INVESTOR DETAILS
Title: Surname:
Namibian Resident: Yes No
Code:
First Name(s):
ID or Passport Number (if foreign national):
Date of Birth:
Code:
Telephone (Home): Telephone (Work):
Fax Number: Cellphone Number:
Employer:
Sale of asset Inheritance Other If other please specify:
Email Address:
Occupation:
Yes No If yes, please provide this tax/GIN reference number:
UNIT TRUST
NATURAL PERSONS APPLICATION FORM
PAGE 1 OF 9 UNIT TRUST | NATURAL PERSONS APPLICATION FORM
A
All sections must be completed in full using BLOCK LETTERS.
Indicate all options selected by means of a cross [X].
Initial any amendments made to the application form.
Ensure that all information provided is accurate.
No instruction will be processed unless all requirements have been met.
The daily cut-off or receipt of instructions is 12h00 and 10h00 for Money
Market Fund instructions.
You may opt to complete this form
digitally - it requires Adobe Acrobat
Reader DC. Download it to your device by clicking on the icon above.
Completed forms should be faxed to +264 (61) 249 444, emailed to
clientservices@namasset.com.na or by clicking the Submit Form button.
Should you have any queries regarding this application, please contact
us on +264 (61) 275 700.
Are you a politically exposed person or a prominent influential person*?
Yes No
** An individual who has been entrusted with a prominent public function, for example Head of State, minister, senior judge, senior politician, military official or
senior executive of a state-owned entity. You are also considered a politically exposed person if you are a family member or close associate of any of the above.
Source of funds (compulsory): Savings Salary
Are you a registered tax payer of the United States of America?
Residential Address:
Postal Address:
-
-
-
PAGE 2 OF 9 UNIT TRUST | NATURAL PERSONS APPLICATION FORM
INVESTMENT OPTIONS
I/We hereby apply to invest in the NUTM collective investment schemes in accordance with the provisions of the relevant Deed of each fund at the respective
fund/s price/s ruling on the date of receipt of the monies by NUTM, subject to receipt of a duly completed Application Form, proof of transfer and all relevant
supporting documentation.
REGULAR DEBIT ORDER AUTHORITY
I/We the undersigned, authorise Namibia Unit Trust Managers to draw against my/our bank account the debit order investment amounts in terms of this
application on the
2nd 26th day of each month for the investment at the ruling price on that day commencing on (date):
All such withdrawals from my/our account will be treated as though they have been signed by me/us personally, and I/we request the bank to debit my/our
account with these amounts. I/We acknowledge that debit order investments are subject to a 30 day clearance period. I/We agree that this debit instruction is
irrevocable and irreversible and hereby indemnify NUTM against any loss or damage it may suffer or incur should the recurring debit order either be reversed or
not be honoured for any reason whatsoever.
C
NEED
Lump Sum
Investment
(Min. N$5 000 p.m.)
(Min. N$10 000 for
Money Market
Fund)
Debit Order
(Minimum
N$500 p.m)
Income
Distribution
Deposited
to Bank
Account
N$
%
Income
N/A
Growth multi-asset N/A
Income
Income & growth
Income & growth
Growth multi-asset
Income
Distribution
Reinvested
OR
Annual
Debit Order
Increase
(Enter Percentage)
%
%
%
N$
or
or
or
or
or
or
N$
N/A
N/A
N$
N$
N$
N$
N$
N$
N$
LOCAL FLAGSHIP FUNDS
NAM Coronation Strategic Income Fund
NAM Coronation Balanced Defensive Fund
NAM Coronation Capital Plus Fund
NAM Coronation Balanced Plus Fund
OFFSHORE FLAGSHIP FUND (NAD-denominated feeder fund)
NAM Coronation Optimum Growth
Fund
LOCAL SPECIALIST FUND
NAM Coronation Money Market Fund
ACTING ON BEHALF OF AN INVESTOR*/JOINT NAME REGISTRATION**
*e.g. Persons with Power of Attorney
. **Insert second name if joint name registration.
Namibian Resident: Yes No
Code:
Title: Surname:
First Name(s):
Code:
Telephone (Home):
Fax Number:
Telephone (Work):
Cellphone Number:
Capacity:
Employer:
Yes No
If yes, please provide this tax/GIN reference number:
B
Are you a politically exposed person or a prominent influential person*?
Yes No
Email Address:
Occupation:
Are you a registered tax payer of the United States of America?
** An individual who has been entrusted with a prominent public function, for example Head of State, minister, senior judge, senior politician, military official or
senior executive of a state-owned entity. You are also considered a politically exposed person if you are a family member or close associate of any of the above.
Additional authorised representatives and joint signatories - Complete Annexure A
GO TO
ANNEXURE A
Residential Address:
Postal Address:
Date of Birth
ID or Passport Number (if foreign national):
-
-
-
-
-
-
PAGE 3 OF 9 UNIT TRUST | NATURAL PERSONS APPLICATION FORM
METHOD OF PAYMENT
Electronic/Internet transfer
Electronic collection by NUTM
Electronic internet transfers may take up to 2 days to appear in our bank account. Units may only be priced upon
confirmed receipt of documentation and funds into the relevant Unit Trust bank account. Please insert the investor’s
initials and surname in the reference section on the proof of transfer in order to assist NUTM with processing the
applications.
Electronic collection by NUTM is restricted to a maximum of N$250 000 per debit. Where a higher amount than this is
requested, multiple debits will be processed on the same day. Funds are deducted from the investor’s bank account 4
days after the receipt of a valid and complete application form and supporting documentation.
Regular debit order Please complete the Debit Order Authority section if you select this option.
NAM Coronation Strategic
Income Fund
Account Holder: NAM Coronation
Strategic Income Fund
Bank: Nedbank Namibia
Branch: Windhoek
Branch Code: 461-617
Account Number: 1199 000 3620
NAM Coronation Capital
Plus Fund
Account Holder: NAM Coronation
Capital Plus Fund
Bank: Nedbank Namibia
Branch: Windhoek
Branch Code: 461-617
Account Number: 1199 000 3671
NAM Coronation Balanced
Defensive Fund
Account Holder: NAM Coronation
Balanced Defensive Fund
Bank: Nedbank Namibia
Branch: Windhoek
Branch Code: 461-617
Account Number: 1199 000 3728
NAM Coronation Balanced
Plus Fund
Account Holder: NAM Coronation
Balanced Plus Fund
Bank: Nedbank Namibia
Branch: Windhoek
Branch Code: 461-617
Account Number: 1199 000 3582
NAM Coronation Money
Market Fund
Account Holder: NAM Coronation
Money Market Fund
Bank: Nedbank Namibia
Branch: Windhoek
Branch Code: 461-617
Account Number: 1199 001 5688
Please note that no cash deposits will be accepted. Any such deposits will be returned net of any related bank charges.
NUTM requires proof of transfer together with receipt of the applicable documentation as set out in this form, before this
application can be processed.
D
DOWNLOAD DEBIT
ORDER AUTHORITY
BANKING DETAILS
The details specified below must be in the investor’s name and will be used for all future banking transactions until such time we are notified of any changes in writing.
Name of Account Holder:
Name of Bank: Branch Name:
Branch Code: Account Number:
Type of Account: Current Transmission Savings
A recent bank confirmation letter or bank statement must accompany this application form as confirmation of proof of bank details. No payments will be made to
third parties (i.e. payments will only be made to the bank account in the name of the registered investor.) We are unable to facilitate payments to credit cards or
market-linked accounts. All payment instructions are executed electronically.
E
NAM Coronation Optimum
Growth Fund
Account Holder: NAM Coronation
Optimum Growth Fund
Bank: Nedbank Namibia
Branch: Windhoek
Branch Code: 461-617
Account Number: 1199 032 9895
PAGE 4 OF 9 UNIT TRUST | NATURAL PERSONS APPLICATION FORM
REGULAR WITHDRAWAL METHODS
N$
Monthly Quarterly Half-yearly Yearly
Selected monetary value per withdrawal
Selected withdrawal frequency:
payable up to two business days thereafter.
