Smart Invoice Commitment Form

1. Company/Business Information

Company Name/ Business Name

TPIN

PACRA Number

Physical Address

Plot No.

Street Name

Town

Country

Email One

Email Two

Mobile One

Mobile Two

2. Owner/ Director/ Legal Representative

Name

Position

Postal Address

Telephone No.

Landline (Optional)

Additional Phone (Optional)

Email

NRC/Passport No*

3. Smart Invoice Solution Required

Desktop/Laptop (Windows)

Tablet (Android)

PDA (Android)

Smartphone (Android)

Online Portal

4. Addition of Branches

To add a branch, complete Appendix A – Application Form to add Branch

Do you want to add a branch?

5. Integration and Certified Software Vendor Details

Certified Software Vendor / Self Details: TPIN

Name

Applicable Invoicing System Name

Applicable Invoicing System Version

6. Commitment by Taxpayer Applying for Smart Invoice Software

TPIN Number for Commitment

Date of Application

*For foreigners, use Passport number in lieu of NRC

Please confirm the following:

I confirm that I am ready to receive and properly use the Smart Invoice software.

I will not format/reset the device without prior authorization from the Zambia Revenue Authority.

I must return any Electronic Fiscal Device(s) within five (5) working days of installation.

I will keep all provided confidential information secure.

I will use confidential information solely for its intended purpose.

Name

Signature

I, Your Full Name, confirm that by submitting this form, I am providing my consent and acknowledge that this serves as my electronic signature.

Appendix A: Application Form to Add Branch

If you wish to add a branch, please complete this form and submit it to the Zambia Revenue Authority.

Branch Name

Branch TPIN

Branch Physical Address

Branch Email

Branch Mobile

SMART INVOICE COMMITMENT FORM

1. Company/Business Information

2. Owner/ Director/ Legal Representative

3. Smart Invoice Solution Required

4. Addition of Branches

5. Integration and Certified Software Vendor Details

6. Commitment by Taxpayer Applying for Smart Invoice Software

Appendix A: Application Form to Add Branch

7. Please select the services you're interested in