bdtfulldisclosurefullpack2014

I

ID Number:

Hereby acknowledge that I/We have been presented with the following documentation by Bradley Trevethan:

1. Disclosure Document

2. Client Consent

3. Risk Analyser

a. Agree

b. Disagree i. Risk Profile Result

If Disagree: Notes

4. Service Contract

a. Acknowledge and refer to:

i. Point 3:

ii. Annexure A:

iii. Annexure B:

iv. Annexure C: c: d:

5. Acceptance of Quote: Date: Ref no:

6. Record of Advice:

5.1

5.2

Client Signature: Date: Place:

Broker Signature: Date: Place:

Bradley David Trevethan

Full name and Surname

FULL RECEIPT OF DOCUMENTATION

Client

BRADLEY DAVID TREVETHAN Independent Assurance Broker B.Sc (Civil Eng.) H.D.E

In strategic association with the following Authorised Financial Service Providers:

Tel: 031 767 8000 [email protected] www.kayserbaird.co.za

10 Abrey Road Kloof 3610

& HEALTH GROUP

PO Box 50236 Musgrave Road 4062

Switchboard: 031 767 8000 Fax: 031 767 8040 Cell: 082 903 3623

FSP Licence No. 41529 Member of the Financial Planning Institute. Membership No: 200200787 VAT No. 4880182870

Kayser Baird FSP Licence No: 8257 Health Group FSP Licence No: 33932

The purpose of this letter is to introduce myself to you and to make the necessary statutory disclosures as required by the Financial Advisory and Intermediary Services Act, “FAIS” (Act No. 37 of 2002).

My name is Bradley David Trevethan and I have in total 13 years experience in the financial services industry and have achieved the following formal qualification: BSc and HDE. I am a Representative of Bradley David Trevethan.

Business Details Name of FSP: Bradley David Trevethan Trading As: Bradley David Trevethan

FSP License number: 41529 Physical Address: 10 Abrey Road Kloof, 3610 Postal Address: PO Box 50236, Musgrave Road, 4062 Telephone: 031 767 8000 Facsimile: 031 767 8040 Email: [email protected]

Website: www.kayserbaird.co.za

Bradley David Trevethan holds a category I FSP license and I am authorised to provide financial services in the form of advice (denoted with an “A”) and/or intermediary services (denoted with an “IS”) in respect of financial products falling within the following license categories:

1.03 A & IS Long-‐Term Insurance : Category A 1.16 A & IS Health Services

1.04 A & IS Long-‐Term Insurance : Category B 1.14 A & IS Participatory interests in

1.05 A & IS Retail Pension Benefits Collective Investment

1.07 A & IS Pension Funds Benefits (excluding retail) Schemes

1.14 A & IS Long-‐Term Insurance: Category C

As a representative of the brokerage I have access to and have been accredited to market products falling into the above categories from the following product providers:

1 Disc Discovery 6 Inv Investec 2 Allan Gray 7 Momen Mometum 3 S Stal Stanlib 8 Glacier Glacier /Sanlam 4 Libert Liberty Life 9 Altr A Altrisk 5 L Liberty Health

I do not own more than 10% of issued shares directly or indirectly of any Life Assurer or Product Provider. I am not an associated company of any life assurer or product provider.

DISCLOSURE DOCUMENT





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I have earned more than 30% of my total commissions from Liberty and Stanlib within the past 12 months.

I earn my income from commission that the product provider pays over to me on the products purchased by my clients. I do not receive any non-‐cash incentives from my product supplier nor do I have any personal interest that may give rise to a conflict of interest The Key Individual(s) accepts responsibility for the representative’s actions. If you feel that your rights have been prejudiced, or you have been aggrieved in any way, you have the right to lodge a complaint. A copy of the complaints process is available upon request at the offices of Bradley David Trevethan. Should your complaint not be handled to your satisfaction, you may forward the matter to the Office of the Ombud for Financial Services Providers. Standard procedure at the offices of the Ombud requires you to provide evidence of your attempt to resolve the matter directly with Bradley David Trevethan. Ombud for Financial Service Providers : Name : Ms Noluntu Bam Address: PO Box 74571, Lynnwood Ridge, 0040 Fax : (012) 348 3447 TOLL FREE 0860 324 766 Email: [email protected] Moonstone Compliance (Pty) Ltd is the FSP’s compliance practice on record and is represented by: Carrie-‐Lee Wollf. Moonstone Compliance (Pty) Ltd Head office can be contacted at: Valerida Centre, Piet Retief Street, 1st Floor, Stellenbosch, 7600. Fax: (021) 883 8005; Tel: (021) 883 8000; www.moonstoneinfo.co.za. The business holds professional indemnity and Fidelity cover with Snyman Van der Vyver underwritten by Santam. All information obtained or acquired from you shall remain confidential unless you provide written consent, or unless Bradley David Trevethan is required by law to disclose such information. As an authorised Financial Services Provider I/we may not request or induce in any manner a client to waive any right or benefit conferred on the client by or in terms of any provision of the General Code of Conduct, or recognise, accept or act on any such waiver by the client. See the quotation or annexure for information on product suppliers; name, physical and postal address, telephone number, name and contact details of their compliance department.





