CURRENCY TRANSFER - REGISTRATION FORM A. PERSONAL DETAILS AND CONTACT INFORMATION First name: Date of birth: SA ID No.: (If applicable) Primary residential address: Surname: Country of birth: Foreign address details: (If applicable) Telephone No.: (Day time) Email address: Cell No.: Alternative Tel No.: B. PASSPORT INFORMATION Passport country(ies) of issue: Passport number(s): Passport expiry date: Permanent SA resident Non SA resident Foreign temporary SA resident SA citizen temporarily abroad Type of SA visa Retired Work Spouse Business Other Permanent residence permit issued on: Permit No.: C. SOURCE OF FUNDS Bonus Capital/Savings Inheritance Transfer from other Financial Service Provider Other: Employment details Salaried employee Self-employed Retired Unemployed Name of employer/business if you are self employed: Incompass reserves the right to request documentary proof e.g. income statement, bank statements etc.
CURRENCY TRANSFER - REGISTRATION FORM D. TAX INFORMATION FATCA* Tax Regulations require us to collect information about each investor s tax residency. In certain circumstances (including if we do not receive a valid self-certification from you) we may be obliged to share information on your account with SARS. If you have any questions about your tax residency, please contact your tax advisor. Should any information provided change in the future, please ensure you advise us of the changes promptly. Individual self-certification If you are only resident in South Africa for tax purposes, please tick this box If ticked please insert your SA Tax Certification No.: or please indicate all countries in which you are resident for tax purposes and the associated tax reference numbers in the table below. Country/countries of tax residency: Tax reference No. (For US citizen/resident TIN3): PLEASE PROVIDE: A certified original copy of your bar coded SA ID book or foreign passport. A copy of your visa (if applicable, for foreign passport holders). Proof of your residential address (original certified copy of a utility bill) from within the last three months. You may be required to provide further documentation. *FATCA - FATCA refers to The Foreign Account Tax Compliance provisions.
CURRENCY TRANSFER - TERMS AND CONDITIONS The parties to this agreement are: Incompass Pty Ltd ( Incompass ) of 2nd Floor Graphic Centre, 199 Loop Street, Cape Town 8001 and the Client named in the attached registration form (the Client ). 1. INTRODUCTION 1.1. Incompass provides facilities for the purchase or sale of currencies for both commercial and personal purpose between the Client and an authorised dealer (as defined by the South African Reserve Bank). Incompass will also, if necessary, facilitate the opening of a bank account for the Client with the authorised dealer. 1.2. At maturity the Client must take delivery of funds into a bank account. 1.3. The Client wishes to enter into a contract or contracts for the purchase, sale and delivery of currency and the Client agrees that all transactions shall be carried out in accordance with the terms and conditions as set out below. The Client mandates Incompass to act as a foreign exchange broker (agent) between him/herself and the authorised dealer. 1.4. The Client confirms that he/she is a acting on his/her own account and not on behalf of any other person. 2. INCOMPASS SERVICES 2.1. Incompass will, when instructed by the Client to do so, enter on behalf of the Client into contracts for the sale, purchase and delivery of currency in the form of a spot contract. 2.2. Incompass will not provide advice to the Client upon the merits of a proposed currency transaction or provide taxation or other advice to the Client (although it may provide information and advice to the Client from time to time as part of separately agreed services). 2.3. In entering into a contract the Client must not treat any information or comments by Incompass as advice and must rely on their own judgement. This also applies to the chosen way for exchange control purposes to take money out of South Africa or transfer funds into South Africa. 3. INSTRUCTIONS AND PAYMENTS 3.1. The Client agrees to provide Incompass with all necessary information and paperwork as set out in the application form or such other paperwork that may be necessary from time to time in order to obtain clearance for the currency transfer, should that be necessary. 3.2. It is the Client s obligation to inform Incompass about their correct residency and exchange control status. 3.3. Incompass endeavours to assist with exchange control procedures but cannot guarantee a positive outcome and cannot be held liable for any loss that might be suffered by the Client due to a delay or other causes. 3.4. The Client will inform Incompass once funds have been transferred into the foreign currency account or ZAR client account. Upon receipt of the amount to be traded by electronic transmission, together with confirmation that the Client has exchange control clearance to transfer funds Incompass will be able to facilitate a foreign exchange transaction on behalf of the Client. 3.5. Incompass and the Client agree on a rate verbally either telephonically or in person, or via email. This verbal agreement is final and cannot be changed. 3.6. Incompass will transmit a deal confirmation, confirming the exchange rate and the deal. The deal confirmation cannot be amended. The Client has to confirm the banking details to take physical delivery of the currency into a bank account nominated by them on the deal confirmation, sign it and return it to Incompass. A delay in returning the signed deal confirmation will result in late payments of funds. 3.7. The Client hereby gives Incompass the authority to sign Balance of Payment forms on behalf of the Client. 4. ACCOUNT OPENING 4.1. Funds leaving and entering South Africa can only be paid into a Client account in his or her own name. Incompass will also, if necessary, facilitate the opening of a bank account for the Client with the authorised dealer. 4.2. The account is interest bearing. For amounts over ZAR 10000 money market rates apply, which change on a daily basis. Incompass charges a fee of 0.5% incl VAT per annum for operating the account. The fees are calculated and accrued daily on the account balances and paid monthly. The Client will receive a monthly statement from the authorised dealer. 4.3. The Client hereby authorises and empowers Incompass to act as their agent and invest money on their behalf with the authorised dealer. 4.4. The Client acknowledges that in granting this mandate they assume, except in so far as there may in law be a right of recovery against the agent, all risks connected with the administration of the entrusted funds, as well as the responsibility to ensure that the agent executes the instructions as recorded in this written contract of agency. 4.5. The Client acknowledges the inherent risk associated with the selected investments. The investor furthermore agrees that Incompass will not be liable for the consequences of market value. The investor bears the total investment risk.
