CHARITY COMMISSION FOR ENGLANO AND WALES Trustee Ellgibility Declaration PLEASE COMPIETE USING BLOCK CAPITALS AND BLACK INK cofflplete odditlonol ILYMS il YGW hove fflofe than 4 ffUSt•esJ Orran15atlon name (Your ty8anlsatrt￿ narne as It ￿P￿ar3 In y￿r 8overning document) ES'KHOSINI BAMBANANI FOUNDATION TRUST Total numbef ol tTU5tees your oryanls•t•on h•$ Tn￿e0 I Tn￿te• 2 Truste• 3 Tnth4 Narn• Mamo Name Naffte KOSANA NCUBE EVIN MYCOCK IKIUNYISIWE MYCOCK KHILE CRAGG S*natur•: Slinature: SIEnatwe: &'8naiure Dale Dale Date Date FJllFJU F3llFJll Fjapju UF31 Worklry vrith vulnerable groups Tkk thls box If your (YEanisation Wofks with vulnerdble people (includifis chlldren) and you declare that you have: Read and undefstood the Charity CommissI￿'S safe8uar(fin8 8uIda￿e Carrfed out all Iiustee eheltslity checks the law requires and on the basls of those thecks are satlsfied that the people acl6n8 as trustees are both ell8ible and suitable act as trustees of Ihis chafity Cofporate Trusteeshlp TKk this box rf your or8*)sat•on has • corporate trustee lanothef (xganlsatson whkh acts as tnjstee such as a local authoflty) and Its dlfeaors are maklry tNs dedaratlon) Personal ben•flt If your or8anlsation pry51or will payl any trustee for belng In￿tee OR any trustee or person connected to them lor providlnB 8oods and services, you declare that thls will: be in the or8anisation's best éntefests be lawful and authorlsed help the or8anisatlon carry out its purposes (Of be a netsssary by.product of rt carrylna out ts purposes) Trust•• eli¢ibllity and r•sponslblllty 8y complelln8 and si8nln8 thls form, you dedare that you: are wllling to art as a tn￿ee of the or8anisatlon namL•d above understsnd Youf orpnisation's purposes (objects) and rules set out In its 80￿rnIn8 document are not prevented from ¥ting as a trustee because You also declare that the inl¢xmatlon you prowde 10 the Charlty Cornfflimioft Is true, complete and correct you under5t*nd that ifs an offence undef section 6011>(b) of the Charltles Act 2011 to k￿￿1n8fy Of recklessly provlde false or misleadins Information your or£anSsatk>n's funds are held (Of will be held) In Its name In a bank or bullding society account In Enlland or Wale5 you will cofflply wlth your fesptyisilx"Iltbes as Irustees . these are set out in the Charèty CtynmissK)n iuldaftce The essentlal Irustee {CC3)' (rf appllcable) the primary addfess and fesldency details vou provide In a tharity fe8istrat60fi appllcatkxi are correct and you will notify th• Charity Commission11 they chan8e have an unspent convictlfy) for one of more of the offences listed here. have an IVA, debt relief (xder and/or a bankruptcy ordof have been rernoved as a tnfjiee in England, Scoitsnd or Wales {by the Chaflty Commisslon c Offke of the Sco(tish Charity Re8ulatorl have been rern(Yded froffl beln8 In the manalefflent or contrd of any body kn Scotland (under felevant legislatlon) have been dlsquaiified by the Charlty Commss•on are a dlsqualified company directof are a designated person for Ihe pwposes of ant terrorlsm ￿l$latIon are on the sex offenders re8lster have been found In contempt ol court for makin (or causlne to be madel a false statement have been [ots￿l luilty ol dls0bed1en￿ to an Ofder Of dlrectlon of the Charlty Cornmlsslon •htt assets. blishin .servlce. loads stern loads attathrnent dalJ ualifiutlon ReasMs Table v2.odt overnmen 820804 CHARITY COMMISSION FOR ENGLAND AND WALES Trustee Eligibility Declaration PLE￿ COMPLETE USING BLOCK CAPITALS AND DLACK INK complele addIt￿nall￿MSlI you hotrf more than 4 Ifvileesl Oryanlsatbon naffle Iyour (nanlsaikni name as It appears In ywr Bovernliig document) ES'KHOSINI BAMBANANI FOUNDATION TRUST Total number d tNstees your orianlsatlon has T￿￿te¢ I Tn￿le• 2 Trust•• 3 Trust•• 4 Name Name IKHANYISIWE MYCOCK Name Naffle EVIN MYCOCK KHILE CPAGG KOSANA NCUBE Si8nature: 98natUfe: Rnaiwe l)ale Date Date Date FJllFJU FJUFJll FJFJ FJll8U F3llFJI Wofklnc wlth vulnerable youp5 rrk thls box If yow organisaiion works with vulnerable people (indLKllni thlldren) and you dedare thal you have: Read and undefstood the Charity Commlsslorfs safeguarding guidarKe Caffied (yJl all trustee eli8ibilily checks the law requires and on Ihe basls of those thecks afe satlsfied that the people actin8 as Irustees are both ell8lble and sultable to act M trustees of this charity Cory>ofate Trnst•eshlp Tick this box rf y￿1 ofe*blsat•on has a corporate trt￿tee (another oreanisatlon whlch acts as tntstee such as a lorAI auth￿ty1 and Its dlrectors are makiry this dedafatk>n) Pefsonal benefft If your organlsatlon pays (or pay) any trustee for belng a trustee OR •ny tfustee or pef50n connerted to them lor Pfovldln8 loods and sefvéce5, you declare that this will: be in the 0f8an1sat￿n,s best Iniefests be lawlul and auihtylsed help the 4Y8anlsatsi)n cafry thit its purposes (or be a nrfessary by-product of It Carry1￿ out fts Pufposes) Truste• er•¢I￿lIty •nd responslbililv v C￿letin8 and si8nln8 (hbs lof m, you dedare that you= fe wl111￿ to act as a trusiee of Ihe or8anisatbon named above understsnd your or8anisatlon's Purposes (objects) and rules set out In its 8overnln8 document are not prevented from actln£ as a trustee because You also dttlare that the Inforrnatlon you provlde to the Charity Cunfflission Is Inje. cofflplete and C¢XTert >u understand that ifs an offence serti 60(1)Ib) of the Chariiles kt 2011 to kftowlnKly or recklessly provlde false or mlsleadlng Inlormat yow ¢xynlsatkn's funds ar• held lor wlll be hekl) In Its name In a bank or bulldln¢ soaety account In En8lafKI Of Wales you will compty with yLwr fesponslbllities as Ifustees . these are set out In the Chafrty C(xMitsslon guklarn afe correct and you will notlfy the Charily Comrnissth rf they thance have an unspenl convlcllon lor one or more of the offences listed here. have an IVA debl relief order and/or a bankfuptcy ordei have bel￿ removed as a trustee in Eneland. Scotland or Wales (by the char￿ Commisslon or Offke of the Scottlsh Chanty Re8ulatoi) have been femoved from beong In the mana8emenl of control of any body In 5coiland {under relerfant legislatlcm) have been disqualilied by the Charity Cofmilsslon afe a disqu•lified company director are a deSI￿ated person for the purposes of ant tefrorlsm legislation re on the sex offerthfs reeister have been fourMI In contempt of court lor makln (or causin6 to be made) a false statemenl have been found £uilty ol disobedience 10 an Ofdef or dlrection of the Charity Comrnsslon hti assets. bllshn iern loads attach￿￿1 daia Ualificati￿ Reasons Table v2.odl .seTrKe. ov.u cr4efnmen 820804