Application Form: Prospectus 2 of 20202020-05-15T14:15:13+02:00
Application Form: Prospectus 1 of 2020

SUBSCRIBER DETAILS:

(If applicant is a legal entity)
(If applicant is a legal entity)
*Please ensure that the deposit reference number entered above is quoted when making payment. The reference should read “DCL – “and your name.
Address
City
State/Province
Zip/Postal
Country

FICA DECLARATION:

In terms of section 42 of the Financial Intelligence Centre Act 38 of 2001 (“FICA”), an accountable institution must develop, document, maintain and implement a programme for anti-money laundering and counterterrorist financing risk management and compliance. For this reason all Investors have to declare FULL source of funds:

SUBSCRIBER BANKING DETAILS:

ACKNOWLEDGEMENTS AND UNDERTAKINGS BY APPLICANT: