Jurastic Person FICA Declaration
To be completed by all clients accompanied with all required documentation
Entity Type
*
Company
Close Corporation
Trust
Entity Information
Registered Name
Trading Name
Registration No.
Trust Name
Trust No.
Contact Details
Office Number
*
Format: (000) 000-0000.
Email
*
example@example.com
Registrered Address
Current Address
Sectional Title Address
Street Address
City
State / Province
Postal / Zip Code
Postal Address
PO Box Number
Suburb
City
State / Province
Postal / Zip Code
Tax Information
If registered in South Africa
Tax Number
VAT registered No
Director Details
Number of Directors
Please Select
1
2
3
4
5
6
7
8
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Member Details
Number of Members
Please Select
1
2
3
4
5
6
7
8
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Trustee Details
Number of Trustees
Please Select
1
2
3
4
5
6
7
8
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Checklist for Supporting Documents
Certificate of Incorporation
Registrar of Directors
Proof of Address
Company Resolution
Certificate of Incorporation
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of
Registrar of Directors
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Proof of Address
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of
Company Resolution
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of
Certificate of Incorporation
Founding Statement
Proof of Address
Company Resolution
Certificate of Incorporation
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of
Founding Statement
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of
Proof of Address
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of
Company Resolution
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of
Copy of Trust Deed
Letter of Authority
Proof of Address
Authorised Signature Resolution
Copy of Trust Deed
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of
Letter of Authority
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of
Proof of Address
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of
Authorised Signature Resolution
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of
Signature
*
Date
*
 -
Day
 -
Month
Year
1
Submit
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