Agri Levy Services - Forms

Submit a Ticket - Amie Levy Registration Form

The Registered Business Name.  
The complete Company Registration Number. 
The Name of the business owner. 
Cellphone number of the owner. 
Contact person for Accounts. 
Contact number of Account Department. 
Email address where Levy Invoice must be send.  
NB! CIPC Registration documents needs to accompany this application form - attach them here. 
Submit