FOCUS ACCOUNT COMPANY APPLICATION FORM

FOR INTRODUCED CLIENTS ONLY

Please complete in full, in BLOCK CAPITALS and black ink and return to us by post (not email). If you need help to complete this
form, please call us on +44 (0)1624 645800.

1. ACCOUNT LOCATION
ISLE OF MAN JERSEY LONDON

2 . A B O U T T H E C O M P A N Y (‘ ‘ T H E A C C O U N T H O L D E R ’ ’ )

FULL NAME OF ENTITY

DETAILS OF ANY TRADING NAMES

NATURE OF COMPANY’S BUSINESS

PRINCIPAL PLACE OF BUSINESS/

OPERATIONS
(if different from registered office)

GEOGRAPHICAL AREA OF BUSINESS

If the company is tax resident in the US, you will need to complete a US Form W-9. The US Form W-9 can be obtained from us on
request, or a copy can be downloaded from the IRS website (www.irs.gov) under the Forms and Instructions section.

DATE OF INCORPORATION (DD/MM/YYYY)

COUNTRY OF INCORPORATION

COMPANY REGISTRATION NUMBER

VAT REGISTERED NUMBER

NAME OF REGULATOR (if applicable)

REGISTERED OFFICE ADDRESS

POSTCODE

BUSINESS ADDRESS (if different)

POSTCODE

CORRESPONDENCE ADDRESS
(if different)

POSTCODE

CONTACT NAME

TITLE (e.g. Mr/Mrs/Miss/Ms/Other)

CAPACITY

BUSINESS TELEPHONE NUMBER +

FAX NUMBER +

EMAIL ADDRESS

WEBSITE

DETAILS OF ANY EXISTING

RELATIONSHIPS WITH NEDBANK
PRIVATE WEALTH

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FOCUS ACCOUNT COMPANY APPLICATION FORM
FOR INTRODUCED CLIENTS ONLY

3. DETAILS OF CORPORATE DIRECTORS AND CORPORATE SHAREHOLDERS INCLUDING ANY NOMINEE

COMPANIES (IF APPLICABLE)
CORPORATE DIRECTOR CORPORATE SHAREHOLDER NOMINEE COMPANY

COMPANY NAME

DATE OF INCORPORATION (DD/MM/YYYY)

COUNTRY OF INCORPORATION

COMPANY REGISTRATION NUMBER

REGISTERED OFFICE ADDRESS

POSTCODE

4. ABOUT THE PERSONS CONNECTED TO THE COMPANY

PERSON 1 PERSON 2

BENEFICIAL OWNER BENEFICIAL OWNER

DIRECTOR DIRECTOR
AUTHORISED SIGNATORY AUTHORISED SIGNATORY
ROLE COMPANY SECRETARY COMPANY SECRETARY
OTHER (please specify) OTHER (please specify)

TITLE (e.g. Mr/Mrs/Miss/Ms/Other)

FORENAME(S)

KNOWN AS

SURNAME

PREVIOUS NAME(S)
(i.e. maiden name, former married name(s) or
if you have changed your name by deed poll) NOT APPLICABLE NOT APPLICABLE

GENDER

OCCUPATION (if retired, previous occupation)

NATIONALITY

DATE OF BIRTH (DD/MM/YYYY)

PLACE OF BIRTH

COUNTRY OF BIRTH

RESIDENTIAL ADDRESS

POSTCODE

TELEPHONE NUMBER + +

MOBILE NUMBER for SMS text

communication and Professional Online + +
Banking Service

EMAIL ADDRESS

PERIOD AT PRESENT ADDRESS YEARS MONTHS YEARS MONTHS

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FOCUS ACCOUNT COMPANY APPLICATION FORM
FOR INTRODUCED CLIENTS ONLY

PERSON 1 PERSON 2

IF LESS THAN THREE YEARS, PLEASE

STATE PREVIOUS ADDRESS(ES)

POSTCODE(S)

PLEASE SPECIFY YOUR PERCENTAGE

SHAREHOLDING/OWNERSHIP
(if applicable)

Tax residency (to be completed by beneficial owners only) - Tax regulations require us to collect certain information about each
beneficial owner’s tax arrangements. Please provide this information below.

FIRST COUNTRY OF RESIDENCE

FOR TAX PURPOSES
NATIONAL INSURANCE NUMBER OR
TAX IDENTIFICATION NUMBER (TIN)
(or equivalent identity number)

To be completed below only if you have multiple tax jurisdictions.

