Welcome to

Ascor® Independent Wealth Managers

About YOU questionnaire

Strictly confidential

All information provided will be kept confidential. We will not disclose your personal information to a third party without your consent unless we are required or authorised to do so by law or other regulation.

Please provide us with some information about yourself, your spouse and financial dependents.

The POPIA (Protection of Personal Information act) will be active from 1 July 2021.
Ascor is compliant with the new POPIA act.
Click here to familiarise yourself with our Privacy and Data protection policy.

PRIVACY AND DATA PROTECTION POLICY

About you questionnaire

Your information

Title * Title

Preferred Name *

Full Names *

Surname *

Maiden name *

Gender *

Male

Female

Language *

English

Afrikaans

ID number *

Birth date *

Contact Method *

E-mail

Text message

Phone

Planned retirement age *

Contact details

Home phone no *

Cellphone no *

Business phone no *

Email address *

Address details

Postal address *

Postal Code *

Physical address *

Physical Code *

Business address *

Business Code *

Employer details

Employer *

Service years *

Highest qualification *

Department *

Career *

Position *

Tax details

Tax number *

Registered tax office *

Dependents

Children or adults financially dependent on you

1. Full Names

Surname

Birth date

Gender

Male

Female

2. Full Names

Surname

Birth date

Gender

Male

Female

3. Full Names

Surname

Birth date

Gender

Male

Female

4. Full Names

Surname

Birth date

Gender

Male

Female

The POPIA (Protection of Personal Information act)

I am aware and have read the POPIA act documentation mentioned above *

YES

Spouse information

Title * Title

Preferred Name *

Name *

Surname *

Maiden name

Gender *

Male

Female

Language *

English

Afrikaans

ID number *

Birth date *

Contact Method *

E-mail

Text message

Phone

Planned retirement age *

Spouse contact details

Home phone no *

Cellphone no *

Business phone no *

Email address *

Spouse employer details

Employer *

Service years *

Highest qualification *

Department *

Career *

Position *

Spouse tax details

Tax number *

Registered tax office *

Partner information

Title * Title

Partner preferred Name *

Partner name *

Partner surname *

Gender *

Male

Female

Language *

English

Afrikaans

ID number *

Birth date *

Contact Method *

E-mail

Text message

Phone

Planned retirement age *

Partner contact details

Home phone no *

Cellphone no *

Business phone no *

Email address *

Partner employer details

Employer *

Service years *

Highest qualification *

Department *

Career *

Position *

Partner tax details

Tax number

Registered tax office

The POPIA (Protection of Personal Information act)

I am aware and have read the POPIA act documentation mentioned above *

YES

reCAPTCHA

If you are human, leave this field blank.

Welcome to

Ascor® Independent Wealth Managers

About YOU questionnaire

Strictly confidential

All information provided will be kept confidential. We will not disclose your personal information to a third party without your consent unless we are required or authorised to do so by law or other regulation.

Please provide us with some information about yourself, your spouse and financial dependents.

The POPIA (Protection of Personal Information act) will be active from 1 July 2021. Ascor is compliant with the new POPIA act. Click here to familiarise yourself with our Privacy and Data protection policy.

PRIVACY AND DATA PROTECTION POLICY

Your information

Contact details

Address details

Employer details

Tax details

Dependents

Marital status

The POPIA (Protection of Personal Information act)

Spouse information

Spouse contact details

Spouse employer details

Spouse tax details

Partner information

Partner contact details

Partner employer details

Partner tax details

The POPIA (Protection of Personal Information act)

The POPIA (Protection of Personal Information act) will be active from 1 July 2021.
Ascor is compliant with the new POPIA act.
Click here to familiarise yourself with our Privacy and Data protection policy.