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BUSINESS NAME REGISTRATION FORM

Use this form to complete the CAC Registration for a Business Name.

Business Name Registration Form

Business Information
Proprietor Information

1. Business Information

Business Name:

Business Commencement Date:

The specific date when a Business officially begins its operational activities.

Email:

Phone/Mobile:

Nature of Business

Nature of Business Category:

Specific Nature of Business (ACCOMMODATION AND FOOD SERVICE ACTIVITIES):

Specific Nature of Business (ACTIVITIES OF EXTRATERRITORIAL ORGANIZATIONS AND BODIES):

Specific Nature of Business (ACTIVITIES OF HOUSEHOLDS AS EMPLOYERS; UNDIFFERENTIATED GOODS AND SERVICES):

Specific Nature of Business (ACTIVITIES OF ADMINISTRATIVE AND SUPPORT SERVICES):

Specific Nature of Business (ART, ENTERTAINMENT, AND RECREATION):

Specific Nature of Business (AGRICULTURE FORESTRY, AND FISHING):

Specific Nature of Business (COMMUNITY BASED ASSOCIATIONS):

Specific Nature of Business (CULTURAL BASED ASSOCIATIONS):

Specific Nature of Business (CONSTRUCTION):

Specific Nature of Business (EDUCATION):

Specific Nature of Business (FAITH BASED ASSOCIATIONS):

Specific Nature of Business (FINANCIAL AND INSURANCE ACTIVITIES):

Specific Nature of Business (FOUNDATION BASED ASSOCIATIONS):

Specific Nature of Business (HUMAN HEALTH AND SOCIAL WORK ACTIVITIES):

Specific Nature of Business (INFORMATION AND COMMUNICATION):

Specific Nature of Business (MANUFACTURING):

Specific Nature of Business (MINING AND QUARRYING):

Specific Nature of Business (POWER):

Specific Nature of Business (PROFESSIONAL, SCIENTIFIC, AND TECHNICAL ACTIVITIES):

Specific Nature of Business (PUBLIC ADMINISTRATION AND DEFENSE; COMPULSORY SOCIAL SECURITY):

Specific Nature of Business (REAL ESTATE ACTIVITIES):

Specific Nature of Business (REPAIR OF MOTOR VEHICLES AND MOTORCYCLES):

Specific Nature of Business (SOCIAL CLUBS BASED ASSOCIATIONS):

Specific Nature of Business (SPORTS BASED ASSOCIATIONS):

Specific Nature of Business (TRANSPORTATION AND STORAGE):

Specific Nature of Business (WATER SUPPLY, SEWERAGE, WASTE MANAGEMENT, AND REMEDIATION ACTIVITIES):

Specific Nature of Business (WHOLESALE AND RETAIL TRADE; REPAIR OF MOTOR VEHICLES AND MOTORCYCLES):

Specific Nature of Business (OTHERS):

Specific Nature of Business (OTHER SERVICE ACTIVITIES):

Description of the Business Activity:

Provide a brief description of what your Business will primarily do.

Registered Office Address:

State:

LGA:

City/Town/Village:

House Number/Building Name:

Street Name:

Head Office Address (if different from registered office)

State:

LGA:

City/Town/Village:

House Number/Building Name:

Street Name:

2. Proprietor

Add Individual Proprietor

Add Corporate Proprietor

Entity Details

Company Name:

Registration Number:

Contact Details

Email:

Phone/Mobile:

Registered or Principal Address

Country

State:

LGA:

City/Town/Village:

House Number/Building Name:

Street Name:

Authorized Signatory Details

Surname:

First name:

Other name(s):

Former name(s):

Date Of Birth

Gender:

Nationality:

Former Nationality:

Residential Address

House Number/Building Name:

Street Name:

City/Town/Village:

State:

Post Code:

Country

Share Allotment

Number of Shares Alloted:

Upload Documents

Upload a Copy of Government-Issued ID:

Choose File

Snapshot or scanned copy of ID. Passport, NIN Card, Permanent Voter's Card, Driver License.

