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(1)

Contact number

Fax number

Are you registered to market life insurance under the Life Offices’ Association and are you fully conversant with and

do you accept the ‘S’ reference system and the consequences of this?

Yes

No

1. I declare that I have explained and handed to the investment owner the applicable terms and conditions relevant to the investment agreement prior

to the signature of the application form.

2.

I declare that I have explained to the investment owner the meaning, implications and potentially detrimental consequences of replacing an

insurance policy. I declare that I have explained to the investment owner the meaning and implications of the valid Momentum quotation.

3.

I acknowledge that, if I have chosen discounted as-and-when commission, the Broker house’s finance model will determine the percentage to

apply on the date of the application’s acceptance.

4.

I acknowledge and understand the implications of the commission vesting term that I have chosen in this document. A default term of two years

will be implemented if no selection is made.

* Please fill in details of servicing financial adviser.

** Please choose the discounting option (if applicable) for as-and-when commission

Telephone

number

Marketing adviser name

Branch name

Marketing

adviser %

split

Marketing adviser code

Financial adviser code

**Discounting

for

as-and-when

Gross

commission %

split

Commission

reference no

Financial adviser

code

Broker house

code

Financial adviser name

Yes

No

Yes

No

*

_

_

Signature of servicing

financial adviser

Date

D D M M

2

0

Y Y

exercise a maturity option

Policy/Contract number

1

FICA declaration

I confirm that I have identified the client, including the investment owner, insured life/ves, contribution payer and cessionary,

where applicable, and verified his/her/their details on this contract under the requirements that section 21 of the Financial

Intelligence Centre Act, No. 38 of 2001, sets out. I further confirm that, in terms of section 22 of the same Act, I have stored

all the verification documents.

Yes

No

Requirements

1.

This form fully filled in, in black ink and in block letters, signed by the policyholder/investment owner, and co-signed by the spouse if married in

community of property on/after 1/11/1984.

2.

Certified copy of an identity document (baptismal/birth certificate, both sides of card driving licence, identity document or passport).

3.

A copy of your original, complete bank statement or a cancelled cheque in confirmation of your bank details.

4.

Trusts:

The trust deed.

A current and valid letter of authority issued by the Master of the High Court, setting out who has been appointed as trustees.

A resolution signed by the designated trustees, authorising certain trustees to act on behalf of the trust (only necessary where not all the

trustees will be signing documents).

This form is only valid for three months after date of signature.

We recommend that you contact your personal financial adviser before making any changes to your financial portfolio.

Contact person

E-mail address

Section 1: Financial adviser

Momentum Group Limited

268 West Avenue Centurion 0157 PO Box 7400 Centurion 0046 South Africa

ShareCall 0860 11 49 30 Cellphone 082 233 6260 Telephone 012 675 3070 Fax +27 012 675 3911

[email protected] www.momentum.co.za

(2)

M M

Y

Y

Y

Y

Yearly

Half-yearly

Quarterly

Monthly

M M

Y

Y

Y

Y

R

Continuation amount

Y

Y

M M

CPI**

Continuation options

Payment method:

*** On stop order payments, we charge an additional fee on the contract, currently 2,5% of each contribution. This will reduce the amount invested to purchase units, and the guaranteed value/s if applicable. Momentum will allow payment by stop order under certain qualifying business conditions only. Attach the stop order form, a copy of the identity document and payment slip to the application.

Contract number

Electronic transfer

Cash (not for monthly contributions)

Funded by an annuity

Stop order***

Employee number

Code

Debit order

_

_

D D M M Y Y Y Y

Telephone - work

Telephone - home

Fax - work

Cellphone

Date of birth

Residential address

Postal address

E-mail address

Gender:

Postal code

Please use the above addresses for correspondence about this contract only.

Postal code

Male

Female

Correspondence language:

English

Afrikaans

RSA ID:

Identity/Registration/Passport number

Yes

No

If a legal entity, the type of legal entity

Contact person in case of legal entity

Title

First name

Surname/Name of legal entity

Initial/s

Previous surnames

Which method of communication

do you prefer?

Note

: For the time being, certain documents from Momentum are not yet available electronically. We will continue posting those to you.

Continue without further contributions

Continue with further contributions

Section 2: Policyholder/investment owner

Post

E-mail

Section 3: Continuation

The continuation date is date of maturity but may be moved to the date of receipt of full requirements, if it is later.

