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Old Mutual Third Party Affidavit PDF

This document is a third party affidavit used to verify a residential address for FICA purposes. It contains the following key points: 1. The deponent affirms their identity and confirms the information in the affidavit is true. 2. The deponent provides their residential address and confirms the prospective client resides at this address. 3. The deponent states their relationship to the client and reason for the client residing at the given address. 4. The deponent attaches an acceptable FICA document showing their name and the address to verify the association.

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289 views1 page

Old Mutual Third Party Affidavit PDF

This document is a third party affidavit used to verify a residential address for FICA purposes. It contains the following key points: 1. The deponent affirms their identity and confirms the information in the affidavit is true. 2. The deponent provides their residential address and confirms the prospective client resides at this address. 3. The deponent states their relationship to the client and reason for the client residing at the given address. 4. The deponent attaches an acceptable FICA document showing their name and the address to verify the association.

Uploaded by

Yla Penida
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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FICA:

THIRD PARTY AFFIDAVIT IN


VERIFICATION OF
RESIDENTIAL ADDRESS
Please print in block letters using black or blue ink.

I, (insert full name and surname of deponent)

with identity number , do hereby make oath and state that:

1. I am an adult male/female* and confirm that the information contained in this affidavit is true and correct.

2. I reside at/own* the property located at (insert physical address).

3. I confirm that (insert name of prospective client)


resides /carries on business* at the abovementioned physical address due to

(state the relationship or reason(s) for the client residing/carrying on business at the given address).

4. In verification of my association to the aforementioned address, I attached herewith a copy of (insert


name) of prescribed and acceptable FICA verification document) which reflects my name and the said address.

Signature of deponent

I certify that the deponent acknowledged to me that he/she* knows and understands the content of this declaration, and took the oath in the manner prescribed
by regulation.

Thus signed and sworn to before me at on this day of 20

Signature of Commissioner of Oaths

COMMISSIONER OF
OATHS STAMP

* Delete where applicable

Old Mutual is a Licensed Financial Services Provider

1
Old Mutual South Africa Limited AML FICA: 3rd Party Affidavit in Verification of Address omms 11.2015 L7864

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