Regulatory Sandbox Form - Securities and Exchange Commission of Zimbabwe

Name(Required)

First Last

Email(Required)

Phone Number(Required)

Company Name(Required)

Date of incorporation(Required)

Registration Number

Company Head Office And Address(Required)

Phone number(Required)

Company website(Required)

Is your business currently registered / licensed / supervised by any other regulatory Authority in Zimbabwe?(Required)

Yes

No

Company size / scale (for existing operations)(Required)

Annual turnover (USD equivalent)(Required)

Annual Income (USD equivalent)(Required)

Total staff complement and breakdown(Required)

Founders / Key Management Details(Required)

Shareholder details(Required)

Name(Required)

Nature(Required)

Type of customers / investors you are targeting(Required)

How is your service, product plan or solution innovative(Required)

Explain associated benefits to the market / investors (e.g efficiency, risk management etc)(Required)

Explain any potential risks to the market / investors and proposed mitigants(Required)

Describe the technology and/or methodology that you are planning to use in offering your product, solution or service to the market.

Where does the IT infrastructure reside

How are you planning to deploy the product, service or solution to the market

Attach your Business Plan (pdf only)(Required)

Accepted file types: pdf, Max. file size: 512 MB.

Are you in / planning to collaborate with any existing financial institution(Required)

Yes

No

Provide details of the nature and arrangement of the collaboration (e.g. outsourcing of service, equity stake participation, joint venture etc.)