Please choose the investment funds in Section 6.

R

Recurring contribution*

Payment frequency:

Date of first contribution increase

Contribution growth:

,

%

or

Please tick and complete the appropriate option:

If you choose a contribution where the new contribution payable is more that 20% of the contributions you paid in either of the previous two years,

it will put your contract in a restricted period. This restriction may limit certain values and contract benefits for a further five-year period. We

recommend that you consult your financial adviser.

Payment date of first contribution

*

Subject to the applicable minimum

**

Consumer Price Index is applied with a five-month lag and limited to a minimum of 2.5% and a maximum of 20%

(3)

R

Date

D D

_

M M

_

2

0

Y Y

Account information

I, the undersigned, authorise Momentum to debit my account with the contributions due for the investment. I undertake to inform Momentum of any change in my bank details and I authorise Momentum to verify such bank details with my bank. I accept that Momentum may debit my account on a date other than that specified. If I am signing on behalf of an institution, I declare that I am duly authorised to do so.

Signature of account holder/

authorised signatory*

Current

Savings

Transmission

No

Yes

Name of account holder

Name of financial institution

Account number

Account type:

Should Momentum group all collections from this account number and deduct them from your account as one amount?

_

_

Branch code

Branch name

Capital Guarantee Fund

Maximum Income

or

Investo Funds

*Attach copy of resolution by legal entity, setting out authority to sign on its behalf

Continue with income required

per month (Rand amount only)

per month (Rand amount only)

Total net cash value

Yes

No

Branch code

_

_

Section 4: Withdrawal options

You can combine this with Section 3 if you take a part of the maturity proceeds in cash.

Portion of maturity proceeds to be paid as a cash lump sum:

OR

Part of the net cash value

(Also fill in Section 3)

To enable us to pay the cash value into your bank account, please fill in Section 5.

R

This option is available only if the continuation amount exceeds R10 000

Income amount

R

Details of bank account into which Momentum will pay income payments must be given in Section 5.

Please note that no further contributions are payable if you choose this option.

We will make direct payments into a bank account only and we will not issue any cheques.

Choose between the Capital Guarantee Fund or Investo funds:

In the Capital Guarantee Fund, we guarantee the capital amount, provided that the income percentage is below the maximum percentage

allowed, but we do not guarantee the interest rate on the fund and it can vary every month.

Please choose the income funds in Section 6.

Income will be paid proportionately from the chosen Investo funds.

Section 5: Personal bank details

Name of account holder

Name of financial institution

Momentum does not allow third-party payments

_

_

2

0

D D M M Y Y

Date

Signature of policyholder/

investment owner

Account type:

Account number

Cheque

Savings

Transmission

Branch name

Section 3: Continuation

(continued)

(4)

Advice fee - continuation amount

Initial advice fee/commission

%

Trail fee/commission

%

Advice fee - recurring contribution

Level of commission

%

% of maximum commission

(0 - 100%)

%

%

As-and-when

%

Trail

Upfront

Advice fee - during extended savings term

%

As-and-when (0 - 5%) *

Endowments

%

Section 6: Investment details

Indicate the full and correct name/s of the fund/s chosen

Amount

or

Percentage

Name of fund/s

Continuation amount

R

R

R

%

%

%

%

R

R

R

%

%

%

R

R

Total

or

Recurring contribution

Total

or

Name of fund/s

R

R

R

R

R

R

R

R

R

R

R

%

%

%

%

%

%

%

%

%

%

%

1

0

0

Amount

or

Percentage

R

R

R

%

%

%

%

1

0

0

Income will be paid proportionately from the chosen funds (where appropriate)

Section 7: Declaration

Payment of full or partial proceeds (delete if not applicable)

1.

I/We warrant that

1.1

I am/We are the legal owner/s of the policy/contract, and competent to deal with the policy/contract.

1.2

My/Our estate/s is/are solvent and has/have never been sequestrated.

1.3

I/We have not ceded or pledged the policy/contract to anyone either by antenuptial contract or otherwise, except *in favour of Momentum as a

security for a loan on it and/or

Insert details of any other dealings with the policy/contract.

*Delete if not applicable.

2.

I/We specifically authorise Momentum to pay the proceeds due to me/us into the account indicated and I/we indemnify Momentum against all actions,

suits, claims, demands, costs and expenses resulting from Momentum giving effect to my/our instruction, including but not limited to all actions, suits,

claims, demands, costs and expenses by any third party claiming greater rights to the policy/contract than me/us. (Delete if not applicable).

(5)

3.

I confirm that my financial adviser will receive an ongoing advisory fee, as indicated in this section, per year on the value of the investment funds. I

understand that all ongoing fees are payable on a monthly basis.

4.

I warrant that the information provided herein is true and correct and that this application form has been completed correctly and fully. Momentum

Group and/or Momentum Wealth, as applicable, will not be liable for any loss or damage that I may suffer as a result of incorrect or fraudulent information

inserted later or any unauthorised amendments to this form.

5.

I acknowledge and accept that this application form is subject to the Momentum

Investo continuation terms and conditions

(MOMAD 135) as at the

date of signature of this application form. I confirm that I have carefully read and have understood the

Investo continuation terms and conditions

and

agree to be bound by them.

6.

I understand and agree that if any tax law, rule or directive or any other law affecting this investment changes in any way whatsoever, Momentum

Group and/or Momentum Wealth as applicable, may make such reasonable amendments necessary to this agreement as it considers appropriate

and will notify the investor within 30 days of such amendment.

7.

I understand and agree that my financial adviser is responsible for determining my risk profile and selecting investments that best suit my risk profile,

personal circumstances and investment objectives.

8.

I understand and agree that the investment option that I selected is subject to market risk and the value thereof will fluctuate with the market. I warrant

that I have not received from Momentum Group and/or Momentum Wealth any assurance or guarantee as to the expected return on my investment.

9.

I warrant that I am capable of evaluating and understanding the investment (on my own behalf or through independent professional advice), and

understand and accept the terms, conditions and risks of the investment.

10. I agree and accept the fees, charges and periods for administrative processes as detailed in this application form, Terms and Conditions, investment

certificate and general business practice of Momentum Group and/or Momentum Wealth, as applicable.

11. I understand and agree that I will be obliged to comply with any minimum and maximum investment terms stipulated by legislation or regulation.

12. If I/we select a portion of the maturity proceeds to be paid as a cash lump sum, I/we cede, subject to the prevailing terms of the contract, all my/our

right, title and interest in the contract to Momentum Connect, in consideration for which I/we accept payment of the cash value from Momentum on

behalf of Momentum Connect.

_

_

2

0

D D M M Y Y

Date

Signed at

2. Signature of policyholder/investment owner

1. Signature of policyholder/investment owner

3. Signature of spouse if married in community of

property

4. Signature of cessionary

Section 7: Declaration

(continued)

1.

Registration number

2.

Name in block letters

3.

Designation

Signature

4.

I am duly authorised to represent the legal entity

In the case of a legal entity:

_

_

2

0

D D M M Y Y

(6)

General

1. I warrant that all the information that I have supplied for the processing of my application is correct and complete and that I have disclosed all the facts that are important to the issuing of this agreement. This information will form the basis of the contract with Momentum Administration Services (Pty) Ltd (”Momentum Wealth”) and/or Momentum Group Limited (“Momentum Group”). Any reference to Momentum in this application will mean Momentum Wealth and/or Momentum Group, as applicable. Any incorrect or incomplete material information that I have given may affect the validity of the agreement. In such a case, I acknowledge that I may be personally liable and accountable for any losses that Momentum Wealth, my financial adviser or I may suffer.

2. I acknowledge that the investments that I invested under this contract are not the proceeds of any crime, as defined in the Prevention of Organised Crime Act, No 21 of 1998, as amended from time to time, as well as any new legislation that may govern the proceeds of crime in future. I am aware that any information that I have given for the purpose of this application is subject to the stipulations of the Financial Intelligence Centre Act, No 38 of 2001, and will be dealt with in accordance with requirements contained in the Act.

3. The application form and the investment certificate form the basis of the agreement between Momentum and me, as applicable.

4. This agreement will start once Momentum has received the fully completed application form and any additional information and/or documents that it may need, and after it has accepted the application.

5. I will initial any alterations or additions to the application form and these will only become binding once Momentum has accepted them.

6. I acknowledge and understand that there is an inherent risk associated with the selected investments that underlie the contract. Neither Momentum, nor its subsidiaries, agents and/or authorised representatives will be liable for the consequences of any adverse market movements or the instructions that they carried out or did not carry out if such instructions are ambiguous or unclear.

