SECTION A: INVESTOR DETAILS (To be completed by the investor.)

Title	First name(s) and surname
South African identity or foreign passport no	Country in which passport was issued
Tax reference no (if applicable)	Country of tax registration

PRODUCT TO BE TRANSFERRED FROM

Product provider name	Tax-free savings account name
No of tax-free savings account from which funds will be transferred
Contact person at transferring product provider	Email
Tel no	Transfer type:	Partial transfer	Full transfer	Estimated value of transfer	R

Note

Please ensure that all of the transferring product provider’s requirements are met when submitting the Tax-free Savings Account

Transfer Request Form to the provider. If these requirements are not met, the transfer process cannot take place.

INVESTOR DECLARATION

I hereby request that the abovementioned tax-free savings account funds be transferred to the product provider and account detailed in Section B.

I confirm that all the information provided above is true and correct.

Signature of investor	Date

SECTION B: TRANSFER TO (To be completed by the receiving product provider.)

Product provider name	Nedbank Ltd	Company registration no	1951/000009/06
Tax reference no	9250083715	Tax-free savings account name	Nedbank Tax-free Savings Account
Tax-free savings account no (if applicable)	Contact person	Nedbank Contact Centre
Tel no	0800 555 111
Email address for receipt of tax-free savings account transfer certificate	tfstransfers@nedbank.co.za

BANKING DETAILS OF RECEIVING PRODUCT PROVIDER (if applicable)

Bank	Nedbank	Account no	1230802711
Branch code	198765	Name of account	Tax-free Savings Account
Reference	Client ID number/Passport number

ON BEHALF OF RECEIVING PRODUCT PROVIDER

We will accept the above tax-free savings account transfer and confirm that:

the above transfer request will be processed according to the regulations published in terms of section 12T(8) of the Income Tax Act; and

the account into which the funds will be transferred is a tax-free savings account as defined in section 12T of the Income Tax Act.