Standard Instruction Golden Mile Plan Membership Application

Standard Instruction Golden Mile Plan Membership Application
WEB APPLICATION
Step 1

Provide your personal details
Name *

First Name Last Name
Email *
example@example.com
Cell Number *
Please enter a valid phone number.
Alternative Number
Please enter a valid phone number.
ID Number *
Physical Address *

Street Address

Street Address Line 2

City Province

Postal Code
Postal Address (if different from physical address)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Inception Date *

Month Day Year
First debit order start date
Emergency Contact (Please provide us with the details of next of kin) *

First Name Last Name
Phone Number (Please provide us with the details of next of kin) *
Please enter a valid phone number.
Documentation

Both of the following copies must be sent with this application:
1. Identification document

Green ID book
Cancel of
2. Proof of Residence (utility bill any document with your name and address)

Cancel of

Step 2

Complete the bank debit order authority
Account Holder Name *
Bank: *
Account Type *

Savings Account Cheque Account Business Account
Account Number: *
Branch Code: *

Step 3

Choose an option plan that suits your needs (If you select a monthly premium of R500 or more, you will receive a FREE 1 Oz INVESTGOLD SILVER MEDALLION after your first 3 months successful payments T&C's apply)
Plan options and Monthly Premium (all plans are 5 year term) *

CLASSIC R300 per month STATUS R500 per month STATUS PLUS R750 per month ACHIEVER R1000 per month ACHIEVER PLUS R1500 per month PRESTIGE R2000 per month
ELITE (enter the amount exceeding R2000pm)
PLEASE NOTE:

IF YOU CANCEL YOUR POLICY BEFORE THE END OF YOUR FIVE YEAR TERM, THE CURRENT MARKET VALUE (at the time of cancellation) OF THE 1 Oz INVESTGOLD SILVER MEDALLION, WILL BE DEDUCTED FROM YOUR FUNDS AVAILABLE WITHIN YOUR ACCOUNT.

INVESTGOLD is herewith instructed and authorised by me First Name & Surname* to select and purchase on the coin market on my behalf any type of coins/medallions/bars or portions thereof in the specific series selected by me by means of utilizing my monthly Golden Mile Plan premiums/funds to pay for such on my behalf.

I am a collector and need a vast variety of coins/medallions/bars and portions thereof. INVESTGOLD must select the best possible products to their knowledge and to their All coins/medallions/bars or portions thereof bought by me or on my behalf, as instructed best ability when purchasing coins/medallions/bars or portions thereof on my behalf. and authorized by me, is kept in safe custody with INVESTGOLD free of charge or until INVESTGOLD asks me to collect such products.

I understand that supply and demand determines buying and selling prices and that INVESTGOLD cannot be held liable for any underperformance as INVESTGOLD does not dictate market conditions.

I may sell any of my coins/medallions/bars or portions thereof to INVESTGOLD or any other interested party once I accept the buyback price offered to me. INVESTGOLD needs not contacting me with every transaction as I herewith provide the needed instruction and authorisation to INVESTGOLD to make use of my monthly Golden Mile Plan remiums/funds on my behalf to select products in the following specific plan and series’ by me.

Enter the percentage you would like to purchase monthly. Your total must equal 100% (eg. you can select 100% Krugerrands or split your purchase 60% Krugerrands, 20% Silver and 20% Rare Coins = 100%)

ENTER YOUR % MUST EQUAL 100%

KRUGERRAND

SILVER

RARE COINS

(When choosing a ‘Custom’ plan the percentages chosen may only be in increments of 10’s)

Defintions:

‘portion(s) meaning portions in products made available via INVESTGOLD’s Co-Ownership plans. One portion is equal to the value of 1% of a coin, medallion or bar;

‘product(s) meaning a coin, medallion, bar or portion thereof;

‘plan(s) meaning ‘ Gold Bullion’, ‘Silver’ and ‘Custom’ whereas each plan has its own selection of specific percentages allocated to a specific series to be utilised;

'Krugerrand' meaning legal tender bullion gold coin minted in South Africa reflecting the word ‘Krugerrand’;

'Silver' meaning any silver coin/medallion/bar

'Rare Coins' meaning any limited edition gold, platinum, palladium or silver coin/medallion/bar

Step 4

Sign for Debit order and GMP Acceptance
I/we hereby request and authorize INVESTGOLD to draw against my/our account with the above-mentioned bank or any other bank or branch I may have or to which (state the amount in words) I/we may transfer my/our account the Rand sum of   Enter the amount in words*   or any variable amount pertaining to this agreement on the 1stselect, 16thselect   or 26th   select      an option please tick of each month. This being the amount necessary for the settlement of the monthly amount due to INVESTGOLD in respect of my/our purchases/contract/agreement dated   Date*   dd/mm/yyyy All such withdrawals from my/our account by INVESTGOLD shall be treated as though they had been signed by me/us personally.

