ZIMBABWE REVENUE AUTHORITY
WHISTLE-BLOWER ONLINE REGISTRATION FORM
SECTION A: General Details
Form of Address
Select Form of Address...
Mr.
Mrs.
Ms.
Miss.
Cde.
Hon.
Dr.
Rev.
*
First Name
*
Last Name
*
ID Number
*
House Number
Street
Country
Select Country
Afghanistan
Aland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua And Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas The
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo The Democratic Republic Of The
Cook Islands
Costa Rica
Cote D'Ivoire (Ivory Coast)
Croatia (Hrvatska)
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji Islands
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia The
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey and Alderney
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong S.A.R.
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea North
Korea South
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau S.A.R.
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Man (Isle of)
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Bonaire, Sint Eustatius and Saba
Netherlands The
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territory Occupied
Panama
Papua new Guinea
Paraguay
Peru
Philippines
Pitcairn Island
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Saint Helena
Saint Kitts And Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent And The Grenadines
Saint-Barthelemy
Saint-Martin (French part)
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard And Jan Mayen Islands
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad And Tobago
Tunisia
Turkey
Turkmenistan
Turks And Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City State (Holy See)
Venezuela
Vietnam
Virgin Islands (British)
Virgin Islands (US)
Wallis And Futuna Islands
Western Sahara
Yemen
Zambia
Zimbabwe
Kosovo
Curaçao
Sint Maarten (Dutch part)
*
Province
City
*
Mobile Number
*
Repeat Mobile Number
*
Fax/Extension
Postal Code
Email Address
*
SECTION B: Banking Details
These details will be used for reward purposes, only if a reward has been established
Name of Bank
Select Bank
AFRICAN BANKING CORPORATION
AGRI BANK
BANC ABC
BARCLAYS
BEVERLEY
CABS
CBZ
CENTURY BANK
CFX
COMMERCIAL BANK OF ZIMBABWE
ECOBANK
FBC BANK
FIRST NATIONAL BUILDING SOCIETY
INFRASTRUCTURE DEVELOPMENT BANK OF ZIMBABWE
INTERFIN BANK CORPORATION
INTERFIN MERCHANT BANK OF ZIMBABWE
INTERMARKET BULDING SOCIETY
JEWEL BANK
KINGDOM BANK
MBCA BANK
Metbank
METROPOLITAN BANK
NEDBANK
NMB BANK
P.O.S.B.
PEOPLES OWN SAVINGS OF ZIMBABWE
PREMIER BANK
PREMIER BANKING CO-OPERATION
RENAISSANCE
ROYAL BANK
STANBIC BANK
STANDARD CHARTERED
Steward Bank
TETRAD
TETRAD BANK
TIME BANK
TRUST BANK
ZABG
ZB Bank
ZIMBANK
*
Branch
*
Bank Account Number
*
Account Name
*
If reporting the case jointly do you want the reward to be paid in the same account?
Yes
No
If not advise other payment arrangement/details
*
Tick one of the following boxes to respond to the questions below:
Question
Response
1. Are you an employee of ZIMRA or a member of the Revenue Board?
Yes
No
2. Are you a near relative of ZIMRA employee or a member of the Revenue Board?
Yes
No
3. Did you obtain the information in the exercise of official duties as a ZIMRA employee or a member of the Revenue Board?
Yes
No
*
Generate username and password for Login Purposes.
Username
Password
Repeat Password
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