The minimum regular withdrawal is N$500 per month per fund.
FROM FUND
Fund Name Value of Regular Withdrawal % Per Fund
NAM Coronation Money Market N$ or
%
NAM Coronation Strategic Income Fund N$ or
%
NAM Coronation Balanced Defensive Fund N$ or
%
NAM Coronation Capital Plus Fund N$ or
%
NAM Coronation Balanced Plus Fund N$ or
%
NAM Coronation Optimum Growth Fund
N$
or
%
AUTHORISED SIGNATORIES
The following individuals are authorised to sign all instructions sent on behalf of the investor:
We instruct NUTM to only action instructions signed by all investors named above.
We instruct NUTM to action instructions signed by any of the investors named in Sections A and B.
Refer to the attached Authorised Signatory list.
NUTM will action instructions signed by any of the investors named above if no election is made.
We jointly and severally authorise NUTM to act upon instructions placed by any one investor on behalf of all joint investors subject to terms (a) to (e ) below:
(a) We authorise NUTM to act upon the instructions given in writing with regard to the units in the fund(s) that we have selected, signed or purportedly signed
by any one of the signatories in Section A and B.
(b) We confirm that these authorisations shall apply to any further units purchased, transferred or otherwise held by the entity.
(c) We agree that this authorisation shall remain in force until notice signed by all the authorised representatives (e.g. directors) in writing of its termination or
replacement is received by NUTM and any such notice shall be without prejudice to the completion of transactions already initiated by NUTM pursuant to
the above terms.
(d) We agree that this authorisation shall be construed in accordance with and governed by the laws of Namibia.
(e) NUTM do not accept monies in cash either directly at the Manager or by a bank deposit, such monies will be returned to the originating source net of fees.
F
G
Total amount to be withdrawn per period
N$
or
%
Full Name
Email Address SignatureContact Number
Please indicate whether you require a joint signing authority by making en election below:
Selected first withdrawal month:
Withdrawals will be paid into your bank account within 2-5 business days after the selected date of regular withdrawal. If the withdrawal date falls on a weekend
or public holiday, the withdrawal will be processed on the next business day.
-
-
-
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
PAGE 5 OF 9 UNIT TRUST | NATURAL PERSONS APPLICATION FORM
SUPPORTING DOC
UMENTATION
(Copies of the supporting documentation are sufficient as long as all texts and photographs are clear and legible.)
The following outlines the supporting documentation required in terms of the Financial Intelligence Act No.13 of 2012 or as amended as well as other
documents required by Namibia Unit Trust Managers (NUTM).
If supporting documentation in terms of the Financial Intelligence Act No.13 of 2012 or as amended has been provided in full to another primary
accountable institution (e.g. the Financial Advisor) and if NUTM has confirmed that such institution has provided written confirmation, the investor is not
obliged to furnish NUTM with such supporting documentation. In this event we require only the proof of identity of the investor/authorised person, power of
attorney (if applicable), and proof of bank details.
For Namibian Citizens and Residents
Copy of ID document bearing ID number and clear photograph or full birth certificate (if minor)
Proof of banking details (e.g. bank statement less than three months old or recent bank confirmation letter)
Guardian contact details (these details are only required when transacting on behalf of a minor)
Proof of Power of Attorney (if applicable)
For Foreign Nationals
Copy of valid passport bearing passport number and clear photograph
Proof of banking details (e.g. bank statement less than three months old or recent bank confirmation letter)
Guardian contact details (these details are only required when transacting on behalf of a minor)
Proof of Power of Attorney (if applicable)
Proof of residential address
I
COM
MU
NICA
T
I
O
N
FROM NAMIBIA ASSET MANAGEMENT
Please send my investor statements by Email Post
Where no choice is made, all communication will be sent by email where an address is supplied, otherwise by post.
