B-1 Applicant/Company intends to be licensed for the service of: (check all that apply)
Electricity Brokerage
Electricity Sale
Electricity Export
Electricity Import
B-2 Applicant/Company’s legal name, postal address, telephone number and web site address
Legal Name
Postal Address
Telephone
Fax
Website Address(if any)
B-3 Office location address
House/Plot Number
Street Name
Town/City
Region
B-4 Contact person for regulatory matters
Name
Title
Business Address
Telephone
Fax
Email
B-5 Existing licence held by applicant
Wholesale Electricity Supplier
Electricity Brokerage
Electricity Distributor
Not Applicable
B-6 Incorporation
Place of Incorporation / Registration
Year of Incorporation/ Registration
B-7 Shares
Authorised share capital
Issue share capital
Subscribed share capital
Paid up share capital