Upload Recent Passport Photograph:

Choose File

Snapshot or scanned copy of Passport Photograph.

Signature:

Choose File

Snapshot or scanned copy of signature on a white background

ADD CORPORATE PRINCIPAL 2

Entity 2

Company Name:

Registration Number:

Contact Details

Email:

Phone/Mobile:

Registered or Principal Address

Country

State:

LGA:

City/Town/Village:

House Number/Building Name:

Street Name:

Authorized Signatory Details

Surname:

First name:

Other name(s):

Former name(s):

Date Of Birth

Gender:

Nationality:

Former Nationality:

Residential Address

House Number/Building Name:

Street Name:

City/Town/Village:

State:

Post Code:

Country

Share Allotment

Number of Shares Alloted:

Upload Documents

Upload a Copy of Government-Issued ID:

Choose File

Snapshot or scanned copy of ID. Passport, NIN Card, Permanent Voter's Card, Driver License.

Upload Recent Passport Photograph:

Choose File

Snapshot or scanned copy of Passport Photograph.

Signature:

Choose File

Snapshot or scanned copy of signature on a white background

Proprietor Information

Personal Details

Surname:

First name:

Other name(s):

Former name(s):

Date Of Birth

Gender:

Nationality:

Former Nationality:

Contact Details

Phone/Mobile:

Email:

Occupation/Designation:

Service Address

This is the address that will appear on the public record. This does not have to be your usual residential address.

Country:

State:

LGA:

City/Town/Village:

House Number/Building Name:

Street Name:

Residential Address

Country:

State:

LGA:

City/Town/Village:

House Number/Building Name:

Street Name:

Means of Identification

Identification Type:

Select the type of identification (e.g., International Passport, National ID Card, Driver’s License, Permanent Voter’s Card).

Identification Number:

Enter the number on the selected identification.

Upload Documents

Government-Issued ID:

Upload scanned copy

Snapshot or scanned copy of ID. Passport, NIN Card, Permanent Voter's Card, Driver License.

Recent Passport Photograph:

Upload scanned copy

Snapshot or scanned copy of Passport Photograph.

Signature:

Upload scanned copy

Snapshot or scanned copy of signature on a white background

ADD PROPRIETOR 2

Proprietor 2 Information

Personal Details

Surname:

First name:

Other name(s):

Former name(s):

Date Of Birth

Gender:

Nationality:

Former Nationality:

Contact Details

Phone/Mobile:

Email:

Occupation/Designation:

Service Address

This is the address that will appear on the public record. This does not have to be your usual residential address.

Country:

State:

LGA:

City/Town/Village:

House Number/Building Name:

Street Name:

Residential Address

Country:

State:

LGA:

City/Town/Village:

House Number/Building Name:

Street Name:

Means of Identification

Identification Type:

Select the type of identification (e.g., International Passport, National ID Card, Driver’s License, Permanent Voter’s Card).

Identification Number:

Enter the number on the selected identification.

Upload Documents

Government-Issued ID:

Upload scanned copy

Snapshot or scanned copy of ID. Passport, NIN Card, Permanent Voter's Card, Driver License.

Recent Passport Photograph:

Upload scanned copy

Snapshot or scanned copy of Passport Photograph.

Signature:

Upload scanned copy

Snapshot or scanned copy of signature on a white background

ADD PROPRIETOR 3

Proprietor 3

Personal Details

Surname:

First name:

Other name(s):

Former name(s):

Date Of Birth

Gender:

Nationality:

Former Nationality:

Contact Details

Phone/Mobile:

Email:

Occupation/Designation:

Service Address

This is the address that will appear on the public record. This does not have to be your usual residential address.

