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Trustee Details.

Welcome trustees, please complete the form below with all of the required details and we will be in contact with you.

Trustee Code of Conduct and Conflict of Interest Policy (1).pdf

First name*

Last name*

Email*

Phone*

Residential Address*

City/Town

Postal Code

ID Number*

Income Tax Number*

Scheme*

Date of Nomination (Date of AGM where you were appointed) *

Year

Month

Day

Certified Copy of ID (Not older than 3 months)*

Proof of Address (Not Older than 3 months) *

Citizenship/Residency*

I am a South African Citizen

I am a South African Permanent Resident

I am a temporary resident

I am a non-resident

Do you hold, or have you held in the past 12 months, any of the below listed positions in ANY COUNTRY OTHER THAN SOUTH AFRICA? If yes, Indicate which position

Head of State

Member of the Royal Family

Cabinet Member

Senior Member of a Political Party

Senior Judicial Officer

Senior Executive of a State-Owned Equity

High Rank in the Military

None of the above

Do you hold, or have you held in the past 12 months, any of the below listed positions IN SOUTH AFRICA? If yes, Indicate which position

President or deputy president of South Africa

Cabinet minister of deputy minister

Premier of a province

MEC of a province

Mayor of a municipality

Leader of a political party

Member of a royal family

Senior traditional leader

Head accounting officer of CFO of a national provincial department

Manager or CFO of a municipality

Chairperson, CEO, accounting authority, CFO, or chief investment officer of a public entity

Judge

Ambassador, high commissioner or other senior representative of a foreign country based in South Africa

Chairperson of a board of directors, chairperson of an audit committee, executive officer

None of the above

Are you a family member or close associate of one of the following categories of people mentioned in the above 2 questions? If YES, please name the person/persons and indicate the position they hold.

If you responded "yes" to any of the previous 3 questions, please indicate your source of wealth, or insert N/A

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