Disclosure in terms of the Financial Advisory and Intermediary Services Act (FAIS) 1. Status as representative in terms of the FAIS Act A contractual relationship exists between Momentum Consult (Pty) Ltd and Henry Arden SmithFranchise Principal/Financial Advisor) with identity number 5210275092088 who is duly mandated by Momentum Consult (Pty) Ltd (hereinafter MC), an authorised financial services provider (FSP), registration : 1969/009289/07, FAIS licence no. 5503. MC accepts responsibility for the activities of the Financial Advisor insofar as they are performed within the scope of the contractual relationship. Where services are offered under supervision they are indicated at item 6 below. 2. Personal Contact Details Cell number: 082 441 1419 Office number: 021 671 0142 E-mail address: henry.smith@momentumconsult.co.za 3. Remuneration Henry is remunerated on both a commission and fee basis or a combination thereof (whichever is applicable) and the income derived from entities within the MMI Holdings (Pty) Ltd group of companies exceeds 30% of the Financial Advisor s total earnings. MC may from time to time pay additional rewards and bonuses to the Financial Advisor. The Financial Advisor does not own more than 10% of issued shares directly or indirectly of any life insurer or FSP. 4. Physical Address Centurion Office (Head Office) Telephone: 012 671 8911 Physical Address: Postal Address: 268 West Avenue PO Box 7400 Centurion Centurion 0157 0046 Office address Telephone: 021 671 0142 Physical Address: Postal Address: 12 Hildalan Road P. O. Box 23684 Bishops Court Claremont 7708 7735
5. Relationships and Insurance MC 5.1. is a wholly owned subsidiary of MMI Group Limited, who in turn is a wholly owned subsidiary of MMI Holdings (Pty) Ltd. MC earns more than 30% of its commission flows from companies within MMI Holdings (Pty) Ltd. 5.2. accepts responsibility for those activities of Financial Advisors that are performed within the course and scope of their mandate but this is limited to the products for which they are authorised to give advice or provide intermediary services. 5.3. MMI Group Limited holds professional indemnity and fidelity insurance cover, but does not hold any guarantees. MC is insured for claims against it, arising from professional negligence, errors and omissions on the part of representatives as well as dishonesty. 6. Representative Qualifications, Membership, Authorisations and Accreditation Henry has the following current qualifications: First Level Regulatory Examination: Representatives. First Level Regulatory Examination: FSPs (Sole Proprietors) and Key Individuals in Categories I, II, IIA, III and IV. Certificate in Financial Planning. Certificate of Accreditation as a Health Care Broker. Certificate of Accreditation of an Organisation as a Health Care Broker. Master of Business Administration. Year started in the financial services industry: 1975 The representative is accredited to give advice and offer intermediary services (under supervision if indicated) on the following products: Product Long-term insurance: Category A Short-term insurance: Personal lines Long-term insurance: Category B1 Long-term insurance: Category B2 Long-term insurance: Category C Retail pension benefits Short-term insurance: Commercial lines Participatory interests in collective investment schemes Health service benefits Supervision 7. Conflict of Interest Management Policy The Board of Directors of MC has in terms of legislation approved and instituted a conflict of interest management policy which it has published on the Momentum website
(www.momentum.co.za) and which is also available in hard copy upon request if you do not have access to the internet. 8. Product Suppliers MC has entered into intermediary agreements with the following product suppliers and may therefore transact with them in an independent capacity under a regulatory authority. ABSA Investment Management Services Momentum Wealth International Alexander Forbes Allan Gray Altrisk Ashburton Bestmed Camargue Compass (Health and Accident) Coronation Coronation International Fedhealth Medical Scheme General & Professional Liability Acceptances Glacier Grindrod Asset Management Hollard Investec Investment Solutions Liberty Life Metropolitan Life Momentum Group Limited Momentum Manager of Managers CIA Coronation Off-shore Brightrock Hollard One Prudential Marriott Asset Management Nedgroup Investments NMG Administrators (Pty) Ltd Old Mutual Old Mutual International Professional Provident Society Professional Provident Society Investments Richton SAFrican Insurance Company Limited Sanlam Stanlib Sizwe Medical Fund Topmed Medical Scheme TSA Administration (Pty) LTd Telesure FSP Solutions and Insurance Companies Bonitas FMI Santam CIB HCV Guardrisk FNB Securities Mutual and Federal Sanlam Employee Benefit (Infinit) 9. Complaints and Compliance Procedures
9.1. If MC or any duly mandated Financial Advisor provided you with financial advice or any other intermediary service, and you feel that we or our representative- 9.1.1. did not comply with the Financial Advisory and Intermediary Services Act and that you suffered financial prejudice as a result; or 9.1.2. intentionally or negligently gave financial advice or rendered an intermediary service to you which caused prejudice or damage or is likely to cause damage; or 9.1.3. treated you unfairly. We request that you please notify us in writing to PO Box 7400, Centurion, 0046, with the below mentioned information. Details are available on the Momentum Website at www.momentum.co.za. The contact details of the complaints department is available in the complaints resolution document. Our compliance department can be contacted at: MMI Group Ltd, 268 West Avenue, Centurion, 0046. Telephone number: +27 12 673 7838 Fax number: 086 519 8626 E-mail address: clientcomplaints@momentum.co.za 9.1.4. Your name, surname and contact details; 9.1.5. A complete description of your complaint; 9.1.6. The name of the person who provided you with financial advice or an intermediary service; 9.1.7. The date on which the matter complained about took place; 9.1.8. All documentation relating to your complaint; 9.1.9. How you would prefer to receive communication from us regarding your complaint, i.e. by e-mail, fax or post, along with the respective contact details for delivery purposes. 9.2. Our procedure when receiving your complaint: 9.2.1. As soon as we receive your complaint, we will send you an acknowledgement of receipt. Please take into consideration that the method of communication chosen by you will determine how quickly we will receive and respond to your complaint. 9.2.2. We will investigate and attempt to resolve your complaint to your satisfaction within six weeks of the receipt of your complaint. 9.2.3. If we are unable to resolve your complaint within six weeks, or are unable to resolve the complaint to your satisfaction, you have the right to refer your complaint to the ombudsman appointed specifically for this purpose. The contact details of the ombudsman are as follows:
PO Box 74571 Lynnwood Ridge 0040 Telephone number: 012 470 9080/99 Fax number: 012 348 3447 E-mail: info@faisombud.co.za Website: www.faisombud.co.za 9.2.4. Please remember, however, that you must refer the complaint to the ombudsman within six months from the date of the notice in which we inform you that we cannot resolve the complaint to your satisfaction. 10. Client Confirmation of Receipt I confirm that I have read this document and that I fully understand its contents. Client name Name of authorised person Signature Date