Individual Mandate Form copy

Mandate Form | Individual
Please complete this form using block letters and tick where appropriate.
Tick (√)
Official Use Only
Local
Client Code
Foreign
Date Received
Account Name:
Contact Person:
First Name(s):
Surname:
Title Dr Mr Mrs Ms etc:
Identification Number:
Residential Address:
Postal Address:
Telephone Number(s):
Facsimile Number(s):
Email Address:
Indicate your normal source of income:
Bank Details
Bank Name:
Branch:
Bank Account Number:
Type of Account Current/Savings:
SETTLEMENT INSTRUCTIONS (TICK ONE)
Yes
No
Settlement seven days from real date:
Settlement on delivery of scrip:
Any other instructions:
1
Old Mutual Securities
Individual Mandate Form
Payment Instructions
Old Mutual Securities is authorised to make
cheques or RTGS transfers payable to:
Yes
Withholding Tax
No
Tick Appropriate Box
Reinvest at Best
On Maturity
Contact Client
Tick Appropriate Box
Do You have any investment Accounts with Old Mutual?
Yes
No
If yes specify:
Client’s Signature:
I hereby declare that the above information provided by me to Old Mutual Securities is true, accurate and complete
STANDARD TERMS AND CONDITIONS - SHARE ACCOUNT
I,
acting on my own behalf / on behalf of
by whom I am duly authorised :
1. Declare that the definitions and interpretation guides set out herein shall apply to this mandate : “Client” means the person or party making this
application and includes the person or party who requires monies to be invested on its behalf by Old Mutual Securities (Private) Limited. “OMSEC”
means Old Mutual Securities (Private) Limited, a company incorporated according to the laws of Zimbabwe and includes all and any nominee company
utilized by Old Mutual Securities (Private) Limited. Words importing the singular include the plural and vice versa; Words importing gender include every
gender; An expression importing a natural person includes a company, partnership, joint venture, association, corporation or other body corporate;
References to parts, clauses and parties are references to parts and clauses of and parties to this mandate; A reference to a party to this mandate or
to any other document includes that party’s successors and permitted assigns;
2. Declare that I am duly authorized to act for and on behalf of the client in all respects and that OMSEC shall not be obliged to conduct any inquiries to
ascertain my authority;
3. Declare that the information provided in the application form is true and correct and that all the documentation provided in support of such application
is genuine;
4. Declare and agree that these terms and conditions shall apply to all and any funds placed with OMSEC, whether in the past, or currently held by OMSEC
or funds that may hereafter be placed with OMSEC.
5. Acknowledge that OMSEC shall act as agent for the Client at all times and shall manage and invest all and any funds placed with them for and on behalf
of the Client and accordingly any appreciation or depreciation resulting from such investment shall be for the account of the Client.
6. Instruct OMSEC, in their absolute discretion but subject always to the Client’s Special instructions herein and the Client’s Special Instructions in writing
from time to time, to invest all and any monies placed with them by the Client, as far as they are able, to the best advantage of the Client;
7. Authorize OMSEC to deduct such fees and/or commissions that may be due to them form time to time from the monies invested by the Client or any
other monies that they may hold that are due to the Client and to account to the Client on a monthly basis or such other longer intervals as may
be convenient;
8. Acknowledge that I have been advised of and agree to the payment of fees calculate on the basis of: In respect of dealings in shares, such fee /
commission as may be prescribed from time to time by the Zimbabwe Stock Exchange; Provided that OMSEC may at any time hereafter vary or alter
these fees by notice in writing to the Client
9. Acknowledge that all fees and/or commissions shall become due and payable within 7 (seven) days of the date of invoice and that a failure to settle any
account on due date shall result in the amount outstanding attracting interest at the rate charged by OMSEC ‘s principal bankers in relation to
unauthorized bank overdrafts; PROVIDED THAT nothing contained herein shall derogate or deemed to derogate from the rights of OMSEC in terms of
the common law or statute.
10. Authorize OMSEC to deduct all and any taxes and/or levies that may be due to the Government of Zimbabwe arising from the monies placed with them
from any monies that may be held by them on behalf of the Client and pay over the same to the Government of Zimbabwe;
11. Acknowledge having been advised that OMSEC will under no circumstances issue cash or open cheques to the Client;
12. Agree that the Client will only be credited with the value of monies when OMSEC actually receives the monies placed.
13. Agree that in placing funds with OMSEC, the Client shall make all cheques payable to its nominee company / companies;
14. Declare that no variation of this mandate, including the addition of any Special Instruction, shall be of any force or effect unless reduced to writing and
signed by both parties; and
15. For the purposes of this mandate, OMSEC are provided with the following Special Instructions
DATED AT
THIS DAY OF
20
FOR AND ON BEHALF OF THE CLIENT
DATED AT
THIS DAY OF
20
FOR AND ON BEHALF OF THE OMSEC
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Old Mutual Securities
Individual Mandate Form