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Received Cash Payments Form

Freezone company name:

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Part I: Identity of individual from whom the cash was received

1. Last name(s):*

2. First name:*

3. Address:*

4. Place:*

5. Country:*

6. Date of birth:*

6. Place of birth:*

7. Occupation, profession or business:*

8. Document used to verify identity:*

8.1 Document issuing country:*

8.2 Number:*

8.3 Issuing Date:*

8.4 Expiration Date:*

8.5 Copy on file:*  Yes No

If more than one individual is involved, please complete the information on additional forms for the other individuals

Part II: Person/Business on whose behalf this transaction was conducted

9. Individual’s full name or name of business:*

10. Address:*

11. Place:*

12. Country:*

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Part III: Description of transaction and method of payment

13. Date cash received:*

14. Multiple payments?*  Yes No

15. Total cash received (in U.S. dollar equivalent):* $

16. Select currency:*

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By submitting this form I declare to be authorized to provide this specific information and that the information provided is complete and correct. Free Zone Aruba (FZA) NV accepts this electronically submitted form as if it was a signed hard copy, and retains the right to request hard copies of the submitted forms.

Date:*

Name:*

Email: * receive a copy.


Please leave this field empty.

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Declaration Form Freezone Facility Charge

Company name*

Account no.

License no.

Fill in corresponding month*

The undersigned declares that total turnover 1 over the month of

Fill in amount and indicate currency by checking appropriate box*

Amounted to  $ Afl

Fill in amount and indicate currency by checking appropriate box*

The undersigned further declares to have paid Freezone Facility Charge in the amount of  $ Afl

Fill in amount and indicate currency by checking appropriate box*

The undersigned further declares to have paid BAZV2 in the amount of  $ Afl

Indicate payment method by checking appropiate box(es)

Payment was made in favor of Free Zone Aruba (FZA) NV by
 Cheque Cash (only amounts under Afl. 1000,-) AB # 4002851 CMB # 21208905

By submitting this form I declare to be authorized to provide this specific information and that the information provided is complete and correct. Free Zone Aruba (FZA) NV accepts this electronically submitted form as if it was a signed hard copy, and retains the right to request hard copies of the submitted forms.

Date:*

Name:*

Email: * receive a copy.


Please leave this field empty.

 

(1) Turnover refers to total value of sales of merchandise, cash or credit in the reported period, whether from export or sales to the local market, as well as the value of sales of merchandise or goods processed on behalf or third parties and the value of all services rendered, including management fees, lease income, etc.
The turnover is the basis for calculating the FFC. (2) The BAZV (health levy) equals 2% of the total Freezone Facility Charge amount.

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