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Full Names of Client: ID number : Personal capacity Yes No Representing: (Owner/Life assured/Company) I acknowledge the following:

1. Appropriate financial advice can only be furnished after a full and proper disclosure of relevant personal and private information about the client;

2. Such information is furthermore required to:

i. Determine my financial situation, financial product experience and financial needs and objectives;

ii. Acquire, maintain and service any financial product or to render related intermediary services.

3. Such information may include any information relating to, or interest in:

i. Long-‐term insurance; ii. Collective investments schemes; iii. Pension funds; iv. Any other financial product or service.

4. My/our interests will be best served for stated purposes if any and all such information is provided by:

i. The financial Services Exchange (PTY) LTD, trading as Astute, or any other institution providing a mechanism for the transmission of such information, or

ii. Any other authorized financial service provider. I/we hereby give consent to the Financial Service Provider and / or his / her / its authorised user(s) below to obtain such information through Astute” Financial Service Provider: BRADLEY DAVID TREVETHAN | FSP license number: 41529 Authorised user: BRADLEY DAVID TREVETHAN I/we confirm that the Financial Service Provider and / or his / her / its authorised user(s) will be acting on my/our behalf and I/we hereby waive and right to privacy only for the stated purpose. All information so obtained must be treated as confidential by the Financial Service Provider and / or his / her / its authorised user(s) and may not be made public in any way without my/our written consent. This consent to obtain information will remain effective until cancelled by me/us in writing. Signed at ___________________________ this _______________day of _______________________ 20 ______

_____________________________________________ Signature of client

CLIENT CONSENT TO OBTAIN INFORMATION





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TO WHOM IT MAY CONCERN: We are committed to transparency and confidentiality relating to your personal and private information. We are required to obtain your relevant personal information in order to:

• Furnish the appropriate financial advice • Determine your financial situation, financial product exposure and your financial needs and objectives • Acquire, maintain and service any of your financial products if required • Render appropriate intermediary and financial services

For these purposes, your personal information is collected and processed:

• Internally by our employees or representatives.

APPOINTMENT OF SERVICING INTERMEDIARY

1. Authorisation to request information: I, (Full Name) ID number: (SA Identity Number) Telephone number: (Best contact Number) Hereby authorize Bradley David Trevethan or any member of his staff, to obtain any information on my behalf regarding my insurance and investment portfolio, and any of my employee benefits, from any Life Office, Retirement Fund or other Financial Institution. I hereby give consent to any Financial Institution or employer in possession of information regarding my insurance, investment and employee benefits portfolio, to release that information upon request, to the person who is, in terms of this document, entitled to request it. It was explained to me and I understand that this consent may possibly have a restricting influence on my constitutional right to privacy. This authorization shall remain valid for 3 months from the date of my signature or until my cancellation thereof in writing: Client signature: Date:





& HEALTH GROUP





2. Appointment of Service Intermediary: I, ID number: Request the Financial Institutions with whom Bradley David Trevethan has a sales agreement, to indicate him on their records, as my official Care Intermediary. I have been properly counseled on the consequences of this letter of appointment. I appoint the advisor above for all my products with: I appoint the advisor above for the FOLLOWING CONTRACTS ONLY: Please ensure that all Trail Fees and Service Fees follow this appointment with immediate effect Percentage amount This appointment may be revoked by me in writing at any time. Client Signature: Date:

Intermediary Information: Name: Bradley David Trevethan – FSP Number: 41529 Code: Tel: 031 767 8000 | Fax: 031 767 8040| Email: [email protected]

NB: Any changes to this document must be initialed by the client.





