Business Registration | Employer | Workers' Compensation Fund Control Board

Employer Details

Employer's Name (Same name registered at PACRA) *

Name under which business is carried on *

Registered name of company (Limited liability companies only)

Employer Type *

Nationality *

ZRA TPIN *

PACRA Number *

Company Email *

Company Phone *

Country *

Have you previously been insured against Workers’ Compensation risks? *

Yes

Address and Location

Plot Number*

Street Name *

Name of Building

Floor & Room No

Landmark

Province *

Town *

Closest WCFCB Branch *

Postal Details

Postal Address *

Postal Name *

Town *

Postal Code *

Business Details

Nature of Business *

Date Incorporated *

Expected date format DD-MM-YYYY. For example 26-01-2019

Date Business Commenced *

Expected date format DD-MM-YYYY. For example 26-01-2019

State the precise nature of your trade, work, business or profession *

Give a general description of the various types of work in which your Worker will be engaged *

State the names of all Branches covered by this return, the nature of business of each Branch and the town or suburb in which the branch is situated. (Note: Subsidiary limited Companies must be registered on a separate form)

Add Branch Remove Branch

Proprietor Details

Title *

Nationality *

Zambian National Registration Number *

First Name *

Last Name *

Email *

Mobile *

Position *

Name of Partner (if any)

Post Box *

Postal Name *

Town *

Postal Code *

Contact Person Details

First Name *

Last Name *

Gender *

Nationality *

National Registration Number *

Position

Email *

Mobile(s) *

At least one mobile number must be provided

Supporting Documents

Please attach the following business documents.

Certificate of company registration*

TPIN Certificate/Tax Clearance form *

NOTE: The size of each document must not exceed 2MB.
Valid formats are pdf, png, jpg, bmp, doc, docx

Employer Registration

Employer Details

Address and Location

Postal Details

Business Details

Proprietor Details

Contact Person Details

Supporting Documents

Please attach the following business documents.

Summary