TAXPAYER BEFORE OCT 2011?
SECTION 2: INDIVIDUAL CATEGORY
CATEGORY TYPE (Tick as applicable)
Self employed
Employee
Foreign mission employee
Other
If OTHER specify:
SECTION 3: PERSONAL DETAILS
TITLE (tick one only)
MR.
MRS.
MS
FIRST NAME
MIDDLE NAME(S)
LAST NAME
PREVIOUS LAST NAME
GENDER (tick one)
MAIN OCCUPATION
MALE
FEMALE
MARITAL STATUS (tick one)
SINGLE
MARRIED
DIVORCED
SEPARATED
WIDOWED
DATE OF BIRTH
_______/_____/___________ DD/MM/YYYY
BIRTH TOWN
BIRTH COUNTRY
BIRTH REGION
BIRTH DISTRICT
NATIONALITY
YES
NO
SOCIAL SECURITY NUMBER
RESIDENT (tick one)
IMPORTER
EXPORTER
TAX CONSULTANT
OTHER INFORMATION (tick applicable ones)
MOTHER'S INFORMATION
MAIDEN LAST NAME
FIRST NAME
SECTION 4: PREVIOUS TAX REGISTRATION INFORMATION (Complete this section if you were a registered taxpayer before October 2011)
IRS TAX OFFICE
OLD TIN NUMBER
IRS TAX FILE #
SECTION 5: IDENTIFICATION INFORMATION
ID TYPE (tick one)
National ID
Voter's ID
Driver's License (ID # is certificate of competence)
Passport
ID NUMBER
____/_____/_______
ISSUE DATE
(DD/MM/YYYY)
EXPIRY DATE
____/_____/_______
(DD/MM/YYYY)
COUNTRY OF ISSUE
PLACE OF ISSUE
SECTION 6: RESIDENTIAL ADDRESS
HOUSE NUMBER
BUILDING NAME
STREET NAME/PROMINENT LANDMARK
TOWN / CITY
LOCATION / AREA
POSTAL CODE
COUNTRY
REGION
DISTRICT
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