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Entered into by and between:

Full name of Client Identity number / registration no

(Hereinafter referred to as the Client)

AND

BRADLEY DAVID TREVETHAN 7009035016082

FSP license number: 41529

(Hereinafter referred to as the FSP)

WHEREAS the Client requires from the FSP to provide financial services in regard to the service categories indicated

in Annexure A; and

WHEREAS the FSP holds contracts with the product providers listed in Annexure B and is authorized according to

his license to provide financial services with respect to the product categories listed in Annexure B,

NOW THEREFORE THE PARTIES AGREE AS FOLLOWS:

1. Consent to obtain information

The Client hereby consents to the FSP obtaining information from all relevant product providers in order to

enable the FSP to comply with the provisions of this contract, with specific reference to the requirement of

a proper needs analysis.

2. Nature and extent of financial services to be provided

The FSP is hereby mandated to-‐

a. establish and recommend to the client the most appropriate financial product within the range of service

categories indicated in Annexure A and within the context of the contracts and authority held by the FSP as

referred to in Annexure B;

b. assist the client with applications to the product provider for the financial product chosen by the client,

subject to the condition that-‐

SERVICE CONTRACT BETWEEN CLIENT AND FSP





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i. accuracy, completeness of all answers, statements and other information provided

by or on behalf of the client, is the client’s responsibility;

ii. if the FSP completes and/ or submits an application form on behalf of the client, the

client must be satisfied as to the accuracy and completeness of the details;

iii. the client takes note of the possible consequences of misrepresentation or non-‐

disclosure of a material fact or the inclusion of incorrect information.

c. communicate with the product provider on behalf of the client and assist the client to effect any changes

on the product held by the client;

d. relay any communication from the product provider to the client and assist the client to respond to the

product provider;

e. cancel the contract between the client and the product provider on behalf of the client;

f. review the appropriateness of the product for the client on an annual basis.

3. Receipt of premiums and other funds from the Client (please initial the relevant spaces)

The FSP receives no premiums or funds from the Client………………………………...

4. Duties of the Client

a. The client shall make such information available as would allow the FSP to analyze the needs and

objectives, financial situation and risk profile of the client for the purpose of establishing the most

appropriate product for the client within the ambit referred to in clause 2(a).

b. The client shall notify the FSP of any material changes in the Client’s financial situation, needs and

objectives, and risk profile, work-‐ or business situation within a reasonable time after the occurrence of the

change, but no later than within 30 days of the change.

c. The client shall have no claim against the FSP for any damage, financial or otherwise, caused by the fact

that the client did not submit, or submitted belatedly, material changes referred to in paragraph (b) above,

to the FSP.

d. The client shall ensure that any request from the FSP for information required in terms of the Financial

Intelligence Centre Act, shall be complied with promptly.

e. The client shall have no claim against the FSP for any damage, financial or otherwise, caused by the client’s

late submission of information referred above, specifically with reference to a delay in the application for





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the product referred to in clause 2(a).

f. The Client hereby confirms that the product recommended by the FSP as contemplated in clause 2(a) will

not be used as a vehicle to launder money, or for the purpose of funding terrorist or terrorist related

activities.

5. Cancellation of the contract

a. This contract may be terminated by either party within 30 calendar day’s written notice to the other party.

b. The FSP shall notify all providers of the product/s referred to in clause 2(a) and with whom the Client is

contracted that the service contract with the Client has been terminated and that all future

communications should be addressed directly to the Client.

c. Such funds or documentation that is held by the FSP on behalf of the client shall be returned to the Client

immediately after cancellation of the contract.

6. Fees

The fee payable to the FSP by the client is indicated in the attached Annexure C.

7. Payment of any account for services rendered by the FSP must be dealt with as follows by the Client (please

tick in the appropriate box)

Settlement within 30 days of delivery of the account……………………………………...

8. Confidentiality of information

a. The FSP undertakes that all information provided by the Client will be kept confidential and will only be

disclosed to third parties with the written consent of the Client, with the following exceptions:

• Client files and information contained therein, is subject to review / monitoring functions of the

Compliance Officer of the FSP;

• Client information may be shared for research – and marketing purposes with other financial

service groups or parties with whom the FSP associates;

• The FSP is obliged to disclose any information if so required by law or in terms of an order of court.