I/we the undersigned "instruct" and authorize INVESTGOLD’s agent Netcash (Pty) Ltd, to draw against my/our account. I/we understand that if bank details have been supplied the withdrawals authorized here will be processed by BankServ. I/we also understand and that details of each withdrawal will be printed on my/our statement.

I/we agree to pay any banking charges relating to this debit order instruction.
This authority may be cancelled by means of giving INVESTGOLD management thirty days notice in writing of change of banking details, sent by prepaid registered post, but I/we understand that I/we shall not be entitled to any refund of amounts, which INVESTGOLD has withdrawn whilst this authority was in force if such amounts were legally owing to INVESTGOLD.

I/We acknowledge that the party hereby authorized to effect the drawing(s) against my/our account may not cede or assign any of its rights and that I/we may not delegate any of my/our obligations in terms of this contract/authority to any third party without prior written consent of INVESTGOLD management.

First Name*   Last Name*   Date*   Signature*

I confirm that all information supplied by me is true and correct and herewith accept INVESTGOLD’s Standard Instruction Authority Golden Mile Plan (SI) Terms & Conditions (SI GMP T&C) which I have read and which have been explained to me. I am aware that as defined in the last mentioned document and following the clause references:

2.1 Investgold is the party with whom I am contracting;
2.2 I am the client referred to therein;
2.3 this is the application form referred to in clause 2.3;
2.4 the products are coins/medallions/bars or portions thereof as chosen by me from the GMP product schedule as defined in the GMP terms and conditions made available to me at the time of purchase;
2.5 GMP broker will be assigned as my consultant with whom I have been dealing;
2.6 the option entitles me to choose coins/medallions/bars or portions thereof when I have paid sufficient money to INVESTGOLD in terms of the agreement entitling me to do so;
2.7 I am liable to pay all the admin charges as defined;
2.8 the contract term has been agreed at 5 years
2.10 I will in due course choose from the product schedule as defined in clause 2.10;

5.1 Investgold will forward to the client (a) a copy of the Investgold Standard Instruction Authority Golden Mile Plan Terms & Conditions (SI GMP T&C) and (b) a Golden Mile Plan Certificate reflecting the contract term. The Client may terminate the contract by submitting a written cancellation within 14 days after the first successful monthly premium payment via debit order. Note that clause 7 will immediately take effect, but INVESTGOLD will take no further action against the client for canceling the contract and the client will not be held liable for any further monthly payments.

By making this application I acknowledge that in all my business dealings with Investgold the terms and conditions reflected in the (a) INVESTGOLD Standard Instruction Authority Golden Mile Plan Terms and Conditions SI GMPT&C and in (b) INVESTGOLD Standard Terms and Conditions (as amended from time to time) will apply to and bind me and be observed by me. In the event of their being any conflict between the (a) INVESTGOLD Standard Instruction Authority Golden Mile Plan Terms and Conditions SI GMP T&C and (b) INVESTGOLD Standard Terms and conditions (as amended from time to time) then the previsions of the former document will apply.
The (a) Standard Instruction Authority Golden Mile Plan Terms & Conditions SI GMP T&C and (b) Investgold Standard Terms & Conditions apply and are available on request and also on www.investgold.co.za

First Name*   Last Name*   Date*   Signature*
IMPORTANT: When you sign this Acceptance Form and return it to us:
- You agree that you have read and understand all the INVESTGOLD Standard Instruction Authority Golden Mile Plan Terms and Conditions SI GMPT&C and (b) INVESTGOLD Standard Terms and conditions.
- You accept the INVESTGOLD Standard Instruction Authority Golden Mile Plan Terms and Conditions SI GMPT&C and (b) INVESTGOLD Standard Terms and conditions; and
- You make warranties to us.
INVESTGOLD | 23 West Street, Houghton Estate, JHB

011 486 1196 (JHB) | 044 877 0339 (GRG) | support@investgold.co.za | REG: 2014/200689/07 | VAT: 4890221775
Should be Empty:

Standard Instruction Golden Mile Plan Membership Application

Step 1

Documentation

Step 2

Step 3

Step 4