Our latest financial statements and fund fact sheets are uploaded to our website (www.namasset.com.na) and copies can be provided upon request.
H
PAGE 6 OF 9 UNIT TRUST | NATURAL PERSONS APPLICATION FORM
J
GENERAL INFORMATION AND CONDITIONS
1. Generally administering, servicing and maintaining your investment account(s).
2. Communicating with you and your financial adviser/broker.
3. Providing your PI to any entity within the NUTM group of companies, with which you already have an existing relationship, or with which you are about to
enter into a relationship, for the efficient servicing/administration of your investments.
4. Providing your PI to third parties (which may include consumer credit bureaus and other similar service providers) which assist with the verification of your
information or assist in establishing and/or obtaining additional information as may be needed by NUTM to meet its regulatory obligations such as, but not
limited to its regulatory obligations under the Financial Intelligence Act, 2012 (Act No. 13 of 2012) or as amended; or assist with the enforcement of
agreements; or which store and/or maintain the PI; or which require the information to process your instructions or to otherwise provide a service to you for
your investment, where such party has procedures in place to protect your PI.
5. Transferring your PI outside the borders of Namibia where the person receiving the PI is subject to and complies with similar data protection laws.
6. Providing your information to local and/or international regulatory authorities, law enforcement agencies and governmental departments, and any other
person that NUTM is required, by law, to share your PI with.
7. Conducting research or servicing products. Where appropriate, your PI will be de-identified such that it cannot be linked back to you personally.
8. Meeting contractual/legal and/or regulatory obligations.
NUTM will ensure that controls are in place to protect your PI and will process your PI as permitted by law. If you feel we have not done so, you are entitled to
contact us and object.
Your PI will be kept until such time as we are legally compelled to delete/destroy it. You have the right to request a copy of the PI that we hold and a right to
request the correction thereof. It is your responsibility to inform NUTM of any changes to your PI.
Where you are acting in a representative capacity on behalf of an investor, all acknowledgements, agreements and consents contained herein are given by you on
behalf of the investor and you warrant your authority to act in such a representative capacity.
Capital Risk
Unit prices will fluctuate relative to the market value of securities comprising the funds’ portfolios and increase or decrease accordingly. Should any guarantee be
furnished against price fluctuations this shall be by a party other than the manager with details and costs clearly defined.
Redemptions
Units will be repurchased by the administrator at the net asset value calculated in accordance with the requirements of the Unit Trust Control Act and the relevant
Trust Deeds and paid to the unit holder within 2 business days of the written request, unless the disinvestment exceeds 5% of the total fund value in which case
the provisions of the Deed dealing with payment in respect of repurchases will apply. If the units to be repurchased are subject to a pledge, written consent is
necessary for the transaction. Redemption from the NAM Coronation Optimum Fund may take 2-5 business days of the written request to be paid to the unit
holder account due to the trading cycle of the fund. Repurchase instructions which include a change in your banking details must be accompanied by a copy of a
recent bank confirmation letter or bank statement less than 3 months old.
Investor Communication
A transaction advice will be sent to you once your investment has been processed. Statements will be issued on a quarterly basis. Our client service consultants are
available during business hours on 061 275 700 (Monday to Friday from 08h00 to 17h00).
Pricing and cut-off times
Forward pricing occurs at 15h00 each business day and at 17h00 on the last business day of each month. Units will be purchased at the ruling net asset value price
on the date of your deposit by NUTM. Completed application forms and notification of deposits must be received before 12h00 and 10h00 for Money Market
instructions. Cut-off time also applies to redemptions and switches (unless the amount being disinvested exceeds 5% of the total fund value). All purchases, except
for debit orders (30 days clearance period), are subject to a 14 day clearance period in respect of subsequent redemptions. Distributions on purchases within the 30
day clearance period will be automatically reinvested.
