Tax Free Savings Account Endowment Application High

START INVESTING

Please select whether you are a New or Existing Investor

New Investor

Existing Investor

Client Number

What is your Risk Profile? *

Low

Moderate

High

Not Sure

Determine your Risk Profile

Do this test first to determine your Risk Profile before applying. Risk Profile Questionnaire

YOUR METHOD OF PAYMENT

A monthly debit order amount of

Under R500

Over R500

Specify monthly debit order amount *

if under R500 then your monthly debit order can only start at R150 up to R499 and if over R500 then your monthly debit order amount can only start at R500 or above.

Monthly Debit Order Date

To be collected on 1st of the month

Or the 15th of the month

If the 1st or the 15th falls on a weekend or public holiday, the funds will be deducted on the first business day following thereafter. Any debit order instruction / amendment must be received in writing at least five business days prior to the selected debit order date in order for it to be acted upon.

Commencement Date

Annual Escalation

0%

5%

10%

Lump Sum Payment (minimum amount - R20 000.00)

EFT : Electronic fund transfers may take up to two business days to appear in the bank account.

Electronic Collection : Collected within two business days after the receipt of this form. Electronic collection is restricted to a maximum of R500 00

Transfer from another fund

Amount *

Collection Date

YOUR TAX INFORMATION

Do you have a Tax Identification Number (TIN) issued by another country?

Yes.

No.

Country of Tax Issue

Tax ID Number (TIN)

Country of Tax Issue

Tax ID Number (TIN)

Country of Tax Issue

Tax ID Number (TIN)

Are you considered a tax payer, or need to submit a tax return, in any other country for which you have not been issued a TIN?

Yes.

No.

Please state the Countries

CHOOSE YOUR INVESTMENT OPTIONS

Investment Option

Allan Gray Bond Fund.

Coronation Strategic Income Fund.

Foord Conservative Fund.

Prescient Income Provider Fund.

Prudential High Yield Bond Fund.

Stylo Beta Conservative.

Investment Option

Coronation Balanced Plus Fund.

Prescient Balanced Fund.

Stylo Beta Growth.

Investment Option

Stylo Beta Conservative.

Investment Option

Stylo Beta Balanced.

Investment Option

Stylo Beta Growth.

Retail Investment Brochure

DETAILS OF LIFE ASSURED

The Investor will automatically be recorded as the Life Assured under the Policy. No other Lives Assured may be nominated.

BENEFICIARY FOR PROCEEDS

Beneficiary 1

Surname

First Name(s)

ID Number

Relationship

Share %

Beneficiary 2

Surname

First Name(s)

ID Number

Relationship

Share %

MAKE AN INFORMED DECISION

Before investing, please read the Terms and Conditions carefully to decide if the product meets your financial needs. Consider getting financial advice if you are not familiar with financial markets and products. View the Investment Option Brochure for information about the characteristics, risks and fees relevant to your investment choice.

PRODUCT BANK ACCOUNT DETAILS

Payment to be made into the following account.

Account Name	Prescient Endowment
Account Number	6220 653 2477
Bank	FNB
Branch	Corporate Account Services
Type of Account	Current
Reference Number	Your 13 digit ID or Passport Number (if foreign national)

PRODUCT FEES

The policy administration fee will be recovered through a sale of units in your Investment Account. The fees that apply to your selected investment options are set out below. internal

PRODUCT FEES

The policy administration fee will be recovered through a sale of units in your Investment Account. The fees that apply to your selected investment options are set out below. external

PROVIDE YOUR PERSONAL DETAILS

Title

Surname

First Name(s)

Gender

Male

Female

Date of Birth *

Nationality

ID or Passport Number (if foreign national)

Income Tax Number

Marital Status *

Single

Married

Divorced

Marital Contract *

Community Of Property

Ante-nuptial Contract

Residential Address

Postal Code

Postal Address

Postal Code

Telephone (W)

Telephone Number (H)

Fax

Cell *

Email Address *

Specify your preferred method of receiving correspondence *

Email

Postal Address

PROVIDE YOUR BANK DETAILS

This must be a South African bank account in the name of the Investor.

Account Holder

Bank

Account Number

Type of Account

Name of Branch

Branch Code

Banking details for debit order deduction / electronic collection (if different from Investor’s bank details)

Account Holder

Bank

Account Number

Type of Account

Name of Branch

Branch Code

COMPLETE THE FORM AND SUBMIT DOCUMENTS

A clear copy of your South African ID or passport (if foreign national)

A document less than three months old containing your residential address

A cancelled cheque or a copy of your bank statement

Proof of your deposit or your electronic fund transfer

If applicable, a completed “Acting on Behalf of the Investor form” plus the supporting documents referred to therein

Complete all relevant sections of this form and submit it, together with the documents listed which can be uploaded below.

FINANCIAL ADVISOR INFORMATION

Name of Financial Services Provider (FSP)	Triarc
FSP License Number	45009
Name of Financial Advisor	G J Nepgen
Telephone	021 810 5700
Email Address	jaco@triarc.co.za

Investor’s fee payment instructions

Initial Fee

0.5%

Annual Fee

0.5%

Tax Free Savings Account Endowment Application High

START INVESTING

YOUR METHOD OF PAYMENT

YOUR TAX INFORMATION

CHOOSE YOUR INVESTMENT OPTIONS

DETAILS OF LIFE ASSURED

BENEFICIARY FOR PROCEEDS

MAKE AN INFORMED DECISION

PRODUCT BANK ACCOUNT DETAILS

PRODUCT FEES

PRODUCT FEES

PROVIDE YOUR PERSONAL DETAILS

PROVIDE YOUR BANK DETAILS

COMPLETE THE FORM AND SUBMIT DOCUMENTS

FINANCIAL ADVISOR INFORMATION

About Us

About us

Contacts