B-Bbee Qualifying Small Enterprise Sworn Affidavit Form (General)

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SWORN AFFIDAVIT – B-BBEE QUALIFYING SMALL ENTERPRISE - GENERAL
I, the undersigned,
Full name & Surname
Identity number
Hereby declare under oath as follows:
1. The contents of this statement are to the best of my knowledge a true reflection of the facts.
2. I am a Member / Director / Owner of the following enterprise and am duly authorised to act on
its behalf:
Enterprise Name:
Trading Name (If
Applicable):
Registration Number:
Enterprise Physical
Address:
Type of Entity (CC, (Pty)
Ltd, Sole Prop etc.):
Nature of Business:
Definition of “Black
As per the Broad-Based Black Economic Empowerment Act 53 of 2003 as
People”
Amended by Act No 46 of 2013 “Black People” is a generic term which
means Africans, Coloureds and Indians –
(a) Who are citizens of the Republic of South Africa by birth or descent;
or
(b) Who became citizens of the Republic of South Africa by
naturalization-
i.
Before 27 April 1994; or
ii.
On or after 27 April 1994 and who would have been
entitled to acquire citizenship by naturalization prior to that
date
3. I hereby declare under Oath that:
The Enterprise is ______________% Black Owned as per Amended Code Series 100 of the
Amended Codes of Good Practice issued under section 9 (1) of B-BBEE Act No 53 of 2003 as
Amended by Act No 46 of 2013,
The Enterprise is ______________% Black Woman Owned as per Amended Code Series 100
of the Amended Codes of Good Practice issued under section 9 (1) of B-BBEE Act No 53 of
2003 as Amended by Act No 46 of 2013,
The Enterprise is ______________% Black Designated Group Owned as per Amended Code
Series 100 of the Amended Codes of Good Practice issued under section 9 (1) of B-BBEE Act
No 53 of 2003 as Amended by Act No 46 of 2013,

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