SECOND COUNTRY OF RESIDENCE

FOR TAX PURPOSES
NATIONAL INSURANCE NUMBER OR
TAX IDENTIFICATION NUMBER (TIN)
(or equivalent identity number)

THIRD COUNTRY OF RESIDENCE

FOR TAX PURPOSES
NATIONAL INSURANCE NUMBER OR
TAX IDENTIFICATION NUMBER (TIN)
(or equivalent identity number)

IF A NATIONAL INSURANCE NUMBER OR

TIN IS NOT AVAILABLE, PLEASE PROVIDE
YOUR RESIDENCY CERTIFICATE
NUMBER

Please note: To help fight against tax evasion, governments around the world have introduced an information-gathering and
reporting requirement for financial institutions. This is known as the Common Reporting Standards (CRS).
Individuals resident in a CRS jurisdiction will have their details forwarded to the tax authorities.
US citizenship
ARE YOU OR HAVE YOU EVER BEEN
YES NO YES NO
A U.S. CITIZEN?

We will require all US citizens and US tax residents to complete a Form W-9, which we can send to you or you can download
from the IRS website (www.irs.gov) under the Forms and Instructions section.
Value of investments/accumulated wealth (to be completed by shareholders/beneficial owners only):
Please complete this section, which is required to meet our ‘know your client’ obligations.

AMOUNT £ AMOUNT £

INHERITANCE DETAILS OF HOW ACCUMULATED DETAILS OF HOW ACCUMULATED

AMOUNT £ AMOUNT £

CASH DETAILS OF HOW ACCUMULATED DETAILS OF HOW ACCUMULATED

AMOUNT £ AMOUNT £

INVESTMENTS DETAILS OF HOW ACCUMULATED DETAILS OF HOW ACCUMULATED

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FOCUS ACCOUNT COMPANY APPLICATION FORM
FOR INTRODUCED CLIENTS ONLY

PERSON 1 PERSON 2

AMOUNT £ AMOUNT £

PROPERTY DETAILS OF HOW ACCUMULATED DETAILS OF HOW ACCUMULATED

AMOUNT £ AMOUNT £

DETAILS OF HOW ACCUMULATED DETAILS OF HOW ACCUMULATED

OTHER

OVER WHAT PERIOD WAS YOUR 0-1 YEAR 1-10 YEARS 0-1 YEAR 1-10 YEARS
WEALTH ACCUMULATED? 10-20 YEARS OVER LIFETIME 10-20 YEARS OVER LIFETIME

PERSON 3 PERSON 4

BENEFICIAL OWNER BENEFICIAL OWNER

DIRECTOR DIRECTOR
AUTHORISED SIGNATORY AUTHORISED SIGNATORY
ROLE COMPANY SECRETARY COMPANY SECRETARY
OTHER (please specify) OTHER (please specify)

TITLE (e.g. Mr/Mrs/Miss/Ms/Other)

FORENAME(S)

KNOWN AS

SURNAME

PREVIOUS NAME(S)
(i.e. maiden name, former married name(s) or
if you have changed your name by deed poll) NOT APPLICABLE NOT APPLICABLE

GENDER

OCCUPATION (if retired, previous occupation)

NATIONALITY

DATE OF BIRTH (DD/MM/YYYY)

PLACE OF BIRTH

COUNTRY OF BIRTH

RESIDENTIAL ADDRESS

POSTCODE

TELEPHONE NUMBER + +

MOBILE NUMBER
+ +
to be used for SMS text communication

EMAIL ADDRESS

PERIOD AT PRESENT ADDRESS YEARS MONTHS YEARS MONTHS

PAGE 4
FOCUS ACCOUNT COMPANY APPLICATION FORM
FOR INTRODUCED CLIENTS ONLY

PERSON 3 PERSON 4

IF LESS THAN THREE YEARS, PLEASE

STATE PREVIOUS ADDRESS(ES)

POSTCODE(S)

PLEASE SPECIFY YOUR PERCENTAGE

SHAREHOLDING/OWNERSHIP
(if applicable)

Tax residency (to be completed by beneficial owners only) - Tax regulations require us to collect certain information about each
beneficial owner’s tax arrangements. Please provide this information below.

