Become a client September 15, 2021by Charl du Plessis Natural persons Companies Natural persons Onboarding IndividiualClient form: Natural PersonsApplicant First NameApplicant SurnameApplicant Identity Number (if SA citizen)Contact NumberApplicant Passport Number (if non SA citizen)Email AddressApplicant Residential AddressCityProvincePostal CodeApplicant Postal AddressCityProvincePostal CodeBroker NamePlease SelectJason MizenJohan ErasmusVolker GrunewaldSupporting documentationUpload Applicant ID / PassportUpload document Upload Applicant Proof of AddressUpload document Important NoticeFICA is a legal framework which exists to help identify the proceeds of unlawful activities and to combat activities related to money laundering, terrorist funding and tax evasion. JVC Insurance Brokers (Pty) Ltd is defined as an Accountable Institution referred to in Schedule 1 of the FIC Act and therefore has the responsibility to Identify and verify new and existing clients as well as keep records of identities of clients and transactions entered into with clients and Report certain large or suspicious transactions to the Financial Intelligence Centre established by the FIC Act. Therefore, if you have been requested to visit this webpage, by a JVC Insurance Brokers representative, please complete the following information in order for JVC Insurance Brokers (Pty) Ltd, to successfully identify and verify you as a client. We take all reasonable steps to protect and securely store all client documents and communications, in whatever form they may exist, from unauthorised access. This includes maintaining privacy and confidentiality during the destruction or return of all records when these are no longer needed. Furthermore, we heed legislative provisions regarding the protection of personal information. Please note that we may not disclose any confidential information acquired or obtained from a client or a product supplier, unless written consent of the client or product supplier has been obtained beforehand or disclosure of the information is required in the public interest or under any law. For more information regarding Protection of personal information, please view our privacy statement here. By submitting the information captured on this form, you declare that you have ensured that the information provided herein is current, complete and accurate and that you are aware that any changes to the information provided must be communicated to JVC Insurance Brokers and or/your appointed financial adviser/broker as soon as practically possible; and should you omit relevant information requested by us, you are aware that any recommendations made may be inaccurate or inappropriate. As we aim to comply with the Protection of Personal Information Act (POPIA) Act 4 of 2013, we would like to advise you that JVC Insurance Brokers is responsible for how Personal Information is processed and we endeavour to comply with the revised conditions set out in POPIA. In addition to the Personal Information collected for the specific purpose of providing financial advice and intermediary services to you, we hereby request consent to utilise the Personal Information for the following purposes: Newsletters Email Campaigns Kindly note that the information provided for the above-mentioned purposes will not be used for any other reason or processed unlawfully. By accepting the above, you are indicating that you are consenting to receive future communication in this regard. Kindly note that you have the right to opt-out at any time.Submit Companies Onboarding CompanyClient form: CompaniesCompany NameCompany Registration NumberCompany Representative NameContact NumberCompany Representative ID number (if SA Citizen)Company Representative SurnameEmail AddressCompany Representative Passport number (if non SA Citizen)Company Registered AddressCompany Postal AddressName of BrokerPlease SelectJason MizenJohan ErasmusVolker GrunewaldSupporting documentationUpload Company Registration Certificate / MOIUpload document Upload Company Proof of registered addressUpload document FICA is a legal framework which exists to help identify the proceeds of unlawful activities and to combat activities related to money laundering, terrorist funding and tax evasion. JVC Insurance Brokers (Pty) Ltd is defined as an Accountable Institution referred to in Schedule 1 of the FIC Act and therefore has the responsibility to Identify and verify new and existing clients as well as keep records of identities of clients and transactions entered into with clients and Report certain large or suspicious transactions to the Financial Intelligence Centre established by the FIC Act. Therefore, if you have been requested to visit this webpage, by a JVC Insurance Brokers representative, please complete the following information in order for JVC Insurance Brokers (Pty) Ltd, to successfully identify and verify you as a client. We take all reasonable steps to protect and securely store all client documents and communications, in whatever form they may exist, from unauthorised access. This includes maintaining privacy and confidentiality during the destruction or return of all records when these are no longer needed. Furthermore, we heed legislative provisions regarding the protection of personal information. Please note that we may not disclose any confidential information acquired or obtained from a client or a product supplier, unless written consent of the client or product supplier has been obtained beforehand or disclosure of the information is required in the public interest or under any law. For more information regarding Protection of personal information, please view our privacy statement here. By submitting the information captured on this form, you declare that you have ensured that the information provided herein is current, complete and accurate and that you are aware that any changes to the information provided must be communicated to JVC Insurance Brokers and or/your appointed financial adviser/broker as soon as practically possible; and should you omit relevant information requested by us, you are aware that any recommendations made may be inaccurate or inappropriate. As we aim to comply with the Protection of Personal Information Act (POPIA) Act 4 of 2013, we would like to advise you that JVC Insurance Brokers is responsible for how Personal Information is processed and we endeavour to comply with the revised conditions set out in POPIA. In addition to the Personal Information collected for the specific purpose of providing financial advice and intermediary services to you, we hereby request consent to utilise the Personal Information for the following purposes: Newsletters Email Campaigns Kindly note that the information provided for the above-mentioned purposes will not be used for any other reason or processed unlawfully. By accepting the above, you are indicating that you are consenting to receive future communication in this regard. Kindly note that you have the right to opt-out at any time.Submit
