Natural Persons acting for Company or CC

Questionnaire for Natural Persons Acting on behalf of Companies and Close Corporations
Company or Close Corporation Information

(Note: The Client is not the person filling in the form, but the company or close corporation on behalf of which the form is being completed)
Company or Close Corporation name*
Company or Close Corporation Registration Number*
Documents proving existence of Company or Close Corporation*

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Does the Company or Close Corporation have a presence in South Africa?*

YesNo
Provide details of Company or Close Corporation presence in South Africa*
e.g. assets, operations or business premises
If the Company is a listed public company, on which stock exchange is it listed?*
Name exchange or Not applicable
SARS income tax number of the Company or Close Corporation*
Company or Close Corporation VAT number*
VAT number or Not Applicable
Number of Directors
Company or Close Corporation Registered Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Describe the Company or Close Corporations business.*
Industry, products or services supplied
Describe the Company or Close Corporations ownership or control structure.*
Which persons or organisations directly control the assets?
Name the ultimate beneficial owners of the Company or Close Corporation.*
Which persons or organisations directly control the assets?
Copy of ID, Passport or registration documents of ultimate beneficial owners.*

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Attach a document (including proof of main place of residence) that details the following about the beneficial owners of the Company or Close Corporation - Name,, main place of residence, mobile number and email address.*

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Personal Information

(If you are acting as the representative of the Company or Close Corporation, please fill in your personal information in this section)
Full Name*

First NameMiddle NameLast Name
Identity or Passport Number*
Citizenship or Permanent Residence*
Copy of ID or Passport*

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Physical Address (Main Residence)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Proof of Residence (If you don’t have proof of your residential address in your name, please request a separate form for you to fill in).*

Proof of residence document (within last 3 months)
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Email address*
example@example.com
Mobile Phone Number*
Authorisation documents to act on behalf of Company or Close Corporation*

Power of Attorney or similar
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Services Required

from GIG Wealth
Please select one or more of the following-*

Short term cover (asset protection)Risk Cover (e.g. employee benefits)Cash ManagementPortfolio ManagementInvestmentKey person InsuranceOther
How will any payments to GIG Wealth or other parties be financed?*
e.g. bank transfer, cash, etc.
Will any of the payments be a cash payment of R 50 000.00 or more?*

NoYes
Transaction frequency*

Single transactionMultiple transactions
Source of Funding/Wealth*

AllowanceBeneficiary of TrustBondBudgetBursaryCompany ProfitsCompany Sale or Sale of Interest in CompanyCourt OrderCryptocurrencyDealer in High Value GoodsDeceased EstateDirector/Member of Company/CCDirector/Owner of own BusinessDividendsDivorce SettlementEncasement ClaimGift/DonationIncome from EmploymentIncome from Previous EmploymentInheritanceLeviesLoanLottery or Gambling WinningsMaintenanceMaintenance FundMaturing InvestmentsNew InvestmentsPensionPrivate Capital RaisePublic Capital RaiseRental IncomeReserve FundSale of Asset/PropertySale of AssetsSale of SharesSavingsStaff ScreeningSurplus Levy
Signature of Representative*

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Questionnaire for Natural Persons Acting on behalf of Companies and Close Corporations