4. • remises: hone No.: o.: Mobile hone No.: E-mail address: S. Attachments '- DECLARATION I declare that to the best of my knowledge, the informal ion provided in this submission is true. Signature of applicant:.............................. Date: . Organisotion: . Receipt No: . ..... 870 Statutory Instruments 22nd May, 2026 Form VIII (Regulation 8(2)(b0)) et to to tot»to»«r4 TOBACCO BOARD OF ZAMBIA The Tobacco Act, 2022 (Act No. 10 of2022) The Tobacco Board of Zambia (General) Regulations, 2026 RETURN OF PURCHASES BY A BUYER < Class oftobacco: Arca og origin: Month cnding: .. . see note I Licensed Purchase method (Auction/Matrix) Sales floor Class of Tobacco purchased Total number of bales purchased Cumulative weight of tobacco Cumulative value of tobacco purchased in purchased in a month (Ke) a month (USS) Note I. - This return is to be submitted, not later than the fifteenth of the month following that to which it refers, to: P. 0. Box 31963 LUSAKA Te EXECUTIVE DIRECTOR, Tobacco Board of Zambia 22nd May, 2026 Statutory Instruments 871 Form IX (Regulation 8(2)(c) and 20(7)) at to ts 3ate 1tet TOBACCO BOARD OF ZAMBIA The Tobacco Act, 2022 (Act No. 10 or2022) The Tobacco Board of Zambia (General) Regulations, 2026 SALES FLOOR SEASONAL TOBACCO SALES RETURN Name of Auction floor K: Class of Tobacco: Selling season 20 . .. . Name of Grower Growers Register Number Total Weight Sold Gross Value of Tobacco Sold US S) Signature Date • 872 Statutory Instruments 22nd May, 2026 (Reverse side of Form) NOTE 1. Please submit the following: (a) a plain showing the site; (b) a plan and elevations; (c) a plan and description of the humidification system of the buildings in which it is proposed to carry on the grading or to store tobacco. NOTE.2 The minimum standards of premises which may be licensed by the Tobacco Board of Zambia for grading tobacco are specified in rule S as follows: (a) (b) they arc of such design and construction as may be approved by an architect appointed for this purpose by the Tobacco Board of Zambia: they arc provided with storage space sufficient to permit the stacking of tobacco received for grading or a waiting dispatch for sale without exceeding a height of two hundred and forty-four centimeters above the level on which the bottom bale rests; (c) the floor surface of the grading shed, storage, sheds and all ramps, platforms and verandas adjacent thereto, and where applicable the walls thereof, are composed of such materials as to be resistant to rising damp and of sufficient strength elasticity to withstand the loads imposed upon diem, and capable of being so mainta.ined and treated as to prevent the harboring of pests of tobacco. d ¢ ¢ 22nd May, 2026 Statutory Instruments 873 FormX (Regulation 9(1)) ) TOBACCO BOARD OF ZAMBIA ._. ........ .,,_.. teas, 3, fart The Tobacco At, 2022 (Act No. 10 0f'2022) The Tobacco Board of Zambia (General) Regulations, 2026 NOTICE OF INTENTION TO SUSPEND OR REVOKE A LICENCE/CERTIFICATE OF REGISTRATION (I) Herc insert To (I} the full names ~dt~~dress . . licensee (2) Here insert IN THE MATTER OF (2) k the licence ,, No. {a lie intends to 'suspen /revoke your licenc«dcertificate o! registration on el if f ... dlr ·, you arc notified that the Board following the foll " .. grounds: {a) (b) ····························"•"''''"''''''''''' , .. . .. . (3) Here insert Accordingly, you are requested to show cause why your licence/certificate of registration (c) (ad) ................................................................. ······· type of application should not be suspended/revoked and to take action to remedy the breaches set out in days of receiving this notice. paragraphs within (3) Failure to remedy the said breaches shall result in the suspension/revocation of your licence/certificate of registration. Dated this day of 20 .. • •Delete as appropriate Executive Director OFFICIAL STAMP 874 Statutory Instruments 22nd May, 2026 Form XI (Regulation 9(2)) tat ea ta tut+a4a h tao+we TOBACCO BOARD OF ZAMBIA The Tobacco Act, 2022 (Act No. IO of 2022) d The Tobacco Board of Zambia (General) Regulations, 2026 NOTICE OF SUSPENSION OR REVOCATION OF A CERTIFICATE OF REGISTRATION/LICENCE (I) Herc insert the full names and address of licensee (2) Here insert the Licence No. (3) Here Insert number of days stipulated To (1) , .. IN THE MATTER OF (2) you are notified that your certificate of registration/licence has been suspended for a period of (3) ./revoked on the following grounds: (a) {b) (c) (d) Dated this day of 20 . Executive Director OFFICIAL STAMP ) 22nd May, 2026 Statutory Instruments 875 Form XII (Regulation 11) ..... __ .,..,_ ~ .. :, ... r:, .. c.-.t TOBACCO BOARD OF ZAMBIA The Tobacco Act, 1012 (Act No. IO of2022) The Tobacco Board or Zambia (General) Regulations, 2026 TOBACCO GROWERS' REGISTER The Tobacco Registers submitted to the Board shall be in the following format: Name of Gtndtr NRC grower Numbtrl Posspor1 Number TPIN TIJZ Number Producflon tobaco Locatton (.'lass of Hectares Expected Sponsor tobaco of Tubo,·co of planted (kuloram) (Dstrit) yeld 876 Statutory Instruments 22nd May, 2026 Form XIII (Regulation 20(3)) TOBACCO BOARD OF ZAMBIA The Tobacco Act, 2022 (Act No. 10 of 2022) The Tobacco Board of Zambia (General) Regulations, 2026 WIELD LEV RETURN Reference No.: . Date of Submission: [DD/MM/YYYY] Buyer's Name: . Buyer's License Number: [Buyer License No.) The TOBACCO BOARD OF ZAMBIA hereby acknowledges receipt of your Tobacco Levy Return submitted for the month of . Tobacco Levy per sales Floor Breakdown Farmers Sales Floor Name Number Mass (kgs) of Bales Gross Levy Amount @2% (USD) (USDJ Exchange Rate (BoZ (ZM) Levy Mid) TOTALS Executive Director OFFICIAL STAMP ) fl 22nd May, 2026 Statutory Instruments 877 SECOND SCHEDULE (Regulations 3(1), 5(1), 71), 8(1), 101) and 23) PRESCRIBED FEES Certificate of Registration Fee Units payable per three years . l. Application for certificate of registration