Mandate and Application Entered Into Between: Sunstone Capital Limited
Mandate and Application Entered Into Between: Sunstone Capital Limited
AND
To be completed by Investors wishing to participate in the Offer, being 35 000 “B” Ordinary Shares and/or 15 000 “UB” Ordinary
Shares of no par value at an issue price of R1 050 per share. The definitions and interpretations of the Prospectus issued by
Sunstone Capital at the time of application apply, mutatis mutandis, to this Application Form.
Note: Sunstone Capital is an authorised financial services provider which provides intermediary services and does not give advice
on the merits of the Offer or give any personal tax, investment or financial advice
INVESTOR DETAILS
SPECIFY CITIZENSHIP/RESIDENCY
I wish to subscribe for the following number of Ordinary Shares on the terms and conditions contained in this Application
Form:
Type of Share Price Per Share Number of Shares Total Value (in Rand)
Source of Funds:
In addition to specifying your application amount, your application will only be complete on payment by electronic transfer of
your application amount on or before the relevant Closing Date, using your initials and surname / trust name / company name
(whichever is applicable) as the reference into the account specified below.
Payment by electronic transfer should be made to the following account:
Please attach the proof of payment to this application or alternatively email to [email protected]
1.3 Subscription for “B” Ordinary Shares and “UB” Ordinary Shares
The subscription for “B” Ordinary Shares of no par value at a price of R1 050 per Share in terms of this Offer, each having 1 vote
per Share.
The subscription for “UB” Ordinary Shares of no par value at a price of R1 050 per Share in terms of this Offer, each having 1 vote
per Share.
Bank:
Branch:
Branch code:
Account name:
Type of Account:
Account Number:
Signature of Bank
Account Holder
PART 2: MANDATE
2.1 Authorisation
2.1.1 Sunstone is the holder of a FAIS Category I license, under license number 48870 and is authorised to make investments
governed by section 12J of the Income Tax Act, as amended, under reference number VCC-0101.
2.1.2 The Investor hereby irrevocably authorises Sunstone to act on its behalf.
2.1.3 Sunstone will, in terms of this mandate, have full discretion to manage the affairs of the Company.
2.1.4 Sunstone is authorised to invest in, and alternate between any of the following financial products in terms of its FAIS
Category I license:
• Securities and Instruments: Shares (1.8)
2.1.5 Sunstone may make use of the staff of the nominated Management Company, which as at the date of this Application
is Sun Stone Capital Management, a private company incorporated in the Republic of South Africa with registration
number: 2017/666366/07 (“the Manager”), to execute certain of the Management and Administrative functions.
2.7 Accruals
All cash received in respect of Investments, including dividends and interest, will be reinvested, unless at Sunstone’s
discretion, it resolves to declare dividends or repay capital to Shareholders.
PART 3: DECLARATION
3.4 FATCA
3.4.1 In an effort to reduce global tax non-compliance, the South African government has indicated its willingness for global
co-operation and information sharing. Accordingly, South Africa has signed an Intergovernmental Agreement (IGA) with
the United States to comply with the Foreign Accounts Tax Compliance Act (FATCA), a law directed at US citizens and
US tax residents.
3.4.2 The Company is required by law to ask for information from all clients on their international citizenship and tax
residency status.
3.4.3 Please note that the information contained in this form may be shared with the South African Revenue Service (SARS).
SIGNATURE
Applications are irrevocable and may not be withdrawn once submitted. Investors should consult their banker, broker or
other professional advisor regarding this Offer.
I warrant that I have the requisite authority and I am authorised to sign this Offer on behalf of the Investor.
SIGNATURE: ____ _
NAME: ________________________
DATE: ________________________
1. FICA documentation
1.1 The following outlines the supporting documentation required in terms of the Financial Intelligence Centre Act No. 38
of 2001 as amended, as well as other documents required by the Company. This documentation is necessary in order
for the Company to identify and verify the client.
1.2 Certified copies of the supporting documentation are sufficient as long as all text and photographs are clear and
legible.
2. Natural Person
2.1 Certified copy of ID document bearing ID number and photograph (copy of passport for foreign nationals)
2.2 Certified copy of proof of residential address (e.g. utility bill or telephone account less than three months old)
2.3 Proof of banking (e.g. bank statement or cancelled cheque less than three months old)
2.4 Contact particulars
3. Natural Person (Minor)
3.1 Copy of the birth certificate (abridged or unabridged)
3.2 In the case of a guardian, provide documents confirming legal guardianship and complete the form for Minor
Declaration.
3.3 Copy of SARS document confirming income tax number of minor (if applicable)
3.4 Proof of address less than three months old
• As the parent / guardian, you may provide a declaration confirming that:
▪ You share an address with the minor. Complete the Declaration of Residential Address.
▪ The minor does not have a tax number
▪ Copy of ID document (SA Citizens) / Passport (Foreign Nationals) of parent / guardian
3.5 Copy of bank letter confirming parent / guardian banking details, alternatively copy of a bank statement (less than
three months old)
4. Natural Person (Non-Resident)
4.1 Copy of foreign ID / passport
4.2 Proof of address less than three months old
• Should you not have proof of address in your name, you may provide a declaration by a third party confirming
that you share an address with them and provide the third party's proof of ID and proof of address (less than
three months old). Complete the Declaration of Residential Address
4.3 Document confirming tax registration number (if applicable)
• If you or any controlling persons associated with the investment have a tax number, tax residency or nationality
in a country other than South Africa. (Foreign Account Tax Self-certification (FATCA) (USA) (if applicable.)
4.4 Copy of bank letter confirming foreign bank details of individual, alternatively copy of a bank statement (less than
three months old)
• For investment products (i.e. retirement annuity, equity linked living annuity, voluntary investment plan, tax
free investment plan and endowment), we do not make payment to non-resident bank accounts
• For stockbroking products (i.e. local shares, offshore shares and ETPs), we will be able to accommodate
payments to non-resident bank accounts
5. Estate Late
5.1 For the deceased we require the following:
• Copy of death certificate
• Copy of ID
5.2 Bank details of estate late account
5.3 Resolution (if more than one executor)
5.4 For the executor/s we require the following: