Page 1
DT 01 ver 1.1 DT01
A B C D
ARE YOU A REGISTERED TAXPAYER?
YES NO
CATEGORY TYPE (Tick as applicable)
Self employed Employee Foreign mission employee Other
Employer's Name If OTHER specify:
TITLE (tick one only)
MR. MRS. MS OTHER SPECIFY
FIRST NAME
MIDDLE NAME(S)
LAST NAME
PREVIOUS LAST NAME
GENDER (tick one)
MALE FEMALE
MAIN OCCUPATION
MARITAL STATUS (tick one)
SINGLE MARRIED DIVORCED SEPARATED WIDOWED
DATE OF BIRTH DD/MM/YYYY
BIRTH TOWN
BIRTH COUNTRY
BIRTH REGION
BIRTH DISTRICT
NATIONALITY
RESIDENT (tick one)
YES NO
OTHER INFORMATION (tick applicable ones) IMPORTER EXPORTER TAX CONSULTANT NOT APPLICABLE
MOTHER'S INFORMATION
MAIDEN LAST NAME
FIRST NAME
CURRENT TAX OFFICE
OLD TIN NUMBER IRS TAX FILE #
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)
PLACE OF ISSUE
HOUSE NUMBER BUILDING NAME
STREET NAME/PROMINENT LANDMARK
TOWN / CITY
LOCATION / AREA
POSTAL CODE
COUNTRY
REGION
DISTRICT
SECTION 3: PERSONAL DETAILS
SECTION 2: INDIVIDUAL CATEGORY
SECTION 6: RESIDENTIAL ADDRESS
SECTION 4: TAX REGISTRATION INFORMATION (Complete this section if you are a registered taxpayer)
COUNTRY OF ISSUE
SECTION 5: IDENTIFICATION INFORMATION
SOCIAL SECURITY NUMBER
GHANA REVENUE AUTHORITY
TAXPAYER REGISTRATION FORM - INDIVIDUAL
SECTION 1: PRIOR REGISTRATION
(THIS FORM IS NOT FOR SALE)
PLEASE SPELL OUT ALL WORDS - NO ABBREVIATIONS
COMPLETE FORM IN BLOCK LETTERS WITH BLACK / BLUE INK ONLY
SEE PAGES 3 AND 4 FOR INSTRUCTIONS
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DT 01 ver 1.1 DT01
TICK IF SAME AS RESIDENTIAL ADDRESS
C/O
Prefix
Number
POSTAL TYPE (tick as applicable)
P. 0. BOX PMB DTD
BOX REGION
BOX TOWN
BOX LOCATION/AREA
PHONE/LANDLINE NUMBER MOBILE NUMBER
FAX NUMBER
E-MAIL
WEBSITE
PREFERRED CONTACT METHOD (tick one)
MOBILE EMAIL LETTER
NATURE OF BUSINESS
ANNUAL TURNOVER IN GH¢
NO. OF EMPLOYEES
HAVE YOU REGISTERED YOUR BUSINESS NAME(S) WITH RGD?
YES NO (IF YES, PROVIDE DETAILS BELOW)
HOUSE NUMBER BUILDING NAME
STREET NAME/PROMINENT LANDMARK
TOWN / CITY
LOCATION / AREA
POSTAL CODE
COUNTRY
REGION
DISTRICT
SECTION 10: DECLARATION
THUMB
SIGNATURE DATE
(DD/MM/YYYY) PRINT
NOTE: THUMB PRINTING SHOULD ONLY BE DONE IN THE PRESENCE OF A REGISTRATION OFFICER
SECTION 11: THIRD PARTY COMPLETION OF FORM
I,
declare that the information given above is correct and complete
first, middle and last name
CELL NUMBER DATE (dd/mm/yyyy)
SIGNATURE
SECTION 12: OFFICE USE ONLY
ORIGINATING TAX OFFICE ASSIGNED TAX OFFICE
VETTING OFFICER FULL NAME GRADE ISIC CODE
DATE OF SUBMISSION ____/____/_______ (DD/MM/YYYY)
IRS TAX FILE #
DATA ENTRY OFFICER DATE OF DATA ENTRY ____/____/_______ (DD/MM/YYYY)
REMARKS ISSUED TIN
TIN
full name of applicant
SECTION 8: CONTACT METHOD
Indicate purpose of contact within the thick outlined box provided (P - Personal; B - Business; H - Home)
POSTAL NUMBER
BUSINESS ADDRESS
declare that the information given above is
correct and complete
I,
RIGHT
BUSINESS NAME OLD TIN
RGD NUMBER
SECTION 9: BUSINESS ( COMPLETE THIS SECTION IF YOU ARE SELF EMPLOYED)
SECTION 7: POSTAL ADDRESS
Page 3
TAXPAYER REGISTRATION FORM INDIVIDUAL
COMPLETION NOTES
SECTION NOTES
GENERAL
Complete Form in BLOCK characters in Black or Blue ink only. Spell out all words - Do not use Abbreviations.
All dates are formatted as dd/mm/yyyy. For example 04/06/2011 is 4th June, 2011.
If FIELD information is Not Applicable please enter N/A.
