Form 4
Regulation 8(1)
THE REPUBLIC OF UGANDA
THE ELECTRONIC SIGNATURES REGULATIONS, 2012
APPLICATION FOR EXCEMPTION FROM LICENCE
To the Minister
1. Particulars of applicant:
(a) Name: ……………………………………………………………
(b) Physical address:
…………………………………………………………………….
…………………………………………………………………….
(c) Postal address: ……………………………………………………
…………………………………………………………………….
(d) Telephone (fixed line): ……………………………………………
(e) Mobile phone:……………………………………………………
(f) Fax: ………………………………………………………………
(g) E-mail address:…………………………………………………..
2. Legal status of applicant:
Indicate legal status of applicant
(Attach certificate of incorporation, memorandum and articles of association where
applicable)
3. Particulars of directors:
Name
(a)

Address

Nationality

Country of usual residence

Select target paragraph3