FIRST COUNTRY OF RESIDENCE

FOR TAX PURPOSES
NATIONAL INSURANCE NUMBER OR
TAX IDENTIFICATION NUMBER (TIN)
(or equivalent identity number)

To be completed below only if you have multiple tax jurisdictions.

SECOND COUNTRY OF RESIDENCE
FOR TAX PURPOSES
NATIONAL INSURANCE NUMBER OR
TAX IDENTIFICATION NUMBER (TIN)
(or equivalent identity number)

THIRD COUNTRY OF RESIDENCE

FOR TAX PURPOSES
NATIONAL INSURANCE NUMBER OR
TAX IDENTIFICATION NUMBER (TIN)
(or equivalent identity number)

IF A NATIONAL INSURANCE NUMBER OR

TIN IS NOT AVAILABLE, PLEASE PROVIDE
YOUR RESIDENCY CERTIFICATE
NUMBER

Please note: we may have a legal or regulatory requirement to share this information with relevant tax authorities.
US citizenship
ARE YOU OR HAVE YOU EVER BEEN
YES NO YES NO
A U.S. CITIZEN?

We will require all US citizens and US tax residents to complete a Form W-9, which we can send to you or you can download
from the IRS website (www.irs.gov) under the Forms and Instructions section.
Value of investments/accumulated wealth (to be completed by shareholders/beneficial owners only):
Please complete this section, which is required to meet our ‘know your client’ obligations.

AMOUNT £ AMOUNT £

INHERITANCE DETAILS OF HOW ACCUMULATED DETAILS OF HOW ACCUMULATED

AMOUNT £ AMOUNT £

CASH DETAILS OF HOW ACCUMULATED DETAILS OF HOW ACCUMULATED

AMOUNT £ AMOUNT £

INVESTMENTS DETAILS OF HOW ACCUMULATED DETAILS OF HOW ACCUMULATED

AMOUNT £ AMOUNT £

PROPERTY DETAILS OF HOW ACCUMULATED DETAILS OF HOW ACCUMULATED

CONTINUED OVER PAGE 5

FOCUS ACCOUNT COMPANY APPLICATION FORM
FOR INTRODUCED CLIENTS ONLY

PERSON 3 PERSON 4

AMOUNT £ AMOUNT £

DETAILS OF HOW ACCUMULATED DETAILS OF HOW ACCUMULATED

OTHER

OVER WHAT PERIOD WAS YOUR 0-1 YEAR 1-10 YEARS 0-1 YEAR 1-10 YEARS
WEALTH ACCUMULATED? 10-20 YEARS OVER LIFETIME 10-20 YEARS OVER LIFETIME

Please copy these pages and add to the application if there are additional persons connected to the company.

5. REASON FOR OPENING THE ACCOUNT

PLEASE STATE REASON FOR

REQUIRING AN ACCOUNT

IF OPENING AN ACCOUNT OUTSIDE

YOUR COUNTRY OF INCORPORATION,
PLEASE INDICATE WHY YOU REQUIRE
AN OFFSHORE ACCOUNT
PLEASE STATE WHAT THE ACCOUNT
WILL BE USED FOR

6. SOURCE OF FUNDS
Please note: We reserve the right to request additional information relating to the initial deposit as well as subsequent transactions.

INITIAL DEPOSIT CURRENCY AMOUNT

Please provide full source of funds information regarding the initial monies that will be transferred to the new account, i.e.
generated from what transaction or business, as well as the country it is coming from, bank name and account name.

INITIAL FUNDS FROM

ACCOUNT NAME

BANK NAME

COUNTRY

PLEASE STATE THE SOURCE OF

WEALTH (I.E. INHERITANCE, SAVINGS,
SALE OF BUSINESS) USED FOR THE
OPENING OF THIS ACCOUNT.

Account Activity
OTHER THAN THE INITIAL DEPOSIT,
HOW MUCH DO YOU EXPECT TO PAY
INTO THE ACCOUNT PER YEAR?

Type and estimated number and value of transactions over a 12-month period:
Examples of type of account activity: • Investment dealing • Trading activities
Into the account Out of the account
TYPE

NUMBER OF TRANSACTIONS

VALUE OF TRANSACTIONS
(specify currency)

WHICH COUNTRIES WOULD YOU

NORMALLY BE TRANSFERRING FUNDS TO?