4.6 Incompass will not be responsible for any loss, consequential or otherwise, arising from changes in tax or other legislation that may have an impact on the performance of the investment. 4.7. The Client understands that this is a financial product and not an investment in an insurance policy with an insurer. A cooling off period does not apply. 4.8. The Client authorises Incompass to make payments from his or her account for foreign exchange transactions to the authorised dealer and to refund funds back into the Client s South African bank account. 4.9. The Client has the option to instruct Incompass to transfer exchanged funds from his or her personal account into other South African bank accounts by completing the beneficiary section on the deal confirmation and returning the signed deal confirmation to Incompass. 4.10. Should cash be deposited into the account, the client needs to ensure to forward a proof of source of these funds to Incompass before the funds can be used. 5. CHARGES FOR FOREIGN EXCHANGE TRANSACTIONS 5.1. Incompass is receiving a facilitation fee from the authorised dealer. The fee is calculated as a percentage of the total deal size of the transaction between the authorised dealer and the Client. The range of this fee is between 0.4% and 1%. The facilitation fee that is paid by the authorised dealer will be included in the rate the authorised dealer is providing for the Client. 6. REPRESENTATIONS The Client confirms that, at the date of this agreement and at the time each contract is entered into and carried out: 6.1. The Client is acting as principal for its own account and has full power and authority and has taken all necessary steps to enable it lawfully to enter into and perform the contract; 6.2. All sums paid under these terms belong to the Client and are not subject to any charge or other encumbrance; 6.3. All information supplied to Incompass by the Client is, or at the same time it is supplied, will be accurate in all respects and the client will not omit or withhold any information which would make such information inaccurate; and 6.4. The Client will inform Incompass immediately if there are any changes. 7. DATA PROTECTION CLAUSE 7.1. The Client understands that the authorised dealer is required to report to SARS on account holders who are US citizens or residents or who have unexplained US indicators, e.g. an address in the US or US passport no. 7.2. All personal data of Investors contained in the application form and all and any further personal data collected in the course of the business relationship with Incompass may be collected, recorded, stored, adapted, transferred or otherwise processed and used ( processed ) by Incompass. 7.3. The data shall be processed for the purposes of account administration, anti-money laundering and counter-terrorist financing identification, tax identification, where appropriate, for the purpose of FATCA compliance. 7.4. Data may be transferred to companies appointed by Incompass (e.g. client communication agents or paying agents) to support Incompass related activity. You may request details of your personal data held on our files, in accordance with South African law. You may also request the update or the correction of any incorrect personal data. Please note that, unless otherwise stated, all sections of the application form should be completed. Failure to fully and correctly complete the application form may result in delays in investment. 8. GENERAL 8.1. These terms set out the entire agreement and understanding of the parties on their subject matter and supersede all previous oral and written communications on the same subject matter. 8.2. These terms shall be governed by South African law and subject to the exclusive jurisdiction of South African courts. 8.3. Incompass will not be responsible for any failure, malfunction or delay of any networks or electronic or mechanical device or any other form of communication used in the submission, acceptance and processing of applications, and/or transactions and trades. Incompass will not be liable to make good or compensate any client or third party for any damages (whether direct or consequential), losses, claims or expenses resulting there from. The client and any third party indemnifies Incompass accordingly.
9. INVESTOR DECLARATION 9.1. I/We agree by my/our signature hereto that I/we have read, understand and agree to be bound by the provisions of this instruction and the terms contained in the Incompass Terms and Conditions. 9.2. We have read the data protection clause in the Application Notes and agree with its terms and conditions. I/We agree that my/our data may be transmitted to external third parties having a business relationship with Incompass, including the authorised dealer. 9.3. I further confirm that the information provided by me is true and correct and undertake to notify Incompass should any of the information change. Client name: Signature of investor/authorised signatory: Date: