Tavcor Motor Group (Pty) Ltd

Client Personal Information & Consent form

Full Name and Surname (the client)

Id Number/ Passport Number

Cell Phone Number

Email:

Residential Address:

Employment Choose an item.SALARIED / SELF EMPLOYED / PENSIONER / STUDENT / MINOR/ UNEMPLOYED / OTHER: ___________________

Job/Occupation/Position TEACHER / LAWYER / DOCTOR / SALES EXEC / MANAGER / OTHER: ________________________

Industry employed in EDUCATION / LAW / HEALTH / GOVT/ MUNCIPALITY / AUTOMOTIVE / OTHER: ____________________________

Source of IncomeChoose an item. ALLOWANCE / BURSARY / COMPANY PROFITS / COMPANY SALE / SALE OF COMPANY INTEREST / COURT
ORDER / CRYPTOCURRENCY / DECEASED ESTATE / DIRECTOR / MEMBER CC / OWNER OF OWN BUSINESS / DIVIDENDS / DIVORCE
SETTLEMENT / ENCASEMENT CLAIM / GIFT / DONATION / INCOME FROM EMPLOYMENT / INCOME FROM PREVIOUS EMPLOYMENT /
INHERITANCE / LOAN / LOTTERY / GAMBLING / MAINTENANCE / MATURING INVESTMENT / NEW INVESTMENT / PENSION / PRIVATE CAPITAL
RAISE / PUBLIC CAPITAL RAISE / SALE OF ASSET / PROPERTY / SALE OF ASSET / SALES SHARES / SALES / BUSINESS ACTIVITY / Other:
(Please specify) ___________________________________

Source of Transaction Funds Choose an item. ALLOWANCE / BURSARY / COMPANY PROFITS / COMPANY SALE / SALE OF COMPANY
INTEREST / COURT ORDER / CRYPTOCURRENCY / DECEASED ESTATE / DIRECTOR / MEMBER CC / OWNER OF OWN BUSINESS / DIVIDENDS /
DIVORCE SETTLEMENT / ENCASEMENT CLAIM / GIFT / DONATION / INCOME FROM EMPLOYMENT / INCOME FROM PREVIOUS EMPLOYMENT /
INHERITANCE / LOAN / LOTTERY / GAMBLING / MAINTENANCE / MATURING INVESTMENT / NEW INVESTMENT / PENSION / PRIVATE CAPITAL
RAISE / PUBLIC CAPITAL RAISE / SALE OF ASSET / PROPERTY / SALES SHARES / SALES / BUSINESS ACTIVITY / Other: (Please specify)
___________________________________

Are you a Foreign/ Domestic public official in a position of authority (Politically exposed)? Yes / No. If yes, position: _________________________
Are you related to, or associated with, a public official in a position of authority? Yes /No. If yes, public official’s full names: ____________________

The FICA Act requires an Accountable Institution (as defined in Schedule 1 to FICA) to establish and verify the identity of its client before entering a
business relationship or single transaction with that client. The client is required to provide an Accountable Institution with his/her personal information and
Verification Documents in order for the Accountable Institution to comply with FICA requirements and enter into a business relationship or facilitate a single
transaction for the client. EFICA (Pty) Ltd (hereinafter referred to as EFICA) has developed a web-based document submission, sharing and verifying
application called eFICA, which has been designed to assist Accountable Institutions with the client verification and risk rating requirements prescribed by
the Financial Intelligence Centre Act, 2001 (FICA) and the Money Laundering and Terrorist Financing Control Regulations to FICA (the Regulations).

The Client hereby agrees that:

The client’s personal information and verification documents, which may be protected by data protection legislation, including amongst others POPI, may be
uploaded to eFICA and shared with another Accountable Institution.

a. EFICA may process the data provided by the client and forward Personal and other Information, including biometric information, provided by the client
to Third Party Service Providers (the South African Department of Home Affairs, the South African Revenue Services, educational institutions, credit
bureaus, Anti Money Laundering Fraud Prevention screening services and fraud prevention organisations) for verification purposes in order for the
Accountable Institution to comply with FICA regulations;
b. All information provided by the client for the use of eFICA is true and correct, and that EFICA and the Accountable Institution may rely on the truthfulness
and correctness of that information.
c. Any Accountable Institution that has an eFICA profile may rely on the records, representations, warranties, and agreements given by the client.
d. In the event of EFICA being transferred, the client agrees that EFICA may provide information about the client (including information that may be protected
by law), to the transferee (i.e. the person to whom EFICA is transferring its rights and obligations), and disclose to a potential assignee or transferee any
information about the client (including information that may be protected by law);
e. Additional information may be requested as needed and client will supply same to to comply with FICA regulations.
f. To the fullest extent permissible in law, the client unconditionally and unreservedly indemnifies and holds EFICA, its affiliates, public officers, directors,
employees, consultants, agents, licensors and service providers harmless against all loss, damages, claims, liability and/or costs, of whatsoever nature,
howsoever and whensoever arising as a result of, and without limitation from, the use of the EFICA service. In addition, the client warrants that he/she
will not seek recourse against EFICA on any basis in connection with any information given, or, in the client’s view, not given.
g. eFICA is hosted on a South African Microsoft Azure server following all first world, industry leading security concerns such as encrypted data, secure
socket layers and firewalls amongst other security practises. The server is further protected using Eset Server anti-virus. All server security patches are
regularly applied, and data breach simulations are tested to ensure security due to the fluid nature of security threats. The data is stored individually,
and no party has access to another party’s data at any time.

INITIAL

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 CONSENT OF A DATA SUBJECT FOR THE PROCESSING OF PERSONAL INFORMATION IN
TERMS OF THE PROTECTION OF PERSONAL INFORMATION ACT, 2013 (ACT NO. 4 OF 2013)

I hereby voluntarily give consent to TAVCOR MOTOR GROUP to process my personal information indefinitely in order for the TAVCOR MOTOR
GROUP to fulfil their contractual obligations, to achieve their business objectives, for marketing purposes and for legal compliance purposes.

I understand the following,

I understand that third parties may have access to my personal information in order for the TAVCOR MOTOR GROUP to comply with their
reporting and/or legalobligations and for the dealership to render all the services requested by me.

I understand further that all my personal information which I provide to this dealership will be processed securely for the purpose for which it was
collected.

I declare that all my personal information provided to TAVCOR MOTOR GROUP is accurate, up to date, is not misleading and that it is complete in all
respects.

I understand that I can request TAVCOR MOTOR GROUP to amend, delete and/or destruct my personal information on receipt of a written
request from myself and that I may, at that time, object to the processing of my personal information.

I am aware that I may file a complaint with the Information Officer of TAVCOR MOTOR GROUP at any time.

For your own information, have regard to the dealership's privacy notice, which specifically sets out how your personal information will be processed and
what your rights are with regard to your personal information.

I the undersigned ______________________ (the Client) hereby confirm that the information provided is true and correct and that I understand the content
of the document.

Signature:---------------------------------------------------------------------- Date: -------------------------------------------------------------------------------------------------

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