COMPANY NAME MAIN PUBLIC CONTACT (MD or CEO) DESIGNATION EMAIL MOBILE TELEPHONE FAX APPLICANT DETAILS DESIGNATION EMAIL MOBILE TELEPHONE FAX FINANCIAL INFORMATION - Please provide summary information for your most recent three years’ accounts in the table below (younger companies should provide as many years as possible). COMPANY REGISTRATION NUMBER FINANCIAL YEAR END YEARS OF OPERATION Click here to enter your Turnover from 2014 - 2016 2016 2015 2014 NET PROFIT AFTER TAX AS A % OF TURNOVER NUMBER OF EMPLOYEES SECTOR CHARTER HOLDING COMPANY PRIMARY BUSINESS OPERATION B-BBEE INFORMATION BEE Verification Agency Black Ownership as a percentage of total Ownership % Black Female Ownership as a percentage of total Ownership % Employment of Black Top Management as percentage of total Top Management % Employment of Black Disabled People as percentage of total Employees % Employment of Black Female Top Management as percentage of total Top Management % Skills Development Spend on Black employees as percentage of Total Annual Payroll % Skills Development Spend on Black Female employees as percentage of Total Annual Payroll % Social Economic Development (SED) Spend as percentage of NPAT % Notable SED Programmes 10 + 14 = Submit