Processing of Personal Information
You acknowledge that NUTM requires your Personal Information (“PI”), in order to perform its obligations fairly, competently, and in accordance with the law. You
acknowledge that failure to provide complete and accurate PI to NUTM may lead to NUTM not being able to accept any investment placed with us or the
suspension, closure or inability to transact or make further contributions to your investment account. You consent (and, if applicable, such consent applies to any
person or entity that you are duly authorised to act on behalf of or in a representative capacity) to NUTM collecting, using, processing, storing, disclosing and
verifying (collectively “process” or “processing”) your PI for the purposes of,
inter alia
:
PAGE 7 OF 9 UNIT TRUST | NATURAL PERSONS APPLICATION FORM
DECLARATION BY INVESTOR
I/We understand and agree to be bound by the provisions of this application form. If on the date of signature of this application form an updated application
form exists and the fees are different on that form, the fees on the updated application form will apply.
I/We understand and/or confirm that:
The information contained herein is correct and that, if this application form is signed in a representative capacity, I/we have the necessary authority to do so
and that this transaction is within my/our powers.
I/We am/are acting for my/our own account and that I/we have made my/our decisions to enter into the investment and as to whether the investment is
appropriate for me/us independently based upon my/our own judgement, upon advice from such advisors as I/we may deem necessary. I/We declare that I
am/we are not relying on any communication from NUTM whether written, oral or implied as investment advice or as a recommendation to enter into
the investment. I/We understand that information and explanations relating to the terms of an investment shall not be considered investment advice or a
recommendation to enter into the investment.
NUTM will only be able to process investments on receipts of funds into the appropriate bank account, proof of deposit, and all relevant documentation.
NUTM will not be responsible for any failure, malfunction or delay of any networks, electronic or mechanical device or any other form of communication
used in the submission, acceptance and processing of applications and/or transactions. NUTM will not be liable to make good or compensate any investor or
third part for any damages, losses, claims or expenses resulting there from.
I/We understand the NUTM Fee Schedule which details the unit trust funds and fee information.
I/We indemnify NUTM accordingly.
I/We will notify NUTM immediately if my/our tax residency or Foreign Account Tax Compliance Act (‘FATCA’) or equivalent classification changes in the
future, or if there are any changes in circumstances that may impact on my/our tax residency status and/or FATCA classification.
I/We agree that Namibia Asset Management and/or Namibia Unit Trust Managers may share information about my/our tax residency status regarding this
investment with the Internal Revenue Service (IRS) of the United States of America as required by FATCA.
I/We have read the general information and conditions contained in section J and agree thereto.
1st Applicant: Signature: Date:
2nd Applicant: Signature: Date:
3rd Applicant: Signature: Date:
4th Applicant: Signature: Date:
M
Click in the
Signature
Box for
instructions
SIGN THIS FORM
WITH DIGITAL ID
INVESTMENT ADVISORY RELATIONSHIP
I acknowledge that I did not receive financial advice from either the NUTM or a financial advisor; OR
I acknowledge that I have received financial advice from a financial advisor, please complete Annexure B.
L
GO TO
ANNEXURE B
FEES SCHEDULE
Fund name Initial fee Annual Management Fee Performance Fee
NAM Coronation Money Market Fund 0.00% 0.50% None
NAM Coronation Strategic Income Fund 0.00% 0.85% None
NAM Coronation Balanced Defensive Fund 0.00% 1.25% None
NAM Coronation Capital Plus Fund 0.00% 1.25% None
NAM Coronation Balanced Plus Fund 0.00% 1.25% None
K
NAM Coronation Optimum Growth Fund
0.00%
1.10%*
None
* Includes a 0.6% annual management fee paid to the underlying fund
-
-
-
-
-
-
-
-
-
-
-
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
PAGE 8 OF 9 UNIT TRUST | NATURAL PERSONS APPLICATION FORM
ANNEXURE A
ADDITIONAL AUTHORISED REPRESENTATIVES
To be completed by persons authorised to transact on behalf of the entity.
e.g. Persons with Power of Attorney.