LIKELY SOURCE OF ONGOING FUNDS

INTO THE ACCOUNT

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FOCUS ACCOUNT COMPANY APPLICATION FORM
FOR INTRODUCED CLIENTS ONLY

7. SERVICES REQUIRED
Please tick appropriate boxes to indicate the services that you may require immediately. You may at any time advise us that you
wish to use other services.
Please note that Focus accounts will be opened in sterling, US dollar and euro. Please advise if you require additional currency accounts.

OTHER CURRENCY REQUIRED

CURRENCY IN WHICH YOUR ACCOUNT STERLING U.S. DOLLAR EURO

WILL BE REPORTED AND VALUED
(tick one box only) OTHER (specify)

Investment income and proceeds from the sale of investments will remain in the currency it is received.
Fixed Term Deposit Accounts

CURRENCY REQUIRED (tick all applicable)

Minimum deposit: £50,000/ STERLING U.S. DOLLAR EURO
US$75,000/€75,000

Other currencies may be available by arrangement.

DO YOU REQUIRE SEGREGATION OF

YES NO
INCOME RECEIVED?

Focus Investment Services

DO YOU INTEND TO USE THE FOCUS

YES NO
INVESTMENT SERVICES?
DO YOU INTEND TO HOLD U.S.
SECURITIES THROUGH YOUR YES NO
FOCUS ACCOUNT?

Where you intend holding execution only securities, we will require you to complete the Shareholders Rights Directive II Decision
Maker Nomination Form.
If you do not intend to hold US secuirties, we will require the completion of US tax forms in the W series prior to the investment
being made. Dealing instructions will not be accepted for US incorporated securities without the correct US tax documentation
being placed.

London Office Accountholders only

Please provide your Legal Entity Identifier (LEI)

LEGAL ENTITY IDENTIFIER

For instructions on how to obtain an LEI, please visit our website www.nedbankprivatewealth.com. Please note that an LEI is
required if you wish to use the Focus Investment Services.

CONTINUED OVER PAGE 7

FOCUS ACCOUNT COMPANY APPLICATION FORM
FOR INTRODUCED CLIENTS ONLY

8. AUTHORISATION
Third party authorisation
If you would like to arrange authority for a third party to operate the account, please tick the applicable box to receive a mandate.
If you do disclose your information to a third party, please consider the risks in doing so and the obligations as detailed within the
Terms and Conditions.
Intermediary Authorisation
DO YOU WISH US TO SEND COPY
STATEMENTS OF YOUR ACCOUNT TO YES NO
YOUR INTERMEDIARY?
DO YOU WISH TO HAVE YOUR
ACCOUNT DETAILS MADE AVAILABLE
TO YOUR INTERMEDIARY VIA THE YES NO
INTERNET?
If yes, an online banking application form
may be sent to your intermediary.
DO YOU WISH US TO DIVULGE
INFORMATION TO YOUR
INTERMEDIARY?
YES NO
If yes, please complete an ‘Authority to
release account information to an
intermediary’ form.
DO YOU WISH US TO ACCEPT
INVESTMENT INSTRUCTIONS FROM A
THIRD PARTY? YES NO
If Yes, please complete and sign a mandate
‘Focus mandate appointing a third party
adviser to give investment instructions only’.

If you have answered Yes to any of the above, please give details of your intermediary.

NAME

ADDRESS

POSTCODE

TELEPHONE NUMBER +

EMAIL ADDRESS

9. YOUR REQUESTS FOR INFORMATION

Security password for your telephone calls

We will accept your security password as specified as authorisation for enquiries via the telephone. We will ask you for selected
characters from your security password.

Important note:
In order to safeguard client security, please only complete your chosen password when you are ready to send your completed
application form to us in the post. The security password is a key factor in verifying client identity when contacting us and, as
such, your account security may be at risk if it falls into the wrong hands.

YOUR CHOSEN SECURITY PASSWORD IS

(password must be a minimum of four characters)

Telephone requests for information will only be accepted if we can adequately identify the caller as the accountholder.

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FOCUS ACCOUNT COMPANY APPLICATION FORM
FOR INTRODUCED CLIENTS ONLY

10. PROFESSIONAL ONLINE BANKING SERVICE

This service should be used to instruct payments, foreign exchange transactions and internal transfers. You can also use the
service to view your account(s) and create essential account reports. Please note that we will only accept payment requests via
the Professional Online Banking Service, or in an original signed instruction sent by post (please refer to our Professional Online
Banking Charges and Cut Off Times document for further details). To run your account efficiently, we strongly suggest that you
apply for the Professional Online Banking Service. Please complete the sections below:

10.1 FACILITIES REQUIRED

Please confirm the facilities required by ticking the relevant box below.