Country:

State:

LGA:

City/Town/Village:

House Number/Building Name:

Street Name:

Residential Address

Country:

State:

LGA:

City/Town/Village:

House Number/Building Name:

Street Name:

Means of Identification

Identification Type:

Select the type of identification (e.g., International Passport, National ID Card, Driver’s License, Permanent Voter’s Card).

Identification Number:

Enter the number on the selected identification.

Upload Documents

Government-Issued ID:

Upload scanned copy

Snapshot or scanned copy of ID. Passport, NIN Card, Permanent Voter's Card, Driver License.

Recent Passport Photograph:

Upload scanned copy

Snapshot or scanned copy of Passport Photograph.

Signature:

Upload scanned copy

Snapshot or scanned copy of signature on a white background

ADD PROPRIETOR 4

Proprietor 4

Personal Details

Surname:

First name:

Other name(s):

Former name(s):

Date Of Birth

Gender:

Nationality:

Former Nationality:

Contact Details

Phone/Mobile:

Email:

Occupation/Designation:

Service Address

This is the address that will appear on the public record. This does not have to be your usual residential address.

Country:

State:

LGA:

City/Town/Village:

House Number/Building Name:

Street Name:

Residential Address

Country:

State:

LGA:

City/Town/Village:

House Number/Building Name:

Street Name:

Means of Identification

Identification Type:

Select the type of identification (e.g., International Passport, National ID Card, Driver’s License, Permanent Voter’s Card).

Identification Number:

Enter the number on the selected identification.

Upload Documents

Government-Issued ID:

Upload scanned copy

Snapshot or scanned copy of ID. Passport, NIN Card, Permanent Voter's Card, Driver License.

Recent Passport Photograph:

Upload scanned copy

Snapshot or scanned copy of Passport Photograph.

Signature:

Upload scanned copy

Snapshot or scanned copy of signature on a white background

ADD PROPRIETOR 5

Proprietor 5

Personal Details

Surname:

First name:

Other name(s):

Former name(s):

Date Of Birth

Gender:

Nationality:

Former Nationality:

Contact Details

Phone/Mobile:

Email:

Occupation/Designation:

Service Address

This is the address that will appear on the public record. This does not have to be your usual residential address.

Country:

State:

LGA:

City/Town/Village:

House Number/Building Name:

Street Name:

Residential Address

Country:

State:

LGA:

City/Town/Village:

House Number/Building Name:

Street Name:

Means of Identification

Identification Type:

Select the type of identification (e.g., International Passport, National ID Card, Driver’s License, Permanent Voter’s Card).

Identification Number:

Enter the number on the selected identification.

Upload Documents

Government-Issued ID:

Upload scanned copy

Snapshot or scanned copy of ID. Passport, NIN Card, Permanent Voter's Card, Driver License.

Recent Passport Photograph:

Upload scanned copy

Snapshot or scanned copy of Passport Photograph.

Signature:

Upload scanned copy

Snapshot or scanned copy of signature on a white background

BUSINESS NAME REGISTRATION FORM

1. Business Information

Nature of Business

Registered Office Address:

Head Office Address (if different from registered office)

2. Proprietor

Entity Details

Contact Details

Registered or Principal Address

Authorized Signatory Details

Residential Address

Share Allotment

Upload Documents

Entity 2

Contact Details

Registered or Principal Address

Authorized Signatory Details

Residential Address

Share Allotment

Upload Documents

Proprietor Information

Personal Details

Contact Details

Service Address

Residential Address

Means of Identification

Upload Documents

Proprietor 2 Information

Personal Details

Contact Details

Service Address

Residential Address

Means of Identification

Upload Documents

Proprietor 3

Personal Details

Contact Details

Service Address

Residential Address

Means of Identification

Upload Documents

Proprietor 4

Personal Details

Contact Details

Service Address

Residential Address

Means of Identification

Upload Documents

Proprietor 5

Personal Details

Contact Details

Service Address

Residential Address

Means of Identification

Upload Documents

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