Title: Surname:
First Name(s):
ID or Passport Number (if foreign national): Please attach a copy of your ID or Passport
Date of Birth: Namibian Resident: Yes No Gender: M F
Postal Address:
Code:
Residential Address:
Code:
Telephone (Home): Telephone (Work):
Fax Number: Cellphone Number:
Email Address: Capacity:
Occupation: Employer:
Yes No
Are you or any director, member or beneficial owner registered tax payers of the United States of America?
If yes, please provide this tax/GIN reference number:
A
Are you a politically exposed person or a prominent influential person*?
* An individual who has been entrusted with a prominent public function, for example Head of State, minister, senior judge, senior politician, military official or
senior executive of a state-owned entity. You are also considered a politically exposed person if you are a family member or close associate of any of the above.
Yes No
-
-
-
PAGE 9 OF 9 UNIT TRUST | NATURAL PERSONS APPLICATION FORM
ANNEXURE B
FINANCIAL ADVISOR DETAIL AND DECLARATION
To be completed by advisor
Contact Name: Company:
Advisor Account Number: Registration Number:
NAMFISA License Number: Authorised Advisor Signature:
An “Accountable Institution” includes but is not limited to the following list of institutions: a bank, long-term insurer or management company registered in terms
of the Unit Trust Control Act or as amended or a person who carries on the business of rendering investment advice or investment brokering services including a
public accountant who carries on such a business, a member of a stock exchange licensed under the Stock Exchanges Control Act 1985 or as amended and
person who has been approved or who falls within a category or persons approved by the Register of Stock Exchanges or the Registrar of Financial Markets. If this
section is completed by an “Accountable Institution” acting on behalf of the client, the supporting documentation on referred to in Section C need not to be
submitted to NUTM*, apart from a copy of the ID and proof or a bank details. NUTM may however still request this information where it is deemed necessary.
*(a copy of ID and proof of bank account is still required)
I/We
Declare that I/we am/are a licensed Financial Service Provider(s) and have made the disclosures required in terms of the Unit Trust Control Act 1981 or as
amended and subordinate legislation thereto to the investor.
Acknowledge and confirm that, in my/our capacity as the primary accountable institution with NUTM being the secondary accountable institution, I/we have
established and verified the identi
ty of the client in accordance with Section 13 of the Financial Intelligence Act No.13 of 2012 or as amended (“the Act”), and
will keep records of such identification and certification according to the provisions of Section 15 of the Act.
Warrant that I/we have explained all fees that relate to this investment to the investor and I/we understand and accept that the investor may withdraw his/
her authority for payment to me/us in writing to NUTM.
on this day of ,year
Signed at:
Signature of financial advisor:
FINANCIAL ADVICE FEES
To be completed by investor
I hereby confirm that I have received financial advice from the financial advisor listed in this section. I instruct NUTM to deduct the following advice
fees to pay the advisor on my behalf.
Initial advice fee: % (Negotiable to maximum 3%). Applied to each contribution and deducted before investment is made.
Annual advice fee: % per annum of the market value of the investment portfolio, charged by way of unit reduction and paid to the Financial
Advisor monthly in arrears. (Negotiable to maximum 1%). If initial advice fee of greater than 1.5% is selected, then the maximum annual advice fee is 0.5%. This
annual advice fee is not part of the normal annual management fee charged by the relevant Fund/s. You may terminate or revise financial advise ees by written
notice to us.
Signature of investor or authorised representative:
Signature of investor or authorised representative:
B
Click in the
Signature
Box for
instructions
SIGN THIS FORM
WITH DIGITAL ID
T +264 (0) 61 275 700 | F +264 (0) 61 249 444 | 1
st
Floor, Millennium House, c/o Robert Mugabe Avenue and Dr AB May Street, Windhoek, Namibia | PO BOX 23329, Windhoek, Namibia |
www.namasset.com.na
Namibia Unit Trust Manager Limited: Registration Number: 96/308 | A subsidiary of Namibia Asset Management Limited | Directors: RG Young (RSA), E Emvula | Company Secretary: U Eiseb
-
-
-
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit