REGISTRATION OF BUSINESS NAMES ACT

FORM BN 1 Rev 1.2011

APPLICATION FOR REGISTRATION BY SOLE PROPRIETOR

(Pursuant to Section 3)

Form should be completed in BLOCK CAPITALS only.

SECTION A. BUSINESS INFORMATION

1. NAME OF THE BUSINESS 2. DATE OF COMMENCEMENT

(Not a future date)

DD MM YY

1B OTHER PROPOSED NAMES OF THE BUSINESS ( IF THE NAME AT ITEM 1 IS REFUSED)

REGISTRATION

# (FOR RENEWALS)

1C. OTHER BUSINESS NAME UNDER WHICH BUSINESS WILL BE CARRIED OUT: THIS NAME WILL ALSO APPEAR ON THE CERTIFICATE

(Where applicable)

3. JUSTIFICATION OF PROPOSED BUSINESS NAME (where applicable)

4. GENERAL NATURE OF BUSINESS:

4A. Sale of:

4B. Type of Service:

5. PRINCIPAL ADDRESS OF THE BUSINESS:

Street/District/

Shop #/ Plaza

Post Office

City/Town

Parish

6. CONTACT NUMBERS:

Tel # - Tel #2 - Fax# -

7. BRANCHES FOR THE BUSINESS: Are there branches from which the business will be/ is being conducted? YES NO

(If yes, provide particulars for the first branch at 7a, 7b and 7c. If there are Additional Branches provide this required information on a schedule).

7A. Name under which branch will operate

7b Address where branch will conduct trade

Street/District/

Shop #/ Plaza

Post office

Town

Parish

7c. Nature of business to be conducted by branch

SECTION B. CERTIFICATION

Only to be completed by applicants required to present certification from a Professional or Regulatory body when certain words referring to a trade, profession or,

occupation form part of the business name.

(E.G.

“MEDICAL”, “UNIVERSITY”, CAMBIO,” “LEGAL,”DENTAL”, ‘BANK’, ‘PHARMACY”, “ENGINEER/ENGINEERING”, “DAYCARE”, “ACCOUNTING”)

Field or profession:

Expiry Date: dd/mm/yy

Certifying Body: Certification # (optional)

Have you provided the relevant certification as a part of your application? Yes No

FORM BN 1 Rev 1.2011

SECTION C. PARTICULARS OF APPLICANT

==============================================================================================================

1. Name of Applicant

Christian

Middle

Surname

1a. Any Former Christian or surname

First/ Christian Name:

Last Name/Surname:

Marriage

Deed poll

2. Place of residence (Verification required)

Street/District

Post Office

Town

Parish

3. Contact Numbers 4. Taxpayer Registration Number (TRN)

Tel # - Tel #2 - - -

5. Other business occupation (if any):

6. Present Nationality* 6a. Nationality of origin* (if different from present nationality)

* Except for nationals of the Caricom Single Market Economy member states, all non- Jamaican nationals are required to present a valid work permit along with

the application)

7. I, the undersigned, hereby apply for registration pursuant to the provisions of the Registration of Business Names (Amendment) Act

2006 , and for that purpose declare all statement of particulars furnished on this form to be true to the best of my knowledge and belief.

Signature ___________________________________________________________Date _____________________________________________________

==============================================================================================================

SECTION D: Particulars of individual/company filing form with the Registrar

Name

Address

Contact Email address

FOR OFFICIAL USE ONLY

Valid Identification Type ________________ Proof of residential address

Verification of TRN Proof of certification Attached Not required

Work Permit Attached To be provided Not required Other. ___________________________

COJ Officer ( Signature/stamp) __________________________________ Date ___________________________________

FORM BN 1 Rev 1.2011

INSTRUCTIONS FOR COMPLETION OF BN 1

This form is to be used for registration by an individual wishing to register or renew his/her business as a sole proprietor.

