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CAC ACCREDITATION FORM FOR PROFESSIONALS

CORPORATE AFFAIRS COMMISSION CAC/ACR/1

(Established Under the Companies and Allied Matters Act, 1990)

Plot 420, Tigris Crescent, Off Aguiyi Ironsi Street, Maitama, Abuja

APPLICATION FOR ACCREDITATION

(For use by firms/individuals)

No.___________________

1. Name of the firm/individual: _____________________________________________

2. Nature of the Business: _________________________________________________

3. Principal Place of business: ______________________________________________

4. Branches (addresses not P. O. Box)

a) (i) ____________________________________________________________

(ii) ____________________________________________________________

(iii) ___________________________________________________________

b) Telephone: _____________________ Email Address: ___________________

5. Full names, enrolment number and signature of each partner (in the case of partnership)

(i) ______________________________ (ii) _________________________________

(iii) _____________________________ (iv) ________________________________

6. Names and signature of representatives:

(i) ______________________________ (ii) ________________________________

(iii) _____________________________ (iv) _______________________________

7. Evidence of eligibility to practice for the year

_____________________________________________________________________

I/We hereby certify that the foregoing particulars are to the best of my/our knowledge, information and belief, correct and I/we undertake to notify the Registrar-General whenever any change is made or occurs in any of them.

8. Indicate State Office for collection of card: __________________________________

Dated at ________________ this _______________ day of _______________ 20______

(Signature of Principal Partner)

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