FICA Questionnaire - Natural Person

Page 1 of 9

All documents must be completed in full, and no funds will be invested or paid without the completed and verification documents. In the event of you also registering a mortgage bond, the bank’s FICA requirements will be requested in addition to the below.

Hover of the icon to see more details about the field.

Personal Information

Please complete field
Please complete field
Non-resident Residency Status*
Non-resident Residency Status
Please select and option
Please complete field
Please complete field
Please complete field
Please complete field, valid email address
Invalid Input

Financial Information

Bank Account Details

  • From which payment of any cash amount is made to the Agency or Waldick Inc.
  • Into which payment of proceeds are to be made
  • Transactional bank account for purposes of any matter with Waldick Inc.
Please complete field
Please complete field
Please complete field
Please complete field
Employment Status (SOI)*
Employment Status (SOI)
Please select and option
Please complete field
Please complete field
In which country do you trade in*
In which country do you trade in
Please select and option
Please complete field
In which jurisdiction is your main trade*
In which jurisdiction is your main trade
Please select and option
Please complete field
Method of Payment for this Transaction (SOF) *
Method of Payment for this Transaction (SOF) <i class="fa-solid fa-circle-info"></i>
Please select and option
Please complete field

Prominent Influential Person (PIP)

Are you a DOMESTIC or FOREIGN PIP? *
Are you a DOMESTIC or FOREIGN PIP? <i class="fa-solid fa-circle-info"></i>
Please select and option
Please complete field
Are you a FAMILY MEMBER or a close associate of such person? *
Are you a FAMILY MEMBER or a close associate of such person? <i class="fa-solid fa-circle-info"></i>
Please select and option
Please complete field

Marital Status

Marital Status*
Marital Status
Please select and option
Please complete the field
Please complete the field
Please select a date
Please complete the field
If Husband domiciled in SA at date of marriage, was any ante nuptial contract entered into?*
If Husband domiciled in SA at date of marriage, was any ante nuptial contract entered into?
Please complete the field
Have you been divorced since you last sold or bought property?*
Have you been divorced since you last sold or bought property?
Please select and option
Are you a resident for tax purposes in South Africa?
Are you a resident for tax purposes in South Africa?
Invalid Input
Please complete the field
Please complete the field
Please complete the field
Please complete the field

Selling Property

Are you Selling a Property?*
Are you Selling a Property?
Please select and option
How did you intend to utilise the property?*
How did you intend to utilise the property?
Please select and option
Please complete the field
Is the property bonded?*
Is the property bonded?
Please select and option

Provide Institution Details

Please complete the field
Please complete the field
Is the original title deed in your possession? *
Is the original title deed in your possession?
Please select and option
Please complete the field
Please complete the field

Managing Agent's / Home Owners Association's (if applicable)

Invalid Input
Invalid Input

Purchasing Property

Are you Purchasing a Property?*
Are you Purchasing a Property?
Please select and option
How are you financing the purchase?*
How are you financing the purchase?
Please select and option
Please complete the field
How do you intend to utilise the property?*
How do you intend to utilise the property?
Please select and option
Please complete the field

Mortgage Bond

Are you taking out a Mortgage Bond?*
Are you taking out a Mortgage Bond?
Please select and option

Bank account details for debit order:
This must be a South African bank account.

Please complete the field
Please complete the field
Please complete the field
Please complete the field
Please complete the field
Please complete the field
Do you have dual Citizenship?*
Do you have dual Citizenship?
Please select and option
Please complete the field
Please complete the field

Documents

We require the following documentation in order to draft our bond documents for Signature:

Identity Document, Marriage Certificate / Ante-Nuptial Contract, Divorce Order (if applicable), Utility Bill reflecting Name and Current Residential address NOT older than 3 months and not from your instructing bank and Proof of bank details for debit order form and copy of Homeowners/Life Insurance Policy where you have elected to utilise insurance provided by a third party.

Please select a file
Please select a file
Please select a file
Please select a file
Please select a file

Sign and Submit

Waldick Inc, as a firm of attorneys, has the privilege of confidentiality in accordance with the Protection of Personal Information Act 4 of 2013 (“POPI”) concerning its clients. By signing below, I consent to the processing of the information contained herein as required under Section 11(1)(a) of POPI. The staff and finance department of Waldick Inc are authorised to access the Company’s details provided herein for the purpose of attending to the Company’s matters and any ancillary matters related thereto. Waldick Inc is further authorised to disclose the Company’s personal information to:

  • The South African Revenue Service;
  • Relevant municipal authorities; and
  • Any litigation attorney mandated to assist with the enforcement or cancellation of the transaction, or with a claim for damages, or any action or application proceedings related to the transaction, solely for the purposes of this transaction.

In addition to compliance with POPI, Waldick Inc will store the Company’s personal information in accordance with the requirements specified by the Legal Practice Council from time to time.

Sign Above
please sign
Please complete the field
Have a Question ?
Waldick Inc. Attorneys