GENERAL INFORMATION:

All the fields on the form are to be filled out with the relevant information except where not applicable, the words “NONE” or “N/A” should be

written. If the space provided is insufficient to contain all the required information, the remaining information must be set out in a schedule. Each

schedule should be numbered sequentially.

Any document lodged with the Registrar must:

• Be on clean, white, good quality letter size paper 8.5 in. x 11in with 0.5 in. margins at the top, bottom and both sides.

• Be typewritten in minimum font size 12 or handwritten clearly in block capital with black or blue permanent ink.

• Be fastened securely at the top left hand corner.

• Free of correction fluid. Any errors should be struck through once and initialled by the applicant.

SECTION A: PARTICULARS OF BUSINESS

In this section, set out particulars relating to the business.

1. The proposed business names: The Registrar will refuse to register any name that is identical or similar to another name used by an

individual/ trader registered under the Business Name Act or company registered under the Companies Act. Additionally if the name is

profane, undesirable, offensive or uses obscene words, or infringes on a registered trademark, it may also be refused by the Registrar.

1a. Other names under which the business is carried out: If the business is carried out under a different name this should be presented.

2. Date of commencement: A business is required to be registered within 14 days after the individual has commenced any business. NOTE: It

should not be a future date

Registration # : Where an individual is requesting renewal of a business name registration, the registration number should be provided. This is

the number assigned by the Registrar of Companies and can be found on issued Certificate of Registration.

NOTE: Every registration and every renewal for registration is valid for three years after the issued date on the Certificate of Registration.

An application for renewal of registration should be made at least fourteen (14) days before the expiration of the current period of

registration.

3. Justification of proposed business names: The use of certain words that suggests a connection with the Crown or members of the Royal

patronage, for example “Royal”, “King”, “Princess”, “Prince” or “Crown”, or suggests a connection with a Government Department, Statutory

undertaking, local authority or with Commonwealth or foreign Government must be justified to the satisfaction of the Registrar prior to

registration.

4A. General nature of the business: e.g. sales of computers and accessories, wholesale of dry goods.

4B. General nature of the business: e.g. catering services, courier services.

5. Principal address must include a street/district/ plaza & shop #, post office and parish.

6. Contact number – telephone and fax number

7. A business may form one or more branches. The particulars of the first branch should be written in at 7A & 7B. You are required to

provide the information regarding each additional branch by annexing schedule.

SECTION B: CERTIFICATION

The use of certain words in a proposed business name which refer to a profession, occupation or other activities may require the applicant to produce

evidence of certification from the relevant professional or regulatory body upon submission of application. These words include but are not limited

to: “Engineer” “Medical” “Dental” “Bank” “Cambio” “Pharmacy” “University”. In the case of an individual who is registered under another

enactment as a prerequisite to practicing his profession or conducting of his trade, proof of such registration must be supplied with the prescribed

form.

SECTION C: PARTICULARS OF APPLICANTS

Set out the particulars in respect to the individual:

1. Applicant’s full name: include Christian name and middle name and surname

1A. Any former Christian or surnames.

2. Residential address: must include a street/district, post office and parish. Every applicant must submit a document verifying his current place

of address. Verification may be made by way of a valid drivers’ license, passport or utility bill.

3. Contact number- home & mobile

4. Taxpayer Registration Number (TRN)

5. Occupation (if other than business owner)

6. Present nationality: Where non-Jamaica national is making an application under these rules, he must furnish, in addition to satisfying the other

provisions of these rules, a permit from the Ministry of Labour indicating he is allowed to engaged in work within the country. This however

does not apply to Nationals of the Caricom Single Market and Economy members States.

6A. Nationality of origin if different from above: Non- Jamaican must present Naturalization papers or Marriage Certificate.

7. The applicant is required to certify that the information provided in the form is accurate.

This form must in all cases (whether new or renewal) be signed by the individual applying for registration and must be sent by post, electronic means

or delivered along with supporting documents and prescribed fees to:

Companies Office of Jamaica

1 Grenada Way

Kingston 5