7. Momentum may terminate this agreement as long as it gives no less than 30 days’ written notice to the investment owner. In this event, Momentum will act in accordance with my final instructions about the termination of this agreement, subject to the applicable legislation. 8. Where Momentum, for whatever reason, cannot allocate the investment amount to the chosen

investment components within two working days, Momentum will add interest to the investment amount of my contract. It will add the interest amount to my original investment amount that it has to invest in the chosen investment components, excluding annuities and Capital Guarantees. Where I only chose an annuity and/or Capital Guarantee component, Momentum will allocate the interest amount to the RMB Money Market Account.

9. Momentum does not guarantee the performance of any investment; however, certain underlying products may carry guarantees. I choose the investment based on my own investment strategy. 10. I acknowledge and understand that neither Momentum nor their subsidiaries, agents and/or

authorised representatives will be responsible for any loss arising from changes in tax or other legislation or the interpretation of them, that may have an impact on the performance of the investment and that did not exist at the time that I made the investment.

11. I declare that I have the necessary legal capacity to enter into this insurance contract or a party with the necessary contractual capacity has properly assisted me.

12. 12.1. Momentum reserves the right to withdraw contract owners’ access to its offshore capacity: if, for any reason whatsoever and depending on the discretion of the chief actuary, it cannot continue to provide offshore capacity for all contributions that the contract owner has to pay. Momentum may then allocate the contributions to the RMB Money Market Fund or any other fund/s that Momentum may make available. 12.2. Momentum reserves the right to withdraw the contract owners’ access to investments

of a particular external manager’s funds, including also collective investment schemes if such fund manager or collective investment scheme has notified Momentum that it will not accept further investments in one or more funds under its management. Momentum may then allocate the contributions to the RMB Money Market Fund or any other fund/s that Momentum may make available.

13. I acknowledge that I am aware that I have the right to any information that the law requires a collective investment scheme or listed company to disclose. I am also aware of Momentum’s duty to obtain and transmit such information if I specifically request this.

14. I irrevocably authorise Momentum to obtain any information from any person required in terms of this investment application. In this vein I undertake to furnish Momentum with certified copies of documents containing such information.

15. I irrevocably authorise Momentum to make available any information at the disposal of Momentum to any third party in compliance with the statutory/regulatory requirements of this investment.

16. Momentum has created different classes of collective investment scheme units to suit the underlying product and licence. The class I have invested in will be based on the underlying product that I have chosen.

17. Momentum is not responsible or liable for losses incurred due to delays, omissions or any other errors on the side of the collective investment scheme management company. 18. All income distributions will be re-reinvested automatically.

Ringfencing

19. I understand “Ringfenced” or “Ringfencing” to mean the suspension of repurchases of my participatory interests in a collective investment scheme under defined circumstances on any business day.

20. I irrevocably authorise Momentum on receiving a notice from the collective investment scheme management companies (mancos) to suspend repurchases, to immediately withdraw the repurchase/switch instruction and to resubmit the repurchase/switch instruction on the following business day.

21. I indemnify Momentum against any damages or loss of whatsoever nature that I may suffer as a result of Momentum acting according to my instructions or those of my financial adviser in the clause above.

Turnaround times

22. Under normal circumstances, Momentum processes valid instructions within two working days after it has received them. However, under the following circumstances Momentum cannot execute my instruction within the two-day turnaround time:

22.1 When the investment is in offshore funds, Momentum Wealth will always carry out instructions at the earliest possible dealing opportunity, subject to the administration procedures and possible fund dealing limitation that accompany investing in offshore funds. I will consult my financial adviser or the Momentum Wealth offshore call centre if I need more information on these procedures. For example, many of the offshore funds allow for dealing on a weekly basis only and, in some cases, quarterly. Momentum cannot guarantee turnaround times, as the notice and settlement periods of the various fund managers are not the same. Even where daily dealing funds are involved, the standard turnaround time for one leg of an offshore instruction is nine working days. I also note that Momentum Wealth does not determine the conversion rates at the time of instruction, but only once it has received the dealing prices.

22.2 In the case of extraordinary occurrences in the industry, which cause extensive market surge, such as the outflows experienced on 11 September 2001, I cannot hold Momentum Wealth responsible for a delay in completing my instruction.

22.3 Delays will also occur if an instruction is incomplete or unclear. Funds invested

23. All investments will be subject to the rules and/or conditions that govern those investments, as the law or the product provider determines from time to time. I understand investment to mean investments in collective schemes as defined in the Collective Schemes Control Act, 2002 insurance policies issued by long-term insurers pursuant to the Long-term insurance Act, 1998, and benefits that pension fund organisations provide.

24. I acknowledge that certain instructions that I may give to Momentum about the underlying investments and products that I have chosen, will be subject to the timing standards, procedures and final prices and exchange rates that the mancos and/or other third parties use and confirm. Momentum will do all it can to make sure that it carries out such instructions within a reasonable period, but will not be responsible for any delays that the market conditions, the management companies or any other third parties cause (as the case may be).

save thru spend

25. I understand that this application to a participating Momentum company entitles me to participation in the save thru spend programme administered by Momentum Interactive (Pty) Ltd, a wholly owned subsidiary of Momentum Group Limited, which is a programme where participants become entitled to certain benefits for transactions that such participants enter into with selected save thru spend partners. A list of save thru spend partners is available from Momentum’s website.

26. I understand that a set of rules issued by Momentum Interactive (Pty) Ltd governs my right to participate in save thru spend and its benefits on acceptance by Momentum of this application. Future updates of the rules and benefits, as well as the suppliers, are available from the Momentum website (www.momentum.co.za) or I may obtain these from the save thru spend client call centre on 0860 728 348.

27. Momentum Interactive (Pty) Ltd reserves the right to amend the rules referred to in 26 above and may change the benefits of save thru spend unilaterally from time to time by providing prior written notice to participants. I understand that I may cancel my participation in this programme if I do not want to accept the amended rules or benefits.

28. I consent to the recording of all conversations between Momentum Interactive (Pty) Ltd and/or its representatives and me, and agree that all information that Momentum Interactive (Pty) Ltd obtains through these conversations will form part of its records. I further consent to all these recordings remaining the sole property of Momentum Interactive (Pty) Ltd.

29. I consent to Momentum Interactive (Pty) Ltd disclosing to any third party any information that I or any other entity supplied to Momentum Interactive (Pty) Ltd by virtue of my participation in save thru spend, provided that the party to which Momentum discloses such information agrees to keep it confidential at all times.

30. Momentum Interactive (Pty) Ltd reserves the right to cancel this agreement if it finds that the information that I have supplied is incorrect and/or false.

31. I acknowledge and understand that any tax liability that Momentum Group or any of its subsidiaries incur in connection with my participation in save thru spend may reduce my save thru spend benefits.

32. This application form was duly and fully completed before I signed it and the information contained in it is true and correct. I will not cede any of my rights in terms of this agreement. 33. I acknowledge and understand that Momentum Group and/or Momentum Wealth and/or their subsidiaries, agents and authorised representatives will not be responsible for any loss or damage arising from any cause, including but not limited to changes in tax or other legislation or the interpretation of these, that I may sustain as a result of me receiving the save thru spend benefit. Furthermore, I indemnify Momentum Group Limited, Momentum Interactive (Pty) Ltd and/or any of their employees and hold them harmless against any claim of any nature arising directly or indirectly from my and/or my dependants’ participation in save thru spend. 34. I understand that

34.1 My participation in save thru spend entails that in order to receive benefits, it is my responsibility to identify myself by showing my save thru spend card and/or registering my save thru spend number when transacting with a save thru spend partner, and that no benefits will result unless I do so; and

34.2 I have to keep detailed records of any transactions that I conclude with any of the save thru spend partners and that if I do not inform Momentum Interactive (Pty) Ltd within 60 days of any discrepancies that may exist between my records and those of Momentum Interactive (Pty) Ltd, I will forfeit any benefit to which I may become entitled in terms of these records.

(7)

for participation. Although I receive the right to participate, I am not obliged to do so. My failure to do so will mean that no benefit will accrue to me on any product with a participating Momentum company.

36. Momentum Interactive (Pty) Ltd may decide at its sole discretion from time to time who may participate in the save thru spend programme.

37. I acknowledge that I will become entitled to the save thru spend benefit from a transaction only once the save thru spend partner with whom I have transacted accepts and settles its liability to Momentum Interactive (Pty) Ltd for the transaction in full. The participating Momentum company will then apply the benefit to the product concerned.

