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
*
-
Area Code
Phone Number
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
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
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
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
1
Certificate of Incorporation
Registrar of Directors
Proof of Address
Company Resolution
Certificate of Incorporation
Browse Files
Cancel
of
Registrar of Directors
Browse Files
Cancel
of
Proof of Address
Browse Files
Cancel
of
Company Resolution
Browse Files
Cancel
of
2
Certificate of Incorporation
Founding Statement
Proof of Address
Company Resolution
Certificate of Incorporation
Browse Files
Cancel
of
Founding Statement
Browse Files
Cancel
of
Proof of Address
Browse Files
Cancel
of
Company Resolution
Browse Files
Cancel
of
3
Copy of Trust Deed
Letter of Authority
Proof of Address
Authorised Signature Resolution
Copy of Trust Deed
Browse Files
Cancel
of
Letter of Authority
Browse Files
Cancel
of
Proof of Address
Browse Files
Cancel
of
Authorised Signature Resolution
Browse Files
Cancel
of
Signature
*
Date
*
-
Day
-
Month
Year
4
Submit
Should be Empty: