Combined Treasury Account Application Form

    • Section 1: CLIENT AND ACCOUNT DETAILS

    • (tick relevant acc type)
    • (tick relevant block)
    • Note: Please provide a copy of your bar coded ID (If an ID card, both sides) , a utility bill/proof of address not older than 3 months and a selfie of you holding your ID.
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      Accepted file types: jpg, gif, png, pdf, word, Max. file size: 32 MB.
      • (explain the intended type of transactions to be conducted during the relationship)
      • Section 2.1: FOREIGN ACCOUNT TAX COMPLIANCE ACT (FATCA) INFORMATION

      • Section 2.2: COMMON REPORTING STANDARD (CRS) INFORMATION

        List all countries, except for South Africa, where you are resident for tax purposes and provide your Tax Identification Number (TIN). A TIN is the tax reference number issued to you by the tax office in the country where you are resident for tax purposes. Where a country does not issue a TIN, complete an equivalent number, for example a social security, national insurance, personal identification or a resident registration number.
      • Section 2.3 EXCHANGE CONTROL INFORMATION – APPLICABLE TO NON RESIDENTS ACCOUNT APPLICATIONS ONLY (MANDATORY)

        Should 1 or 2 above be ticked – Emigration confirmation details must be supplied to Exchange Control for review.
      • Section 3: INTERMEDIARY MANDATE

        The Client hereby appoints and authorises: St Pauls Forex (Pty) Limited (“the Agent”) To be the Client’s Agent, and to implement the following on the Client’s behalf: 1. To open accounts and deposit funds with Mercantile Bank a division of Capitec Bank Limited (“Mercantile Bank”) in the Client’s name, whether current, savings, investment, foreign exchange margin accounts or foreign currency accounts and to manage these accounts on behalf of the Client. 2. To withdraw funds held in the Client’s name from Mercantile Bank to meet specific underlying trade related transactions in the Client’s name. 3. To give instructions to Mercantile Bank to transfer and/or convert the Client’s funds from current to call accounts or call to current accounts, or transfer funds to any other account with Mercantile Bank or at another recognised financial institution in order to facilitate any transactions envisaged in this mandate. 4. To give instructions to Mercantile Bank acting on the Client’s behalf, to purchase and/or sell foreign currency (spot and forward) in the Client’s name, to transact in other over-the-counter foreign exchange products and/or to invest in money market products and do all things and sign all such documents as are necessary to execute and settle such aforesaid transactions on the Client’s behalf. 5. To open an electronic banking (“BANK@bility”) profile on behalf of the Client at Mercantile Bank allowing the Client viewing access only to the Client’s accounts loaded on the Client’s profile and/or instruct Mercantile Bank to load the Client’s accounts on the BANK@bility profile of the Agent for viewing purposes only; to enable the Client and/or the Agent to monitor transactions and balances on these accounts through BANK@bility. .6. In general to act for the Client in all matters concerning any transactions or dealings with Mercantile Bank relating to the authority granted herein. 7. To accept on the Client’s behalf Mercantile Bank’s terms and conditions of business and sign any documentation relating thereto. The Client hereby confirms that he/she is acquainted with such terms and conditions and acknowledge that he/she will be bound by such terms and conditions at all times until termination of the Client’s business relationship with Mercantile Bank. 8. To accept and pay on the Client’s behalf Mercantile Bank’s fees and charges. The Client undertakes to pay Mercantile Bank’s fees and charges on due date. The Client hereby warrants that any transactions undertaken on the Client’s behalf by the Agent shall comply with any Rulings, Regulations and Legislation, including but not limited to, the South African Reserve Bank Exchange Control Regulations and, further the Client warrants that the Client is not, as at the signature date hereof, and shall not, during the currency of this mandate, be, in contravention of any Exchange Control Rules, Regulations and/or Legislation. The Client hereby acknowledges that in granting this mandate the Client assumes all risks connected with the administration of the entrusted funds by the Agent (except in so far as there may in law be a right of recovery against the Agent), as well as the responsibility to ensure that the Agent executes the instructions as recorded in this mandate as specified by the Client; The Client hereby abandons any claim which the Client may have against Mercantile Bank release Mercantile Bank from all liability and indemnify Mercantile Bank against all direct or consequential losses, liabilities, actions, suits, proceedings, costs, claims, demands, damages, charges and expenses (including all legal and professional fees and disbursements) directly or indirectly incurred in consequence of, or in any way related, including but not limited, to; Mercantile Bank acting in terms of this mandate; or funds being transferred by the Agent or Mercantile Bank on instruction of the Agent; or accessing of banking or other accounts of the Client via BANK@bility or otherwise; or failure, delay, unauthorised use, incorrect procedure, data destruction or errors arising from the omission or incorrect input by the Client or the Agent; or usage of the internet and/or BANK@bility; or breach by the Agent of its obligations under this mandate and/or breach by the Client of its obligations under the Client’s agreements with Mercantile Bank This mandate shall remain in force until the Client have given Mercantile Bank seven (7) days written notice that this mandate is terminated. The Client hereby indemnifies Mercantile Bank and holds it harmless against any claims, damages and losses which may be made against Mercantile Bank by any person (including the Client and/or Agent), arising from or relating to this mandate or Mercantile Bank acting upon an instruction from the Client’s Agent
      • DECLARATION

        The Client hereby confirms that the above information in section 1 (Client and Account Details) and sections 2.1 and 2.2 (FATCA Information and CRS Information) is true and correct. The Client undertakes to advise Mercantile Bank within 30 days of any change in circumstances which affects my citizenship, nationality or tax residency status or causes my information contained herein to become incorrect. The Client furthermore confirms that section 3 (the mandate) shall remain in force until the Client has given Mercantile Bank seven (7) days written notice that this mandate is terminated. The Client hereby indemnifies Mercantile Bank and holds it harmless against any claims, damages and losses which may be made against Mercantile Bank by any person (including the Client and/or Agent), arising from or relating to this mandate or Mercantile Bank acting upon an instruction from the Client’s Agent.
      • ACCOUNT OPENING TERMS AND CONDITIONS

        I the undersigned, confirm that I have read, considered understood and agreed to the Mercantile Bank Terms and Conditions (the terms) in its entirety as well as the FAIS disclosure; which govern all dealings with Mercantile Bank. The full terms are available at https://www.mercantile.co.za/Treasury/Pages/Documentation.aspx and are also available on request. 
      • CLIENT SIGNING ARRANGEMENT

      • MM slash DD slash YYYY
      • The below signing arrangement must not include the Intermediary’s Signature, this will be dealt with in terms of the internal signing arrangement. I/we give hereunder the signing authorities in force as from the date the account is opened, until further notice in writing:
      • Note: Documents may also be signed by designated Intermediary signatory/ies, provided appropriate mandate is on record. * Do not insert names. Insert official designations e.g. Account Holder, Power of Attorney, Intermediary.