ACCOUNT VIEWING YES NO

INTERNAL TRANSFER YES NO

FOREIGN EXCHANGE YES NO

PAYMENTS YES NO

REPORTING SERVICE YES NO

10.2 AUTHORISATION OPTIONS

Please indicate which authorisation option you require to match your operational mandates.
Three stage process which requires an inputter, verifier and an authoriser
Two stage process which requires an inputter/verifier and an authoriser
Single process which requires only one inputter

10.3 APPLICANTS FOR PROFESSIONAL ONLINE BANKING SERVICE (USERS)

Please confirm the full name and mark yes/no for access requirements applicable to each applicant.
Verifiers and authorisers must coincide with your operational mandate. Please note individuals can be set up as having all levels
of authority, but can only fulfil one function in the process.

PAYMENT LIMIT
FULL NAME INPUTTER VERIFIER AUTHORISER
ONLY

10.4 SECURITY MANAGER INFORMATION

A Security Manager is reponsible for any changes to new and current users (including amendments, deletion or enquiries etc).
This information is required for security purposes to help identify users at your company/organisation.

SECURITY MANAGER ALTERNATIVE SECURITY MANAGER

FORENAME

SURNAME

EMAIL ADDRESS

TELEPHONE NUMBER + +

FOR ADDED SECURITY AND TO HELP US

TO IDENTIFY YOU, PLEASE PROVIDE A
PASSWORD. PLEASE WRITE IN PRINT
AND BLOCK CAPITALS, AND KEEP TO
ONE WORD.

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FOCUS ACCOUNT COMPANY APPLICATION FORM
FOR INTRODUCED CLIENTS ONLY

11. DECLARATION
To be made by those duly authorised by the board of directors. You wish to open an account with us in accordance with the
published Terms and Conditions as well as the Professional Online Banking Terms and Conditions, which you acknowledge having
received and to which you agree to be bound.
You authorise us to make enquiries and take up references as we consider appropriate in connection with this application form and
this authorisation is to remain effective until we receive written notification to the contrary.
You understand that we do not accept any liability whatsoever in respect of any losses which you may suffer as a result of any
fraud or negligent misuse of the banking services, including telephone banking, unless such loss occurs as a result of fraud or gross
negligence on the part of us or our employees or agents.
You confirm that you have examined the information on this form and to the best of your knowledge believe it to be true, correct
and complete. You agree that you will notify us within 30 days if any information on this form becomes incorrect.
You confirm that you will maintain the account balance above the minimum required.
‘Order Execution’ acknowledgement: You acknowledge that you have received a copy of our ‘Order Execution Policy’ and agree to
be bound by it.
You acknowledge that where we are placing deals under an execution-only arrangement, you are not receiving the same level of
protection under the legislation as you would where we have provided investment advice or made recommendations. We are not
obliged to consider the suitability of the product based on our knowledge of you and taking into consideration your risk appetite.
We will process the investment assuming you have made an informed decision on the basis of your own research, having
independently reviewed the product literature or illustrations. We will not perform any reviews on the continuing suitability,
performance, or risk of the investment once the transaction has been processed.
Data Protection
The information requested on this form will be used by us to provide the specified services and to confirm your identity. You
acknowledge that you have read and accept our Privacy Notice, which can be found at www.nedbankprivatewealth.com. This
document details how we collect, process, store and dispose of the personal information you have provided to us. It also outlines
your individual rights to your information and how you can access it.
If you wish to receive our newsletters and other marketing communications or promotions, please tick this box.
If you wish to cease these communications in the future, you can do so by contacting us.
The terms of this Account Application form shall be governed by and construed in accordance with the laws of the Isle of Man,
Jersey or UK (as applicable).

