New Investors
On receipt of this form, Prescient Fund Services will send you a subscription form within 24 hrs. Please note, that the transaction will only be completed upon receiving a signed subscription form. Any additional requirements will be sent via email.
Email Address *
Surname: *
Forenames in full: *
Contact Number *
The remaining questions are optional, if you have the information at hand, please include, if not, please press submit, in which case someone at Prescient will follow up with you.
Investor type (optional)
Clear selection
Entity name if the investor is a Trust or Company (optional)
Title (optional)
Clear selection
Identity/ Registration number (optional)
Source of Funds* (optional)
*If you’re uncertain about the description for your Source of Funds, please leave it blank. Prescient Fund Services will provide you with guidance for an appropriate description.
If applicable: Wealth Manager/Investor Advisor Name
If applicable: Wealth Manager/Investor Advisor Entity
If applicable: Wealth Manager/Investor Advisor Email Address:
Number of shares at R102.25 (minimum total acquisition cost of R250 000)
Total Value** (optional)
**Please ensure that the Total Value divided by the Price Per Share (R102.25) results in a whole number of shares, as the Company can’t issue fractions of shares.
Bank:
Branch:
Branch Code:
Account Name:
Account Number:
FICA Requirements
SOUTH AFRICAN CITIZENS (NATURAL PERSON)
• ID document, drivers licence or a passport
• Proof of address. (e.g. utility bill or telephone account less than three months old)
• Proof of income tax number
• Proof of bank statement

SOUTH AFRICAN COMPANIES
• Certificate of Incorporation (CM1) and Notice of Registered Office and Postal Address (CM22)
• Proof of business address
• Proof of income tax number
• Proof of authority to act for the company e.g. a directors’ resolution
• ID documents in respect of all authorised representatives and also all individuals, or legal entities holding 25% or more of the voting rights
• Proof of bank statement

TRUSTS
• Letters of authority from the Master (SA trust) or foreign regulator (foreign trusts)
• Trust Deed
• Proof of income tax number
• Proof of authority to act for the trust e.g. resolution
• ID documents in respect of the all authorised representatives and also all beneficiaries mentioned by name in the trust deed
• Proof of bank statement
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