Application Forms Accfin Account Application Type of Account * Other Individual/Sole Proprietor Company/Close Corporation Trust Will you make use of any of the following FVLN services? Tax Services * Yes No If you are a Company/CC/Trust please tick both Provisional & Tax Return Client Services as "yes". If you are an Individual client, and not registered for Provisional tax, please only tick the "Yes" for Tax Return and "No" for Provisional Tax. Who is a Provisional Tax Payer? Provisional Tax Client * Yes No Tax Return Client * Yes No Secretarial Services * Yes No Company/CC Details Registered Name (If applicable) Trust Details Trading Name (If applicable) Reg No CC / PTY Trust Reg No Date of Incorporation Company/CC/Trust Representative Individual/Sole Proprietor Details Surname Full Names ID Number Title Other Mr Mrs Dr Ds Ms Trading Name (If applicable) Postal Address PO Box Area Town/City Province Code Residential Address Residential Address Street Name Area Town/City Province Code Business Address Building Name Street Area Town/City Province Code Principal Business Activities Telephone No (H) Fax No Telephone No (W) Cell No Email Auditor Appointment Date Are you registered for Provisional Tax? Yes No Income Tax No Receiver Office Income Tax Registration No PAYE No Are you registered for SDL? (Skills Development Levy) Choose an option Yes No SDL No (Auto Populated) UIF No VAT No Financial Year End Relevant Partner at FVLN J Coetser P Coetser A Nothnagel J De Lange G Venter E Venter C Gouws In-House Bank Details Bank Name Other Absa Bank Ltd African Bank Ltd Albaraka Bank Limited BoE Private Clients Bidvest Bank Limited Capitec Bank Ltd FirstRand Bank Ltd Grindrod Bank Habib Overseas Bank Limited HBZ Bank Limited Investec Bank Ltd Mercantile Bank Limited Nedbank Group Limited Rand Merchant Bank RMB Private Bank South African Bank of Athens Limited Sasfin Bank Ltd Standard Bank of SA Ltd Wesbank Account Type Savings Cheque Current Account Name Account Number Branch Name Branch Code I hereby declare that the above information is true and correct to the best of my knowledge. * Yes Signature Clear Name & Surname * Submit If you are human, leave this field blank.
