Prospective Client Checklist

First Name

Last Name

Calling Name

Personal Email

Identity Number

Nationality

Where you born in another country other than South Africa (SA)?

If not in SA what date did you become a SA citizen?

Current Marital Status

Current Marital Status*

Married Divorced Single Other

Marriage Type

Marriage Date

Spouse Full Name

Spouse Calling Name

Spouse ID

Have you been divorced before?

Have you been divorced before?

Yes No

If yes, please provide divorce decree/ agreement*

Beneficiaries – Dhevan recommends your spouse is your main beneficiary and your children are your secondary beneficiary for tax purposes

Primary Beneficiary*

Full Name

Percentage

Full Name

Percentage

Full Name

Percentage

Full Name

Percentage

Secondary Beneficiary*

Full Name

Percentage

Full Name

Percentage

Full Name

Percentage

Full Name

Percentage

Full Name

Percentage

Residential Address

Postal Address

Home Landline

Mobile Personal

Medical Aid

No.

Occupation

Department/Sector

Source of Income

Income Tax Number

GEPF Pension No.

GEPF Persal No

Date when you plan on leaving?

Banking Details*

Bank Name

Bank Branch

Account Type

Account Number

Account Holder's Name

* All areas marked with an * require documents with details reflected thereon. For example: ID – identity document required; income tax number – SARS document reflecting your tax number.

087 354 9015
retirewell@retiresa.co.za

Suite F110A
iZulu Office Park
Rey’s Place, Ballito, 4399

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Disclaimer: The guidance on ‘Retire or Resign’ decisions provided here is independent and not issued by or on behalf of the Government Employees Pension Fund (GEPF). We do not act on behalf of the GEPF.