AUTHORISED SIGNATORY 1 AUTHORISED SIGNATORY 2

NAME

CAPACITY

SIGNATURE

DATE (DD/MM/YYYY)

AUTHORISED SIGNATORY 3 AUTHORISED SIGNATORY 4

NAME

CAPACITY

SIGNATURE

DATE (DD/MM/YYYY)

PAGE 10
FOCUS ACCOUNT COMPANY APPLICATION FORM
FOR INTRODUCED CLIENTS ONLY

12. BOARD RESOLUTION

You hereby certify that at a Meeting of the Directors of
(‘‘the Company’’)
held at the day of
It was resolved:
1. That an account be opened with us and that we are authorised and requested to pay or honour all cheques, drafts, or other
orders or receipts for money purporting to be drawn or signed on behalf of the company, and to debit the same to such
account, whether such account be in credit or otherwise, provided that such cheques, drafts, orders or receipts are signed by
(insert ‘‘any two Directors’’ or ‘‘a Director and the Secretary’’ or as otherwise resolved);

2. That we are authorised to treat all cheques, drafts, orders or receipts as having been duly endorsed or signed on behalf of the
company and discount or otherwise deal with them provided that such endorsements purport to be signed by (insert ‘‘any two
Directors’’ or ‘‘a Director and the Secretary’’ or as otherwise resolved);

3. That we are hereby authorised to honour and comply with all instructions to deliver or dispose of any securities or documents
or property held by us on behalf of the company, provided such instructions are signed by (insert ‘‘any two Directors’’ or ‘‘a
Director and the Secretary’’ or as otherwise resolved);

4. That (insert ‘‘any two Directors’’ or ‘‘a Director and the Secretary’’ or as otherwise resolved) are hereby authorised on behalf
of the company:
4.1. to borrow money and to obtain credit for the company from us on any terms and to make and deliver notes, drafts,
acceptances, instruments of guarantee, agreements and any other obligations of the company therefore in a form
satisfactory to us; The terms of this account application form shall be governed by and construed in accordance with the
laws of the Isle of Man, Jersey or UK (as applicable);
4.2. to grant security interests in and/or pledge or assign and deliver, as security for money borrowed or credit obtained, stocks,
bonds, instruments, bills receivable, accounts, mortgages, merchandise, bills-of-lading, warehouse receipts and other
documents, insurance policies, certificates, and any other property now or hereafter held by or belonging to the company,
with full authority to endorse, assign or guarantee any of the same in the name of the company;
4.3. to discount any bills receivable or any paper held by the company with full authority to endorse the same in the name of
the company;
4.4. to withdraw from us and give receipt for, or to authorise us to deliver to the bearer or to one or more designated persons,
all or any documents and securities or other property held by it, whether held as collateral security or for safekeeping or for
any other purpose;
4.5. to authorise and request us to purchase or sell for account of the company stocks, bonds and other securities;
4.6. to execute and deliver all security and other agreements, financing statements and other papers required by us in
connection with any of the foregoing matters and affix thereto the seal of the company;
4.7. to authorise the company’s bankers to respond to client identification documentation provided by us by the execution and
delivery to us of our standard customer identification authority and other papers required by us in connection with the
company’s identification; and
5. That a list of the names and specimen signatures of the persons at present authorised to sign under these resolutions be
furnished to us in a form satisfactory to us and that we be advised in writing of all changes which may take place in the same
from time to time.
You agree that your signatures to this corporate account application shall be your acknowledgement that you have received a
copy of our Terms and Conditions and that the Terms and Conditions as amended from time to time shall form an agreement
between you and us as if incorporated herein.
You acknowledge that we have elected to classify all clients as ‘Retail Clients’ and you will be treated as such in respect of all
business we conduct for you. This classification means that you will receive the highest level of regulatory protection available for
complaints and compensation and receive information from us in a straightforward way, and determines the regulatory
requirements that will apply to us when providing investment and ancillary services to you. You have the right to request a different
classification, as a ‘professional client’ or ‘eligible counterparty client’ as defined by the EC Markets in Financial Instruments
Directive, subject to meeting the required criteria, but this will result in you having a decreased level of regulatory protection. Any
such request should be made in writing to us.

CONTINUED OVER PAGE 11

FOCUS ACCOUNT COMPANY APPLICATION FORM
FOR INTRODUCED CLIENTS ONLY

You hereby certify that the signatory(ies) whose specimen signature(s) appear in section 11 are duly authorised to sign on behalf of
the company in accordance with the terms of this corporate account application:

CHAIRMAN/DIRECTOR SECRETARY/DIRECTOR

SIGNATURE

DATE (DD/MM/YYYY)

Any changes to the above will be notified to you immediately.

