VDMA FICA Onboarding Form

ONBOARDING

INTRODUCTION AND LEGAL BASIS

The Financial Intelligence Centre Act No.38 of 2001 (as amended) (“FICA”) requires VDMA LAW to establish and verify the identity of all its clients, including the client’s ownership and control structure as well as the nature of their business.

Please complete this questionnaire in full in order for us to be in compliance with the requirements of FICA. All personal information will be processed in accordance with the Protection of Personal Information Act No. 4 of 2013 (“POPIA”). For more information on how we process personal information, please refer to our Privacy Policy.

Completing this form does not mean that VDMA LAW has accepted your instruction or agreed to act for you.

We may request additional information before opening a file, accepting instructions, receiving funds or making payments. If you are instructing us on behalf of another party (e.g. you are a law firm instructing us on behalf of your underlying client), please complete a separate questionnaire for the underlying party.

COMPLETION INSTRUCTIONS

Please answer all questions that apply to you or the client and provide the supporting documents requested in each relevant section. Start by completing Section 1 and selecting the client type, then complete the sections listed below for that client type.

SECTION 1: TYPE OF CLIENT

Are you completing this form as: *

Individual person: Complete Sections 1, 2, 10, 11, 12, 13 and 14.

Company / Organ of State / Juristic Person: Complete Sections 1, 3, 8, 9, 10, 11, 12, 13 and 14.

Close corporation: Complete Sections 1, 4, 8, 9, 10, 11, 12, 13 and 14.

Trust: Complete Sections 1, 5, 8, 9, 10, 11, 12, 13 and 14.

Partnership: Complete Sections 1, 6, 8, 9, 10, 11, 12, 13 and 14.

Non-profit organisation: Complete Sections 1, 7, 8, 9, 10, 11, 12, 13 and 14.

If you are unsure which category applies, select the closest client type in Section 1, complete all sections that apply and provide any additional information or documents requested by VDMA LAW. Before signing, check that all required declarations have been completed and that the person signing has authority to submit the form.

Please specify client type:

If acting on behalf of another person or entity, state your role:

Please specify your role:

SECTION 2: INDIVIDUAL CLIENT DETAILS

Complete this section if the client is an individual person.

Full legal names:

Surname:

Date of birth:

South African ID number:

Passport number (if foreign national):

Passport country of issue:

Nationality:

Country of birth:

Country of residence:

Tax residence (if known):

Tax number (if applicable):

Mobile number:

Alternative number:

Email address:

Residential address:

Postal address (if different):

Approximate period in current employment/business:

Occupation and position held:

Employer / business name:

Industry:

Documents to Upload / Provide

Allowed formats: PDF, JPG, PNG (Max 1MB each).

South African ID document / Smart ID card *

Proof of residential address *

Valid passport (if foreign national):

Visa / permit (if applicable):

Proof of tax number (if applicable):

Marriage certificate / ANC (if relevant):

Power of attorney / authority document:

Other supporting documents:

SECTION 3: COMPANY / JURISTIC PERSON CLIENT DETAILS

Complete this section if the client is a company or other juristic person.

Registered name:

Trading name:

Registration number:

Date of incorporation:

Country of incorporation:

Company email address:

Company telephone number:

Website:

Income tax number:

Industry / sector:

Countries in which the company operates:

Registered address:

Principal place of business:

Postal address:

Describe the company’s business activities:

Is the client registered for South African VAT? NOYES

VAT number:

If the client is a non-South African entity and not registered for South African VAT, please complete the VAT Declaration in Section 14 of this questionnaire.

Company documents to upload / to be provided

Allowed formats: PDF, JPG, PNG (Max 1MB each).

CIPC disclosure certificate / company registration documents:

Beneficial ownership register or declaration:

Share register / securities register:

Proof of principal place of business:

Organogram / ownership structure chart:

VAT registration document, if applicable:

Proof of registered address:

Tax registration document, if applicable:

Identification documents for directors:

Identification documents for beneficial owners:

Other supporting documents:

SECTION 4: CLOSE CORPORATION DETAILS

Complete this section if the client is a Close Corporation.

Registered name:

Trading name:

Registration number:

Date of registration:

Registered address:

Principal place of business:

Nature of business:

Members Information

Provide full details and percentage interest for each member.

Member 1 Full Name:

ID / Passport Number:

Percentage Interest (%):

Member 2 Full Name:

ID / Passport Number:

Percentage Interest (%):

Member 3 Full Name:

ID / Passport Number:

Percentage Interest (%):

Add additional members?

Member 4 Full Name:

ID / Passport Number:

Percentage Interest (%):

Member 5 Full Name:

ID / Passport Number:

Percentage Interest (%):

Documents to upload / to be provided

Allowed formats: PDF, JPG, PNG (Max 10MB each).

Founding statement (CK1):

Latest amended founding statement (CK2), if applicable:

CIPC disclosure certificate:

ID / passport documents for all members:

Proof of business address:

Beneficial ownership declaration:

Other supporting documents:

SECTION 5: TRUST DETAILS

Complete this section if the client is a Trust.

