Investment Promotion Centre

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YOUR PROJECT

REPUBLIC OF KENYA

ONE STOP APPROVAL PROCESS

INVESTMENT APPLICATION FORM

To be submitted to:

INVESTMENT PROMOTION CENTRE
P. O. BOX 55704
NAIROBI.
FAX: 254-20-336663

FOR OFFICIAL USE ONLY
REF. NO:…………………………………………………………..

DATE RECEIVED:……………………………………………..
PROJECT PROPOSAL FORM
(Full and accurate completion of this form will speed up the project approval process. Please Contact IPC staff if in difficulty.

[Please fill the Form in Bold Print]

PART 1.
A. DETAILS OF THE APPLICANT
(i) Name of Company/Business: ____________________________________________________________
(ii) Contact Person: ______________________________________________________________________

(iii) Contact Person’s Address: ______________________________________________________________

_____________________________________________________________________________________

(iv) Contact Person’s Phone: __________________________________ Fax: _________________________

(v) Type of Business Entity: _______________________________________________________________

(Indicate whether a Limited Company, A Patnership, Etc.,)
(vi) Country of Incorporation: _______________________________________________________________

(vii) Date of Incorporation: _________________________________________________________________

(viii) Business Address: ___________________________________________________________________

_____________________________________________________________________________________

(ix) Business Phone: _____________________________________ Fax: ____________________________

(x) Indicate (by ticking one) whether the Company is: ( ) Operating ( ) New

(xi) Indicate (by ticking one) whether you wish to Manufacture Under Bond (MUB)

(MUB is Manufacturing for export markets ONLY) ( ) Yes ( ) No

B. PROPOSED LOCATION OF BUSINESS
(i) Land Registration No. (L.R. No.): ________________________________________________________
(ii) District: ___________________________________ Town: ___________________________________

(iii) Street/Road: ________________________________________________________________________

C. SHAREHOLDING
NAME OF SHAREHOLDER* NATIONALITY & ADDRESS DETAILS OF SHAREHOLDING
Authorised No. of Shares Value of Each Share Total Value (Kshs) %

TOTAL

* For non-Kenyan shareholder (where source of share capital is external), please give full foreign address.

D. BOARD OF DIRECTORS
NAME OF DIRECTOR* NATIONALITY ADDRESS

* For non-Kenyan directors, please give full foreign address.

PART II.
A. PRODUCTION
(i) Name of Activity: ______________________________________________________________________
(ii) Indicate (a) products OR (b) services as appropriate:-

(a) PRODUCTS TO BE PRODUCED ANNUAL PRODUCTION (Quantity)

___________________________________

(b) SERVICES TO BE PRODUCED

_____________________________________________________________________________

(iii) For Manufacturing, indicate installed capacity per annum if different from (ii)(a) above: _________________

_____________________________________________________________________________________

B. PRODUCTION PROCESS
(i) Briefly describe the production process involved: ___________________________________________
___________________________________________________________________________________

___________________________________________________________________________________

C. ESTIMATED MAIN DOMESTIC RAW MATERIALS AND INPUTS CONSUMPTION PER YEAR
Raw Material Quantity

(i)___________________________________

(ii)___________________________________

(iii)___________________________________

(iv)___________________________________

___________________________________

D. ESTIMATED IMPORTED RAW MATERIALS AND INPUTS PER YEAR
Raw Material Quantity

(i)___________________________________

(ii)___________________________________

(iii)___________________________________

(iv)___________________________________

___________________________________

PART III.
A. MARKET (Domestic & Exports)
(i) Indicate expected domestic and export market share %

Domestic Market _______________

Export Market _______________

(ii) Give five (5) years Projected Sales Figures (Kshs. 000)

Domestic Sales Export Sales
Year Quantity Value (Kshs) Quantity Value (Kshs)

PART IV.
A. EMPLOYMENT DETAILS
KENYAN EMPLOYEES
Management

Technical/Professional

Skilled

Others
NUMBER
__________________

__________________

TOTAL
EXPATRIATE EMPLOYEES
Management

Technical/Professional

NUMBER
__________________

__________________

TOTAL

(i) Explain need for expartriate employee(s)

______________________________________________________________________________

B. TRAINING PROGRAMME (Local Employees)
Category to be Trained Management Skilled

Number to be Trained ____________________ ____________________

Period of Training ____________________ ____________________

Institutional or on the job ____________________ ____________________

C. INDICATE OTHER BENEFITS OF THE PROJECT
____________________________________________________________________
____________________________________________________________________

____________________________________________________________________

PART V:
INVESTMENT AND FINANCING PROGRAMME
A. CAPITAL COSTS (Estimated)

FIXED COSTS AMOUNT
Land & Land Development
Building
Plant & Equipment (C& F)
Sub-Total
OTHER COSTS
Working Capital
Others
Sub-total
GRAND TOTAL

B. FINANCING PLAN
The total capital investment indicated in Part IV (A) will be financed as follows:
(Specify Value in Kshs. 000)
Type of Financing Local Financing Foreign Financing
* Equity
Loan
Suppliers Credit
Others
Total

* Should equal both local and foreign share capital shown in Part I (C).

PART VI.
(i) State any foreign exchange commitments, and attach draft agreements,
(e.g. Royalties, Management Fees, Patents, etc.,)

______________________________________________________________________________
______________________________________________________________________________

______________________________________________________________________________

(ii) Specify any other assistance required

______________________________________________________________________________
______________________________________________________________________________

______________________________________________________________________________

PART VII.:
DECLARATION
I hereby certify that the foregoing particulars are correct to the best of my knowledge in every detail.

Name: ______________________________________________________________
Signature: ____________________________________________________________

Date: _______________________________________________________________

Please note that a Certificate of Incorporation is a requirement for the issue of General Authority Certificate, Trade licenses, Exchange control approvals, and tourism licenses. Please enclose it with your Application Form.

Indicate Enclosures: (Tick in the box).
1. Certificate of Incorporation in Kenya.

2. Articles and Memorandum of Association.

3. Joint-venture Agreement (draft)

4. Technical, Management, Royalties etc.
Agreement (draft)

5. Others.