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MSME REGISTRATION FORM - GROWTH ORIENTED MSME - NIGERIA
REGISTRATION
Please fill in the details below.
1.
Name of Entrepreneur
2.
Name of Business
3.
Contacts
Email
Telephone
4.
Do you have a PIN for paying Taxes?
Yes
No
5.
What is your Personal PIN?
6.
Gender
Female
Male
7.
Age
18 to 20 years
20 to 25 years
26 to 30 years
31 to 35 years
8.
Experience (Years) running any Business
None
1 to 5 years
6 to 10 years
Over 10 years
9.
Level of Education
Primary School
Secondary/High School
Diploma
Bachelors Degree
Masters Degree
10.
Marital Status
Single
Divorced
Married
11.
Number of Dependents
None
1 to 3
Above 3
12.
Location
13.
Does the Business have PIN for taxes?
Yes
No
14.
Business PIN
15.
Are you the Owner or Manager?
Owner
Manager
16.
Number of Years the Business has operated
less than 1 year
1 to 5 years
6 to 10 years
Over 10 years
17.
State of Business Incoporation
Partnership
Company
Self Help/Association
Any other
18.
Location of the Business
City
Peri Urban
Rural
19.
Sector of Business
Trade
Manufacturing
Service
Agriculture/Agribusiness
Green
Infrastructure
Any other
20.
Specific Type of Business
21.
Number of Employees
0
1 to 5
6 to 10
over 10
22.
Average Annual Turnover (USD/$)
0 to 10000
10001 to 50000
50001 to 100000
100001 to 150000
150001 to 200000
over 200000
23.
Have you ever accessed a Business Loan?
Yes
No
24.
If yes, when was that?
Less than 12 months ago
1 to 2 years ago
over 3 years ago
25.
How much was/is the loan amount USD/$?
Less than 10000
10001 to 50000
50001 to 100000
100001 to 150000
150001 to 200000
over 200000