SECTION 1
PRIOR
REGISTRATION
Tick YES, if you are a registered taxpayer and / or have a TIN, otherwise tick NO.
SECTION 2
CATEGORY
Tick appropriate check box(es).
Self Employed, if self employed.
Employee, if you are employee of a business concern – specify employer’s name.
Foreign Mission Employee , for employees of international organizations who have been identified and approved by the
Ministry of Foreign affairs as such under international conventions. Ghanaian and foreign nationals not identified as such
by the Ministry of Foreign Affairs who work for international organizations should select employee. Please specify Foreign
Mission name under employer’s name.
Other, specify, e.g. Student.
SECTION 3
PERSONAL
DETAILS
Title - Tick one only; If other specify title.
Middle Name(s) - all other legal names (no aliases) other than first and last name.
Last name - Same as SURNAME.
Previous Last name - same as Previous Surname (due to legal change of name or by marriage).
Gender : Tick appropriate box.
Main Occupation: Indicate your main occupation e.g. Civil Servant.
Marital status: Tick appropriate box.
Birth Country: if birth country is not Ghana, enter N/A for birth region and district.
Resident: This specifies your residency status.
For Tax Administration in Ghana, Resident individual means;
(1) an individual is a resident individual if that individual is
a. A citizen of Ghana, other than a citizen who has a permanent home outside Ghana for the whole of the calendar year.
b. Present in Ghana for a period, or periods amounting in aggregate to, 183 days or more in any twelve-month period that
commences or ends during the calendar year.
c. An employee or official of the Government of Ghana posted abroad during the calendar year or
d. A citizen who is temporarily absent from Ghana for a period not exceeding 365 continuous days where that citizen has
a permanent home in Ghana.
Other Information: Select or Tick those that apply. Are you an Importer, Exporter, or Tax Consultant.
Mother's maiden last name: This is your mother's maiden surname.
SECTION 4
TAX
REGISTRATION
If you are already a registered taxpayer, specify
Current Tax Office, office where you transacted tax business.
Old Taxpayer Identification Number, the 10 character ‘old’ TIN assigned.
IRS tax file number, the file number allocated.
SECTION 5
IDENTIFICATION
ID types: Tick ID type for registration and complete section with the details of that ID type.
All ID types, except for passport, are Ghana IDs. A colour photocopy of the ID should accompany the application
for verification. In the case of Passports, attach picture page and passport details page to the application.
Original ID may need to be validated. Employees of foreign mission as specified above are to submit
information details (copy of passport info) to the Ministry of Foreign affairs. Note: The Driver Licence ID number
is the Certificate of Competency, not PIN. This is located at the bottom right hand corner of the Driver licence.
Page 4
SECTION 6
RESIDENTIAL
ADDRESS
House number - this is the number of the house on the street. For example for 250 Ako Adjei Street the house number is
250 and Ako Adjei street is the street name.
Building Name: Conspicuously and recognizable labelled building, for example VAT HOUSE.
Street name - Name of street including description of landmark(s) that could aid in locating the
building e.g. Ring Road, 50m from Kwame Nkrumah Circle.
Postal Code : applicable to only applicants with foreign postal addresses.
Location / area - Name of location - suburb and description of area within a city or town. For example DANSOMAN
(AKOKOFOTO) or NORTH KANESHIE (LAST STOP).
SECTION 7
POSTAL
ADDRESS
Provide Postal address.
Postal type: Select the Postal type applicable.
I. P. O. Box: Normal Post box.
II. P.M.B: Private Mail Bag.
III. DTD: “Door To Door” delivery .
Box Location / area - Name of post office area - e.g Cantonments or Accra-North.
SECTION 8
CONTACT METHOD
Provide details of method of contact - Phone Number, Mobile Number etc and
Indicate the purpose of that method by preceding each method of contact information with:
B – for Business (contact at business location);
H - Home (contact at home);
P - Personal (direct personal contact);
in bolded boxes, and supply contact information to the right of the bolded box.
Select the preferred method of contact by ticking one of the following checkboxes: Letter, Email, Mobile, Fax
SECTION 9
BUSINESS
Complete if you are Self employed or have registered business(es).
Nature of business: Provide a brief description of business activities or nature of business.
Annual Turnover: Annual turnover for the past calendar year or twelve months; or projected annual turnover.
No. Of Employees: Number of employees or projected number of employees.
Business Names: If you have registered business name(s), provide name(s), old taxpayer identification number (TIN) and
the Registrar General's Department's business number.
Business Address: Explanatory notes as in section 6.
SECTION 10
DECLARATION
Applicant must provide full name (as given in Section 3) and sign. Applicant is held liable for any false declaration.
Applicant may thumbprint in place of signature. The thump-printing must be in the presence of Ghana Revenue Authority
(GRA) Registration Officer and in a GRA office. Section 11 must be completed If applicant is not the one submitting the
application.
SECTION 11
THIRD PARTY
DECLARATION
The third party submitting or completing the application shall complete all boxes Full Name, New TIN, Cell phone
number, Date and Signature and will be held liable for any false declaration.
Note: The third party is required to have the new 11 character TIN and should submit or attach a colour photocopy ID of
themselves (i.e. one of the IDs identified in section 5) to the application.
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