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Annexure A

• Long Term Insurance

i. Risk cover

ii. Investments

• Short Term Insurance

i. Motor car

ii. Household contents

• Retirement planning (before retirement)

• Retirement planning (after retirement)

• Investments in collective investment schemes

• Cover for health care:

• Other: ___________________________________________________

Annexure B

Contracts held by the FSP:

1. Discovery

2. Allan Gray

3. Stanlib

4. Liberty Life

5. Liberty Health

6. Investec

7. Momentum

8. Glacier/Sanlam

9. Altrisk





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Authority held by the FSP:

CATEGORY I

• Long-‐Term Insurance: Category A

• Long-‐Term Insurance: Category B

• Long-‐Term Insurance: Category C

• Retail Pension Benefits

• Pension Funds Benefits (excluding retail)

• Participatory interests in Collective Investment Schemes

• Health Service Benefits

Annexure C

The fee payable by the client comprises the following (please initial the appropriate box):

a. An hourly rate calculated at R ……..……… per hour

b. A fixed amount of R …………………………….....

c. Commission only based on the services rendered in respect of the financial product/s as

disclosed in the provided quotation …………………………………………………………………

d. An ongoing advice -‐ / management fee calculated at ……..% of the nett asset value / portfolio

value and payable monthly / quarterly, which fee will be disclosed to the client on a

quarterly/annual basis.

Important note: The amount of commission payable to the FSP is disclosed in the quotation or contract document as sent to the client.

RISK ANALYSER

What does the Risk Analyser do? The aim of this Risk Analyser is to help the financial adviser and client to determine which risk profile the client may be categorised under. Whilst every attempt has been made to ensure the accuracy of the information contained herein, Liberty cannot be held responsible for any errors that may occur or for any damages suffered as a result of such errors.

Please answer the following questions: 1. My current age is: a. Under 31 b. 31 to 40 e. Over 60 c. 41 to 50 d. 51 to 60

2. The current value of my savings/capital (including equity in property, share, RA’s. provident funds etc.) is equal to: a. Less than half my current (or last earned) annual income b. Half of my annual income (salary), pension, interest, etc. c. The amount of my gross income in one year d. Double my current (or last earned) annual income e. Three times my current (or last earned) annual income f. Five times my current (or last earned) annual income

3. Within the next few years I expect my income to: a. Decline in real terms b. Stay about the same (gains equal to inflation) c. Increase gradually (slightly faster than inflation) d. Increase dramatically (much faster than inflation) e. Fluctuate and be unpredictable (Select this option if you only have investment income)

4. Based on my lifestyle and medical history, I expect my risk of serious health problems over the next 10 years to be: a. Above average b. Average c. Low d. Almost nil

5. Regarding dependants (minor or adult) and other major costs that I need to incur before retirement: a. I will be able to meet all expenses for dependants (including education) and other costs out of my income. b. I will have to withdraw a small portion of my savings to pay for dependants and other costs. c. I will have to withdraw more than half of my savings to pay for dependants and other costs. d. I expect that paying for dependants and other costs will leave me with very little savings when I retire. e. I don’t have dependants or major costs to worry about.

6. My investment experience is best described as follows: a. I have never invested in equities, either directly or through unit trusts and do not understand these things. b. I’ve invested a small amount of money in equities or unit trusts and/or I know what these things are. c. I’ve invested a fair amount of money in equities or unit trusts and/or have a good understanding of equities. d. I’ve invested in commodities, options and international shares and/or am very knowledgeable about investment e. I have a company retirement plan and/or other investments, but I’m not sure exactly where I’m invested and/or I don’t fully

understand the different asset classes.

7. I plan to start withdrawing money from my savings in: a. Less than five years b. Five to ten years c. Eleven to fifteen years d. More than fifteen years e. I am already using my savings

8. How do/would you react to fluctuations in the market? a. I am (or would be) very concerned if my investments lose value and am (or would be) inclined to sell immediately. b. If an investment loses 5% over a quarter, I am (or would be) likely to sell and invest elsewhere. c. I wait (or would wait) until I have watched the performance of an investment for at least a year before making changes. d. Even if poor market conditions result in significant losses over several years, I will try and stick to a consistent long-term investment

plan.

9. You invest R100 000 for ten years. Given the best and worst case scenario below, which investment option would you choose? (NB: Not that the best and worst case scenario are equally profitable.)

a. Best case outcome:R500 000 - Worst case outcome: R50 000 b. Best case outcome: R850 000 - Worst case outcome: R20 000 c. Best case outcome:R300 000 - Worst case outcome: R65 000 d. Best case outcome: R150 000 - Worst case outcome: R100 000

10. When I buy car insurance I: a. Choose the lowest excess to ensure maximum cover even though my contract costs more. b. Choose a moderate level of excess in order to reduce the contribution. c. Choose a high excess in order to pay a low premium even though losses may not be covered. d. Choose to carry no insurance.