Name of trust:

Master’s reference number:

Date of trust deed:

Trust address:

Purpose of trust:

Trustees Information

Provide full details for each trustee of the trust.

Trustee 1 Full Name:

ID / Passport Number:

Contact Email:

Authorised to Act?

Trustee 2 Full Name:

ID / Passport Number:

Contact Email:

Authorised to Act?

Trustee 3 Full Name:

ID / Passport Number:

Contact Email:

Authorised to Act?

Trustee 4 Full Name:

ID / Passport Number:

Contact Email:

Authorised to Act?

Add additional trustees?

Trustee 5 Full Name:

ID / Passport Number:

Contact Email:

Authorised to Act?

Trustee 6 Full Name:

ID / Passport Number:

Contact Email:

Authorised to Act?

Founder / donor full name:

Founder / donor ID or passport number:

Founder / donor nationality:

List all named beneficiaries and/or classes of beneficiaries:

Trust documents to upload / to be provided

Allowed formats: PDF, JPG, PNG (Max 10MB each).

Trust deed:

Amendments to trust deed:

Letters of Authority:

ID/passport documents for founder/donor (where available):

ID/passport documents for trustees:

Proof of address for trust / trustees:

ID/passport documents for named beneficiaries (where requested):

Other supporting documents:

SECTION 6: PARTNERSHIP DETAILS

Complete this section if the client is a Partnership.

Partnership name:

Trading name:

Date partnership commenced:

Business address:

Nature of business:

Partners Information

Provide full details for each individual or juristic partner.

Partner 1 Full Name / Entity Name:

ID / Registration Number:

Percentage Interest (%):

Authorised to Act?

Partner 2 Full Name / Entity Name:

ID / Registration Number:

Percentage Interest (%):

Authorised to Act?

Partner 3 Full Name / Entity Name:

ID / Registration Number:

Percentage Interest (%):

Authorised to Act?

Partner 4 Full Name / Entity Name:

ID / Registration Number:

Percentage Interest (%):

Authorised to Act?

Add additional partners?

Partner 5 Full Name / Entity Name:

ID / Registration Number:

Percentage Interest (%):

Authorised to Act?

Partner 6 Full Name / Entity Name:

ID / Registration Number:

Percentage Interest (%):

Authorised to Act?

Documents to upload / to be provided

Allowed formats: PDF, JPG, PNG (Max 10MB each).

Partnership agreement:

Source of funds documents:

ID/passport documents for individual partners:

Registration documents for juristic-person partners:

Beneficial ownership information for juristic-person partners:

Proof of business address:

Other supporting documents:

SECTION 7: NON-PROFIT ORGANISATION DETAILS

Complete this section if the client is a Non-Profit Organisation.

Registered name:

Trading / operating name:

Registration number:

NPO number (if applicable):

PBO number (if applicable):

Registered address:

Main activities / objectives:

Countries or regions where organisation operates:

Main sources of funding:

Documents to upload / to be provided

Allowed formats: PDF, JPG, PNG (Max 10MB each).

Founding document / constitution:

Registration certificate:

NPO certificate (if applicable):

PBO approval (if applicable):

List of directors / trustees / office bearers:

Funding documentation (if requested):

Proof of address:

Other supporting documents:

SECTION 8: PERSON ACTING ON BEHALF OF THE CLIENT

Complete this section if you are acting as an authorised representative on behalf of the client.

Full names of representative:

Surname:

ID number / passport number:

Nationality:

Capacity / role:

Email address:

Mobile number:

Residential address:

Relationship to client:

I hereby confirm that I have the necessary authority, mandate and capacity to act for and on behalf of the client, and to represent the client in all matters relating hereto. I further confirm that I am duly authorised to sign, submit, receive, communicate and/or otherwise deal with any documents, information, instructions or correspondence required in connection with this matter on behalf of the client.

Please state your authority to act on behalf of the client to establish this business relationship with VDMA LAW:

Documents evidencing authority (e.g. resolution, power of attorney, letter of engagement)

Allowed formats: PDF, JPG, PNG (Max 1MB each).

Authority document 1:

Authority document 2 (if applicable):

Authority document 3 (if applicable):

Authority document 4 (if applicable):

SECTION 9: BENEFICIAL OWNERSHIP DECLARATION

In terms of section 21B(2) of FICA, VDMA LAW is required, where the client is a legal person, to establish the identity of the ultimate beneficial owner of the client. A beneficial owner is defined as a natural person who, independently or together with another person, directly or indirectly, owns a legal person or exercises effective control of a legal person. Effective control, for these purposes, is direct or indirect control of 25% or more of the company’s share or voting rights. Complete this section for companies, close corporations, trusts, partnerships, NPOs and other entities. Please provide the details of the beneficial owner(s) of the client below. Please clearly indicate if there are no beneficial owners.

Beneficial Owners Information

Provide details for all ultimate natural persons owning or controlling 25% or more of the client.