13. DOCUMENTATION REQUIRED

We are required to confirm the identity and address of all account signatories/directors and beneficial owners (where different)
plus any additional authorised signatories included in the Declaration (section 10) for the account.
We therefore need the following documents which will be treated as confidential. All originals will be returned to you.
1 For at least two of the account directors, and where different, two signatories, we require a copy of their passport, or a copy of
their driving licence* or a copy of any other government issued ID document bearing their photograph and signature certified by a
suitable person i.e. an official of a British embassy, qualified solicitor, notary public, member of the judiciary, qualified accountant,
a director, officer or manager of a regulated financial services business. The certifier must be licensed/practising/member of a
professional body/authorised to certify documents; and
2 An original utility bill (not a mobile telephone bill or internet bill), statement from a recognised bank, statement from a recognised
bank credit card provider, rates bill, council tax bill or income tax bill, not more than six months old showing name and residential
address (a certified copy is acceptable if completed as stated below).**
We reserve the right to request documents for all signatories/directors if we deem it necessary.
To certify a document:
The certifier must state on the copy documents the following:
”I certify that this is a true copy of the original document”.
When certifying photographic ID also include the wording “and is a true likeness”.
The documents must be signed, dated and bear the stamp of the office of the certifying person as well as have printed clearly
in capitals the name, position, profession and contact details of the certifier. If you do not possess a passport, driving licence or
government issued ID card, please contact us.
In addition to the above, we also require the following for limited companies
– A completed limited company mandate which includes appropriate board resolution (see section 11).
– Sight of the original certificate of incorporation, or receipt of a certified copy.
– A copy of the latest available accounts.
We cannot process your application without sight of these documents which will be returned without delay. If any of these
requirements cause difficulty, please contact us.
* Only UK, Jersey, Guernsey or Isle of Man driving licences can be accepted.
** The certifier must have seen the original document and met the individual face-to-face.

PAGE 12
FOCUS ACCOUNT COMPANY APPLICATION FORM
FOR INTRODUCED CLIENTS ONLY

14. YOUR CHECKLIST

A fully completed account application form Certified copies of the following documents will be required:
A fully completed Self Certification of Authorised signatory list
Entity Tax Status form Certificate of incorporation
Corporate structure chart if part of larger structure Memorandum & articles of association
A copy of the business plan if the entity’s principal Certificate of good standing/certificate of incumbency
function is e-commerce/e-gaming
Directors and shareholders register
A copy of the company accounts
Declaration of trust if a nominee company forms part of
A copy of licence (if applicable) the structure
W-9 forms to be completed for any US national/resident ID and address documents for directors/signatories, as
Relevant W forms for US security trading appropriate
‘Authority to release account information to an ID and address documents for all shareholders/beneficial
intermediary’ form (if applicable) owners owning over 25% of the company or holding a
‘Focus mandate appointing a third party adviser to give controlling interest
instructions only’ form (if applicable)
Shareholder Rights Directive II Decision Maker
Nomination Form if applicable

Please note that additional information and/or further mandates may be required.
Please do not email your application form to us as the personal information contained within this form may be compromised by
way of fraudulent interception.
Please note: we will require the original completed and signed copy of this application form and items in the checklist above to
finalise account opening formalities.
When you have completed this form simply post it to:
Nedbank Private Wealth or Nedbank Private Wealth or Nedbank Private Wealth
St Mary’s Court 20 Hill Street 31 The Esplanade Seventh Floor
Douglas Isle of Man St Helier Jersey 12 Arthur Street
British Isles IM1 1EU Channel Islands JE1 1FB London EC4R 9AB

PAGE 13

Nedbank Private Wealth is a registered trade name of Nedbank Private Wealth Limited.
Nedbank Private Wealth Limited is licensed by the Isle of Man Financial Services Authority. Registered office: St Mary’s Court 20 Hill Street Douglas Isle of Man.
The Jersey branch is regulated by the Jersey Financial Services Commission. The London branch is authorised by the Prudential Regulation Authority and regulated by the
Financial Conduct Authority and the Prudential Regulation Authority. Registration No: 313189. The UAE representative office in Dubai is licensed by the Central Bank of UAE.
Representation in South Africa is through Nedbank Limited. Registered in South Africa with Registration No 1951/000009/06, an authorised financial services and registered
credit provider (NCRCP16). C3g 02/21