In strategic association with the folloiwng Authorised Financial Service Providers:



& HEALTH GROUP

Scoring of Questions

Please give yourself the following scores depending on the answers you gave, and then add up your scores

Question a b c d e f Your score

Total Score

1. 15

12 9 1

0 - 2. 0 1 4 8 10 12 3. 0 1 4 10 0 - 4. 0 2 5 10 - - 5. 9 6 3 0 9 - 6. 0 1 5 8 0 - 7. 1 2 8 13 0 - 8. 0 1 4 8 - - 9. 6 10 2 0 - -

10. 0 1 3 5 - -

Investment Portfolio guide

Depending on your score obtained above, your propensity for risk falls into one of the following categories:

Score Risk Profile NOTE

0 - 25 Conservative Conservative Investors are investors who want stability and are more concerned with protecting their current investments than increasing the real value of their investments

You have been made aware that due to the restrictions imposed by Regulation 28 of the Pension Funds Act, you are unable to select certain portfolio combinations. As a result, you acknowledge that, although the portfolios chosen are not in line with your risk profile, they comply with Regulation 28 requirements.

26 - 45 Moderately Conservative Moderately Conservative investors are investors who want to protect their capital and achieve some real increase in the value of their investment

46 - 65 Moderate Moderate Investors are long-term investors who want reasonable but relatively stable growth. Some fluctuations are tolerable, but investors want less risk than that attributable to a fully equity based investment

66 - 85 Moderately Aggressive Moderately Aggressive investors are long-term investors who want real growth on their capital. A fair amount of risk is acceptable.

86 - 100 Aggressive Aggressive Investors are long-term investors who want high capital growth. Substantial year-to-year fluctuations in value are acceptable in exchange for a potentially high long-term return.





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(Full needs analysis was not conducted)

Section 1: Client Details

Full name of Client Identity number

Date of birth: Male: Female: Postal Address Physical Address: Code: Code:

Telephone number Work:

Fax number/Fax to email:

Telephone number Home:

Cell phone number:

Email address:

Section 2: Advisor Details Please see attached disclosure about the Financial Services Provider Section 3: Reason for the fact that there is no need analysis in place (tick the appropriate box) The client did not wish to give all the necessary information that would enable me to do a complete Financial needs

analysis. Detail:

I did not have sufficient time due to circumstances beyond my control. Reason:

Section 4: Advice Record Summary of the information and material on which advice was based. Client’s financial situation, needs and objectives (e.g. Long-‐term or short-‐ term investment needs):

Actions considered: Description of Action Product Type and Provider Comment

RECORD OF ADVICE / NEW BUSINESS





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Actions recommended and reasons: Description of Action Product Type and Provider Reason for Recommendation Section 5: Declaration by the client 5.1 I hereby declare that I am aware of the fact that: A full analysis could not be undertaken and that there may thus be limitations on the appropriateness of the advice and; That I must carefully consider whether the advice on its own is appropriate considering my objectives, financial situation

and needs; To prevent the risk of concluding a transaction that is not appropriate to my needs, objectives and circumstances, I should

obtain a full Financial Needs Analysis 5.2 Either A or B A: I, the client, hereby declare that I accept the advice provided to me as set out above, and that: The advisor provided me with his practice details The advisor discussed the quote/s, attached to this document and signed by myself, with me in detail The advisor discussed the replacement policy advice record /replacement disclosure document with me in details (please

scrap if not relevant) I did not sign the application form while any part of it was not completed yet I am aware of the fact that I take full responsibility for all the information provided in the application form, whether

provided by myself or on my behalf B: I, the client, hereby declare that I DO NOT accept the advice provided to me as set out above, and that: I CONFIRM having been duly and properly advised of the full implications of my actions and, having considered same, I

fully understand the course of action that I am about to undertake. I declare that I am aware of the fact that I must carefully consider whether the product selected is appropriate considering

my objectives, circumstances and needs.

Advisor Client Name & Date ……../……/………… Advisor Signature

Section 6: Declaration by the advisor 6.1. I declare that the advice record is an accurate and complete record of the recommendations and advice that I gave the client. 6.2. The advice that I provided is subject to Setion 8 (4) of the General Code of Conduct

Ad Advisor Name & Date ……../……/………… Advisor Signature

BR B BRADLEY DAVID TREVETHAN





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Requested servicing changes:

Record of Advice:

Portfolio changes:

FAIS RECORD OF ADVICE FOR SERVICING CHANGES / EXISTING BUSINESS

Policy No: Owner/Client:

I confirm I confirm that the above information is a correct indication of the above advice provided in respect of the servicing servicing changes is appropriate to my needs and concerns.

Signed at Signed at ____________________ on this_______________ day of _________________ 20___________

_____ _____________________ _________________________________ S Signature of Owner/Client Signature of Financial Advisor

Bradley David Trevethan

bdtfulldisclosurefullpack2014

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bradley david trevethanfull

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