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BROKER APPOINTMENT

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					                                             BROKER APPOINTMENT

                                                   Letter of Engagement


We,......................................................,confirm the engagement of...South Cape Financial Services to:

Authorisation                                                                  Yes                           No

You are hereby authorised to obtain all information in respect of our policy/policies held at the various
financial institutions.

Appointment as Financial Advisor                                               Yes                            No

We understand that this will entitle the Executive Financial Adviser to any future review
fees/commissions that may be payable under our various policy/policies.


Confirmation of receipt: Signature: ............................................................

We confirm that we have been presented the initial Contact Disclosures and a copy of the Statutory
Notice.

Access to Information

The broker acknowledges that in the course of rendering services in terms of this broker authority to
the client, he shall come into possession of information of a confidential nature. The broker shall not,
whether during the course of this agreement or at any time thereafter use or disclose or allow third
parties to use or disclose any of the confidential information except to the extent permitted by the
client.

Signature:...............................................................................Date-------/------/------

ID Number............................................................................

Policy/Policies number.........................................................

Address:................................................................................

          ...................................................................................

          ...................................................................................


AUTHORIZED FINANCIAL SERVICE PROVIDER NO 14799

				
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posted:10/17/2013
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