Acceptance of Quotation and Installation Documentation

FundsAtWork umbrella fund Acceptance of quotation and installation documentation

Name of employer

Checklist for installation information Document Signed / initialled by Completed by Compulsory Page 

Sections on installation form

Employer details MD, FD or authorised Employer or Yes 2 signatory of employer Broker

Broker details N/A Broker Yes 3 Advisory body details Advisory body Advisory body Yes 4

Transfers from previous fund MD, FD or authorised Employer or Yes – if applicable 7 signatory of employer Broker Take-over of existing insurance cover MD, FD or authorised Letter from Yes – if applicable signatory of employer existing 7 underwriter

Advisory body investment choice MD, FD or authorised Employer or signatory of employer Broker 8 Contribution collection: Authorised signatory on Employer or Yes Automatic fund transfer details bank account Broker 9

Member communication request form MD, FD or authorised Employer or Yes signatory of employer Broker 14

Mandatory additional documentation and annexure

Acceptance of FundsAtWork quotation MD, FD or authorised Employer or fund Yes (quotations are valid for 3 months). If quotation signatory of employer or trustees has expired please re-quote existing fund trustees

Copy of employer’s certificate of registration or N/A N/A Yes any other official document that proves the existence of the employer eg if school then a registration certificate or letter from the department of education showing school’s registration number Cancelled cheque or letter from the bank on N/A N/A Yes the bank’s letterhead

Copy of letter appointing broker MD, FD or authorised N/A Yes signatory of employer or existing fund trustees Broker (key individual) accreditation from FSB N/A N/A Yes website Member data in MS Office Excel format N/A Employer Yes Acceptance of quotation and installation documentation

Name of employer

Start date - -

• Please submit this form together with all supporting documentation and membership data to [email protected] before the inception date of the scheme. • If the data provided by the employer at installation differs by more than 25% from the data on this accepted quote then Momentum will do a re-costing and inform the employer accordingly. • If the employer changes the benefit structure at installation, the scheme will be installed as per the accepted quote. A re-quote will then be prepared and the applicable changes will only be made in the following month.

Quotation number Version number Benefit structure number For participation in the FundsAtWork Umbrella Pension Fund Provident Fund Employees have been informed in writing of the eligibility requirements, contributions that will be paid and the benefits that will be provided according to the accepted FundsAtWork quotation. If members are joining FundsAtWork from another fund they have also been informed of the impact of the transfer. If the previous fund was a stand alone fund then the trustees have to sign below. If the previous fund was an umbrella fund or if this is a new arrangement, no signatures are required.

Signature: Chairperson of the Board of Trustees

Signature: Trustee

Employer duly authorised signatory and employer details By signing this quotation you, the employer, are confirming that you have read, understood and accept all the conditions of the booklet entitled “Your FundsAtWork quote in detail” as it applies to your proposed participation in the FundsAtWork umbrella fund/s and that you have been fully appraised under the Disclosure in terms of the Financial Advisory and Intermediary Services Act (the FAIS Act). Special rules and policies will be prepared based on this acceptance.

Name of employer Please attach copy of registration certificate

Type of legal entity (State whether CC, Ltd, (Pty) Ltd, Trust, Association, etc)

Physical address

Postal code

Postal address

Postal code

Contact person (full name)

Email address

Telephone number

Fax number

Please note that only the managing director or financial director of the employer may sign here. Alternatively the managing director or financial director may appoint an authorised signatory.

Designation

Signature

FundsAtWork Acceptance of quotation and installation documentation — March 2013 Page 2 of 15 Broker details

Broker / Agent code

Contact person

Broker / Agent name

Broker house

Broker house code

Reference No (ABSA & FNB brokers only) Physical address

Postal code

Postal address

Postal code

Email address

Cellphone number

Do you have a Momentum contract? Yes No

Have you received the letter for the Yes No FundsAtWork website registration?

Are you in service with Momentum? Yes No If out of service please contact your marketing adviser as soon as possible.

Broker signature

Momentum Distribution Service — Marketing adviser

MDS branch

MDS adviser code

Production credits %

Marketing adviser signature

Initials of the signatory ie MD or FD or authorised signatory of employer

FundsAtWork Acceptance of quotation and installation documentation — March 2013 Page 3 of 15 Momentum Distribution Service — Specialist marketing adviser / Business development manager

MDS branch

MDS adviser code

Production credits %

Specialist marketing adviser / Business development manager signature

Delivery details All communication (special rules, policy documents and member packs) will be emailed / delivered to the employer’s address (as shown on page 2). If this does not apply please indicate below where these documents must be sent to:

The marketing adviser The broker (address as on page 3)

If the marketing adviser please provide internal code

Do you require the registered and approved special rules? Yes No

Advisory body details The following members form the advisory body and they are authorised to sign documentation in respect of the employer's participation in the FundsAtWork Umbrella Pension / Provident Fund. Please note that you may not have more employer representatives than member representatives. The minimum number of advisory body members is two: either two member representatives or one member and one employer representative.

The advisory body as indicated below undertakes to notify Momentum in writing if there are any changes to the details provided below.

Name and surname

Representing (please tick applicable)) Member Employer

Email address

Cellphone number

Signature

Name and surname

Email address

Cellphone number

Signature

FundsAtWork Acceptance of quotation and installation documentation — March 2013 Page 4 of 15 Advisory body details (continued)

Name and surname

Email address

Cellphone number

Signature

Name and surname

Email address

Cellphone number

Signature

Name and surname

Email address

Cellphone number

Signature

Name and surname

Email address

Cellphone number

Signature

Name and surname

Email address

Cellphone number

Signature

FundsAtWork Acceptance of quotation and installation documentation — March 2013 Page 5 of 15 Advisory body details (continued) The Financial Advisory and Intermediary Services Act No. 37 of 2003 (FAIS) The main objectives of the FAIS Act are as follows: • to create a regulatory framework which ensures the protection of the consumer; • to make sure that consumers are given sufficient information to enable them to make informed decisions; • to regulate the selling of financial products and the advice-giving activities of financial services providers and their representatives. The legislation applies to any person (both natural and legal) that falls within the definition of a financial services provider or a representative who gives advice or provides an intermediary service in respect of a wide range of financial products to members of the public. This includes financial products such as securities, participation in collective investment schemes (eg unit trusts), insurance contracts, and benefits provided by pension funds and medical schemes as well as investments in foreign currency and deposits. Investment choices under FundsAtWork 1. When a scheme is first installed the advisory body is requested to choose the default product option or options where applicable (ie Founder, Narrator, Provider and Entrepreneur) and the investment portfolio or portfolios within these product options, as they know the profile of the employees. This choice by the advisory body does not constitute advice as it is made outside the fund. It is advisable that the advisory body in making this choice work with the broker to the scheme and a written record of advice is provided by the broker. The record of advice must include a brief summary of the information and material the advice was based on, the products that were considered and the products recommended, with an explanation of why the products selected satisfy the identified needs and objectives. 2. Under the FundsAtWork umbrella funds each member may then decide to stay in the default product option or change the product option and / or the investment portfolio/s. 3. If the advisory body following the installation of the scheme requests a bulk switch, ie an investment switch for the whole membership, they must seek advice from the broker and must insist on a written record of advice to be provided by the broker. 4. If an individual member approaches a member of the advisory body and asks for advice on which portfolio to invest in or whether they will have enough money to retire on, the advisory body member should not provide any advice on these matters and should refer the member to the broker. If the advisory body member does provide the member with advice then they can be sued in their personal capacity. 5. The Momentum Multi-Manager Smooth Growth Fund Global is the trustee choice portfolio for the Founder, Provider and Entrepreneur product options. The portfolio does not offer a full capital guarantee; a market value adjustment might apply on non-benefit payments like full or partial terminations and investment switches. Employers on the Founder, Provider or Entrepreneur product option and their employees should be made aware of the market value adjustment before the scheme is installed and afterwards if they choose to invest in this portfolio. The advisory body and members who prefer not to invest in a portfolio with a market value adjustment should not select the Founder product option and on the Provider and Entrepreneur product options they can elect to invest in another portfolio.

I have read and understood the section titled “Advisory body details” Yes No

Anniversary month Please note that this is the month that benefit statements are issued. The premiums for the insurance benefits and the fees are reviewed in July of each year.

Home loans (if applicable) to be provided via

First National Bank Standard Bank FundsAtWork offers housing guarantees for members, who need to renovate their home, buy a house, buy land to build a house or pay off another housing loan debt. If you would like to make this facility available to the members please ensure that the necessary paperwork has been completed and submitted to the bank so that your members can apply for a non-mortgaged home loan. The contact details of the relationship managers are: Ulana Simpson Regina Sidwell FNB Standard Bank Email address [email protected] E mail address: [email protected] Telephone number 087 577 9763 Telephone number 011 981 0291 Cellphone number 083 296 0343 Cellphone number 083 274 3868

FundsAtWork Acceptance of quotation and installation documentation — March 2013 Page 6 of 15 Transfers from previous fund (Section 14)

Name of transferring fund

Has the process to obtain a Section 14 Certificate been initiated? Yes No

Administrator of transferring fund

Approximate Section 14 value R

Details of contact person at previous administrator

Email address

Telephone number

Transfers within FundsAtWork (eg members breaking away from existing employer on FundsAtWork)

Name of existing employer

Group code

Take-over of existing insurance cover Where existing insurance cover is being taken over from another underwriter it is essential that the underwriter provides us with the detail requested and that this section is completed in full to ensure that no members are prejudiced by the take-over. Subject to Momentum’s free cover limits and policy terms and conditions, the cover of the members actively at work in the existing arrangement will be taken over.

Name of previous fund / scheme

Underwriter Please attach the letter from the previous underwriter on their letterhead showing the accepted covers including any terms and conditions. If the letter is not attached at installation stage then the free cover limit as quoted will apply.

Are there members in receipt of disability income benefits? Yes No If yes, please add these members on the installation data template indicating that they are disability claimants.

FlexiCovers Members in the Provider or Entrepreneur product options may only flex their insurance benefits after the first month’s payment of contributions and premiums have been processed.

FundsAtWork Acceptance of quotation and installation documentation — March 2013 Page 7 of 15 Advisory body’s investment choice (If other than Narrator product option)

The Momentum Multi-Manager Smooth Growth Fund Global is the trustee choice default portfolio for the Founder, Provider and Entrepreneur product options. The portfolio does not offer a full capital guarantee; a market value adjustment might apply on non-benefit payments like full or partial terminations and investment switches. Employers on the Founder, Provider or Entrepreneur product option and their employees should be made aware of the market value adjustment before the scheme is installed and afterwards if they choose to invest in this portfolio. The advisory body and members who prefer not to invest in a portfolio with a market value adjustment should not select the Founder product option and on the Provider and Entrepreneur product options they can elect to invest in another portfolio.

Founder product option: Please tick one Momentum Multi-Manager Smooth Growth Fund Global FundsAtWork Passive +4 If no choice is made them the contributions will be invested in the Momentum Multi-Manager Smooth Growth Fund Global investment portfolio.

Provider product option: Percentage of contributions Momentum Multi-Manager Smooth Growth Fund Global % Momentum Secure Bonus % Momentum Lifestages (if chosen then 100% of the contributions have to be invested in the portfolio) % Momentum Enhanced Factor 7 (CPI+7%) % Momentum Enhanced Factor 6 (CPI+6%) % Momentum Enhanced Factor 5 (CPI+5%) % Momentum Enhanced Factor 4 (CPI+4%) % Momentum Enhanced Factor 3 (CPI+3%) % 100%

Entrepreneur product option (please state portfolios): Full name of investment portfolio Portfolio number Percentage of contributions % % % % % % % % 100%

Notes  This instruction will be effective after the 1st month’s contributions have been paid.  Momentum will not be liable for any losses the members incur if the information is unclear, illegible or incorrect in any way.  You will receive a copy of the group holdings report as confirmation of the implementation of this investment choice. Please inform us within 10 calendar days of sending this instruction to Momentum if your instruction was not executed or was executed incorrectly. Momentum will not accept any liability or responsibility whatsoever of any losses incurred resulting from the non-execution or incorrect execution of your instruction.

Designation

Signature

FundsAtWork Acceptance of quotation and installation documentation — March 2013 Page 8 of 15 Contribution collection Retirement contributions and insurance premiums will be collected from:

Branch name

Branch code

Account number

Account name

Current Transmission Savings

Preferred deduction day *

Date of first collection * Deductions may be done on any pre-defined day during the period from the 15th up to the 5th of the following month.

Please attach a cancelled cheque or a letter from the bank, on their letterhead, confirming the bank details.

I hereby grant Momentum authorisation to collect the monthly retirement fund contributions to the FundsAtWork Umbrella Pension / Provident Fund and insurance premiums, after they have been confirmed, from the abovementioned account:

Designation (authorised signatory on bank account)

Signature

FundsAtWork Acceptance of quotation and installation documentation — March 2013 Page 9 of 15 Name of employer

Employer portal details The employer portal enables each employer to control the monthly contribution, exit and claim processes. The employer will be able, amongst others, to add new members, transfer members between branches, inform Momentum when members leave and provide Momentum with the necessary automatic fund transfer instruction each month. There are three levels of access on the employer portal: change, 2nd authorisation and view only. The designated signatory of the employer authorises the level of access that each user will have and also indicates which pay point the user must have access to. 2nd authoriser facility After the changes have been loaded, the 2nd authoriser will confirm the claims loaded and / or the total contributions and premiums that will be collected from the bank account via the automatic fund transfer facility. If you require this functionality, please add the 2nd authoriser below. Please note that this is not a compulsory function.

User 1 User 2 User 3 User 4

Title, first name and surname

ID number

Level of All changes All changes All changes All changes access View only View only View only View only

2nd authoriser for 2nd authoriser for 2nd authoriser for 2nd authoriser for claims claims claims claims

2nd authoriser to 2nd authoriser to 2nd authoriser to 2nd authoriser to confirm confirm confirm confirm contributions contributions contributions contributions

Pay point

Email address (more than one user can’t have the same email address)

Contact number

Existing user ID

Instruction Grant access Grant access Grant access Grant access

OR OR OR OR Remove access Remove access Remove access Remove access

Please note that if the employer has more than one pay point, a user for each pay point needs to be authorised to have access. The designated signatory of the employer must notify Momentum in writing if there are any changes to the level of access, as specified in the table above. This includes notification if any user’s access needs to be removed. Please note that only the managing director or financial director of the employer may sign here. Alternatively the managing director or financial director may appoint an authorised signatory.

Designation

Signature

Employer portal details (continued) The authorised users will be provided with login details (Webname and User ID). The user will then need to phone the client contact centre on 0860 65 75 85 to set up a Pin (personal identification number). It is imperative that the login details and the Pin are treated with the utmost confidentiality. If the login details and / or the Pin are shared or compromised in any way, Momentum will not be held responsible for any unauthorised use. Please note that all transactions and changes made by the authorised user will be updated automatically after submission. Momentum therefore will not be held liable for any processes / transactions / changes resulting from any incorrect submission.

We require this information for each pay point; please complete this section for each pay point if more than one. The contact person at the employer will be the only person from whom we will accept instructions for this pay point and who will confirm the contributions every month. Please ensure that the contact numbers are secure, as confidential information will be sent to these numbers.

Pay point number

Pay point name

Contact person (full name)

* Reminder date

Email address

Telephone number

Cellphone number

Fax number

Physical address where training must take place

Postal code

* Reminders will be sent to the person shown above (one user per pay point) via email if no authorised user has accessed the employer portal in respect of the monthly reconciliation process by the reminder date (preferably 5 days before the contribution collection date) specified above.

Designation

Signature

Employer portal terms and conditions

Designation

Signature

Employer portal terms and conditions

Designation

Signature

Member communication request form In terms of Section 7D of the Pension Funds Act, trustees have a statutory duty to ensure that relevant and appropriate information is supplied to fund members to inform them of their rights, benefits and obligations in terms of the rules of the fund.

The trustees of the FundsAtWork umbrella funds, taking legislation into account, have developed a communications policy. Part of the policy includes member training for all new retirement schemes. Client educators employed by Momentum have been tasked with providing this training.

If you require the member training to be run at more than one site, a contact person for each site should be completed.

Site / Pay point name Contact person & contact Address where presentation will take place Estimate number of details members at site

The contact person specified will be contacted by the client educator to arrange sessions at the employer’s site specified.

If no member communication session is required, kindly specify the reason below:

Done by the broker

Other:

FundsAtWork Acceptance of quotation and installation documentation — March 2013 Page 14 of 15 Minimum Disclosure Requirements Pension Funds Circular 86:

All new employees joining a retirement fund must be given an explanatory booklet or pamphlet within three months of joining. Existing members must be given a benefit statement containing the following minimum information:-

 The name of the fund and its registered address

 Details of the contact person for queries

 Fund reference number with the FSB

 Names of trustees

 Member’s name and personal details such as date of birth, pensionable salary and date of admission

 Date of statement

 Date of calculation of benefits

 Current contribution paid by member and frequency

 Current contribution paid by employer and frequency

 A statement of benefits payable on:

o normal retirement o death o disability o ill health early retirement o withdrawal

 Statements to the effect that:

o fund documents can be inspected at the registered office of the fund or at the employer and copies can be obtained at a cost o if the benefit statement conflicts with the rules, the rules will prevail o procedure for internal dispute resolution and access to the Pension Funds Adjudicator o it is important to obtain professional advice before electing benefits on cessation of membership o benefits are subject to tax o a note stressing the importance of updated beneficiary nominations

Members are to be notified of specific events such as conversions of status of the fund, transfers in terms of section 14 of the Act, restructuring of the fund.

Designation

Signature

FundsAtWork Acceptance of quotation and installation documentation — March 2013 Page 15 of 15