Beneficial Owner 1

Full Name:

ID / Passport Number:

Nationality:

Country of Residence:

% Ownership:

Nature of Control:

Beneficial Owner 2

Full Name:

ID / Passport Number:

Nationality:

Country of Residence:

% Ownership:

Nature of Control:

Beneficial Owner 3

Full Name:

ID / Passport Number:

Nationality:

Country of Residence:

% Ownership:

Nature of Control:

Add additional beneficial owners?

Beneficial Owner 4

Full Name:

ID / Passport Number:

Nationality:

Country of Residence:

% Ownership:

Nature of Control:

Beneficial Owner 5

Full Name:

ID / Passport Number:

Nationality:

Country of Residence:

% Ownership:

Nature of Control:

Beneficial Owner 6

Full Name:

ID / Passport Number:

Nationality:

Country of Residence:

% Ownership:

Nature of Control:

Beneficial Owner 7

Full Name:

ID / Passport Number:

Nationality:

Country of Residence:

% Ownership:

Nature of Control:

Does the client have any corporate shareholders, trusts or other entities in its ownership structure? NoYes

Provide details of each ownership layer:

Upload ownership organogram / structure chart:

Are there any nominee shareholders, nominee directors, silent partners or persons exercising control on behalf of someone else? NoYes

Provide details of nominees or silent partners:

BENEFICIAL OWNERSHIP CONFIRMATIONS

Please confirm all of the following:

All beneficial owners have been disclosed No person has been deliberately excluded or concealed The client will inform the firm of any change in beneficial ownership The information provided is accurate and complete

SECTION 10: SOURCE OF FUNDS

Please describe the nature of the legal services required from VDMA LAW:

Primary source of funds:

Please specify the other source of funds:

SECTION 14: TAX STATUS & SIGNATURE SUBMISSION

VALUE ADDED TAX (VAT) DECLARATION

Are you a non-South African client who is NOT registered for South African VAT? * No - Registered for SA VAT or South African ClientYes - Non-SA client NOT registered for SA VAT

ANNEX A: VALUE ADDED TAX (VAT) DECLARATION

This declaration must ONLY be completed by non-South African clients who are NOT registered for South African VAT.

Section 11(1) and (2) of the Value Added Tax Act No. 89 of 1991 (“VAT Act”) makes provision for the supply of certain goods and services rendered to clients that are not residents of the Republic of South Africa to be made at the zero rate of VAT (i.e. 0%) by VAT vendors. VDMA LAW, as a VAT vendor, is obliged by law to obtain and retain written confirmation from non-resident clients in order to substantiate the levying of VAT at 0% for services supplied to non-resident clients.

It is a further requirement that VDMA LAW must be in possession of this VAT declaration within a period of 90 days calculated from the earlier of the time an invoice is issued or the time any payment of consideration is received. In the absence of this VAT declaration, the services supplied by VDMA LAW will be charged at the VAT standard rate of 15%.

Name of client (recipient of services): *

Foreign Tax ID / Registration Number:

Country of Tax Residence: *

Registered office address:

I confirm that the client is not a resident of South Africa. I confirm that neither the client nor any other person that is or could be considered a recipient of VDMA LAW’s services on this matter or in any other matter in which it engages VDMA LAW, will receive or enjoy any of the services while in the Republic of South Africa. We agree that any invoice reflecting VAT at 0% will be paid within 90 days. We undertake to notify VDMA LAW if/should any of the above information change.

FINAL DECLARATIONS & SIGNATURE

By ticking this box, I confirm that I am authorised to submit this form and that the information provided is true, accurate and complete. I understand that any transfer of funds to a VDMA LAW account may require the disclosure to VDMA LAW of information relating to the source of the funds concerned together with additional supporting documentation. I confirm that VDMA LAW is authorised to carry out any additional checks on the information provided as it may deem necessary. I confirm that should VDMA LAW be required to engage with other parties on my behalf (e.g. instruct counsel in other jurisdictions), VDMA LAW may provide the above information to those parties.

Full name of person completing form: *

Capacity / Designation: *

Date: *

Place / City: *

Signature: *

INTRODUCTION AND LEGAL BASIS

COMPLETION INSTRUCTIONS

Documents to Upload / Provide

Company documents to upload / to be provided

Members Information

Documents to upload / to be provided

Trustees Information

Trust documents to upload / to be provided

Partners Information

Documents to upload / to be provided

Documents to upload / to be provided

Documents evidencing authority (e.g. resolution, power of attorney, letter of engagement)

Beneficial Owners Information

Beneficial Owner 1

Beneficial Owner 2

Beneficial Owner 3

Beneficial Owner 4

Beneficial Owner 5

Beneficial Owner 6

Beneficial Owner 7

SECTION 11: POLITICALLY EXPOSED PERSON / PUBLIC OFFICIAL DECLARATION

SECTION 12: SANCTIONS DECLARATION

SECTION 13: ADVERSE INFORMATION DECLARATION

VALUE ADDED TAX (VAT) DECLARATION

FINAL DECLARATIONS & SIGNATURE