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J401REPUBLIC OF SOUTH AFRICATRUST REGISTRATION & AMENDMENTS FORM (Inter-Vivos)Application Form Selections:Trust RegistrationComplete All SectionsBond of Security AmendmentsComplete Sections 1.1, 1.3, 8, 9Trustee AmendmentsComplete Sections 1.1, 1.3, 6, 9General Trust AmendmentsComplete Sections 1.1, 1.2*, 1.3, 3*, 4*, 5*, 9Auditor AmendmentsComplete Sections 1.1, 1.3, 7, 9Trust CopiesComplete Sections 1.1, 1.3, 9Other* A separate application form must be submitted for each amendment type* If applicableSECTION 1: SUMMARY DETAILS1.1 TRUST NAME & FILE NUMBERTrust NameTrust File Number *1.2 TRUST GENERAL DETAILSAsset LocationProbable Trust DurationSource of FundsRoad Accident Fund (RAF)Is Annual Audit Required?YesNoNo. of Trustees (Persons)(to be captured for this application)No. of Beneficiaries (RAF)ClassUnknownNo. of Trustees (Organization)(to be captured for this application)No. of Mentally Incapacitated/ Minor Beneficiaries (RAF)Minimum No. of Trustees Allowed(on the trust)Maximum No. of Trustees Allowed(on the trust)Is this a Court Order Application?YesOtherNo.NoCourt NameCase No.FOR OFFICE USE ONLYReceived By:Signature:Stamp:Page 1 of 7
J4011.3 APPLICANT/AGENT DETAILSOrganisation Details (If Applicant is an Organisation)Organisation NameRegistration NumberDetails of Contact Person/Organisation RepresentativeSurnameTitleFirst NamesNationalityID No/ORPassport NoPreferred Method of CommunicationPreferred Method of CollectionMasters Office BoxE-mailCollect By HandMasters Office BoxPostPostCollect By HandContact DetailsMasters Office Box NoTel NoCell NoFax NoE-mailPostal AddressAddress Line 1Address Line 2ProvinceCity/TownPostal CodeCity/TownPostal CodePhysical AddressMark here with an "X" if address is the same as above or capture your Physical AddressAddress Line 1Address Line 2ProvinceApplicant's other roles on the TrustIs Applicant a Trustee?YesNoIs Applicant the Main Contact for future Trust communication?YesNoIs Applicant an Auditor/ Accountant of this Trust?YesNoIs Applicant the Founder?YesNoPage 2 of 7
J401SECTION 2: SUPPORTING DOCUMENTS (APPLICABLE FOR TRUST REGISTRATION)DocumentsSubmittedNumber of Submitted DocumentsApplication Form (Mandatory)YesNoOriginal or Certified Trust Deed (Mandatory)YesNoProof of Payment (Mandatory)YesNoAcceptance of Trusteeship (Mandatory)YesNoTrustee(s) Identification - Certified Copies of ID/Passport/Organisation Proof Of Registration (CK1) (Mandatory)YesNoTrustee(s) Representative Identification - Certified Copies of ID/Passport (Mandatory for Organisation Trustee(s))YesNoBeneficiaries Declaration Form (Mandatory)YesNoBeneficiaries Identification - Certified Copies of ID/Birth Certificate/Passport/Organisation (CK1) (Mandatory for RAF)YesNoBeneficiaries Guardian Identification - Certified Copies of ID/Passport (Mandatory for RAF)YesNoBond of Security/Proof of Exemption (If Applicable/ Mandatory for RAF)YesNoUndertaking by an Auditor/Accountant (If Applicable/Mandatory for RAF)YesNoFinal Certified Court Order (If oYesNoYesNoYesNoYesNoYesNoYesNoYesNoYesNoYesNoRAF – Road Accident FundPage 3 of 7
J401SECTION 3: MAIN CONTACT DETAILSOrganisation Details (If Applicant is an Organisation)Organisation NameRegistration NumberDetails of Contact Person/Organisation RepresentativeSurnameTitleFirst NamesNationalityID No/ORPassport NoPreferred Method of CommunicationPreferred Method of CollectionMasters Office BoxE-mailCollect By HandMasters Office BoxPostPostCollect By HandContact DetailsMasters Office Box NoTel NoCell NoFax NoE-mailPostal AddressAddress Line 1Address Line 2ProvinceCity/TownPostal CodeCity/TownPostal CodePhysical AddressMark here with an "X" if address same as above or capture your Physical AddressAddress Line 1Address Line 2ProvinceMain Contact’s other capacities on the TrustIs Main Contact a Trustee?YesNoIs Main Contact an Auditor of this Trust?YesNoIs Applicant the Founder?YesNoSECTION 4: BANK DETAILSBank NameBranch NameBranch CodeAccount NumberPage 4 of 7
J401SECTION 5: FOUNDERS DETAILSFOUNDER 1Organisation Details (If Founder is an Organisation)Organisation NameRegistration NumberDetails of Founder/Organisation RepresentativeSurnameTitleFirst NamesID No/ORNationalityPassport NoIs Founder a Trustee?YesNoFOUNDER 2Organisation Details (If Founder is an Organisation)Organisation NameRegistration NumberDetails of Founder/Organisation RepresentativeSurnameTitleFirst NamesID No/ORNationalityPassport NoIs Founder a Trustee?YesNoFOUNDER 3Organisation Details (If Founder is an Organisation)Organisation NameRegistration NumberDetails of Founder/Organisation RepresentativeSurnameTitleFirst NamesID NoNationality/ORPassport NoIs Founder a Trustee?YesNoPage 5 of 7
J401SECTION 6:TRUSTEES SUMMARYNo.Trustee Type(*)Indi / OrgTrustee Full Name /Organisation NameID/ Passport/ RegistrationNoRepresentative Full NameRepresentative ID/ e Types: Organisation/IndividualNames must be written as on the ID / PassportPlease insert Acceptance of Trusteeship Forms below this pagePage 6 of 7
J401SECTION 7: AUDITOR’S DETAILSOrganisation Details (If Auditor is an Organisation)Organisation NameRegistration NumberDetails of Auditor/Organisation RepresentativeSurnameTitleFirst NamesNationalityID No/ORPassport NoAuditor’s Accreditation DetailsIRBASAIPACIMAAccreditation No.SAICAACCAOtherIf Other, SpecifySECTION 8: BOND OF SECURITY (MANDATORY FOR RAF/ IF APPLICABLE)Is Bond Security Required?YesNoSecurity Amount:If Bond Of Security is notrequired, provide reason forexemptionRProvide Reason, IfSecurity Amount is Lessthan Initial Value ofAsset:Financial InstitutionPolicy / Reference NumberInitial Value Of AssetsR(Only applicable for Registration)SECTION 9: DECLARATIONI, the undersigned, confirm that the information provided above is accurate and will inform the Master of any changes that take place pertaining to the information provided above.Date:/(CCYY//MM/Signature:DD)Page 7 of 7
No. Trustee Type(*) Indi / Org Trustee Full Name /Organisation Name ID/ Passport/ Registration No Representative Full Name Representative ID/ Passport . 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. Trustee Types: Organisation/Individual Names must be written as on the ID / Passport . Please insert Acceptance of Trusteeship Forms below this pageFile Size: 660KBPage Count: 7