38. The contra proferentem rule (i.e. the rule that causes the wording to be construed against the party who drafted the wording in cases of doubt) will not apply in the interpretation of the terms and conditions.

Multiply

39. I, the principal member, hereby apply for my dependants (where applicable) and me to become members of Multiply administered by Momentum Interactive (Pty) Ltd. If Momentum Interactive (Pty) Ltd accepts the application, the rules and regulations of the programme that bind me and to which I agree to adhere to will serve as evidence of the acceptance. A copy of the rules is available from the Momentum website (www.momentum.co.za) or I may obtain this from the Multiply client call centre at 0861 88 66 00.

40. I consent to paying the monthly contributions in return for the benefits supplied by Multiply to my dependants (where applicable), and me. I understand that it is my sole responsibility to ensure that Momentum Interactive (Pty) Ltd receives my monthly contributions.

41. I acknowledge that Momentum Interactive (Pty) Ltd reserves and will have the right to cancel the membership applied for in this document if any of my dependants (that are members of the programme by virtue of this application) or I breach any of the terms and conditions of this agreement, inclusive of Momentum Interactive (Pty) Ltd rules and regulations pertaining to the Multiply programme that are in force from time to time.

42. Momentum Interactive (Pty) Ltd reserves the right to amend the rules referred to in 39 above and the Multiply benefits unilaterally from time to time by providing prior written notice to participants. I understand that I may cancel my participation from this programme if I do not want to accept the amended rules or benefits.

Lifecycle Philosophy

43. I acknowledge that Momentum has based this philosophy on four portfolios with different risk profiles. Momentum will automatically switch my investment from portfolio to portfolio, depending on the remaining initial savings term unless Momentum receives a written instruction from me where I clearly indicate my specific investment choice.

44. Momentum reserves the right to alter the term that activates the switch from one portfolio to another. The effective date of a switch may also depend on my age.

45. As I near the end of my specified initial savings term, I authorise Momentum to implement a conservative investment approach.

Financial adviser

46. The financial adviser is responsible for making sure that I receive and understand all appropriate advice, product and fee information that the financial adviser has to give to me, including any changes in the working practices and procedures of Momentum.

Fees

47. Momentum will pay the financial adviser’s fees that this application form sets out. Momentum will deduct these fees from my investment. I acknowledge that these fees are based on the agreement between the financial adviser and me.

48. The investment certificate will specify all fees that momentum charges under these contracts. Momentum will send the investment certificate to me after it has accepted the application. It is the responsibility of the financial adviser to make sure that I am fully informed of all fees and costs under this agreement.

49. Momentum reserves the right to review its fees that apply to the contract after giving appropriate and reasonable notice of these changes. This includes, but is not limited to, the fees based on the total funds and number of contracts in my Investo Portfolio.

50. I instruct Momentum to withdraw a trail fee, as specified in the advice fee section, from the

each of the Collective Investment Schemes I am invested in proportionately. Designer Annuity

52. Momentum will register and hold all investments in the name of Momentum Wealth for my exclusive benefit.

53. Once the Investo Designer Annuity has started, I may not cancel it (subject to cool-off). I may, however, end my contract with Momentum, provided that I transfer my investment to another registered insurer under section 37(2) of the Long-term Insurance Act. The amount that I transfer will be the investment value of the contract on the date that Momentum realised (sold) the units, less any other fees that may apply. If Momentum receives my instruction to transfer this contract within 30 days, Momentum will refund all the initial fees that it charged on the investment.

Long-term Insurance policies

54. I acknowledge and understand that I cannot hold Momentum and/or any of its subsidiaries, agents, and/or authorised representatives responsible for any damage or losses that I suffer if I sign this application before completing it in full. I acknowledge and understand that it is an offence to sign a blank or uncompleted application form, as stated in the Policyholder Protection Rules that have been published under the Long- term Insurance Act of 1998.

55. I acknowledge that any funds of a collective investment scheme that I have chosen as underlying contract assets do not constitute assets that I own, but rather that Momentum owns the assets and that the investment owner participates in those through the medium of the contract. Accordingly, the prices of units of such collective investment scheme funds published in newspapers cannot be directly correlated to the unit prices of the contract.

Retirement Annuity/Pension Preservation/Provident Preservation

56. I apply for membership of the Momentum Pension Preservation Fund or the Momentum Provident Preservation Fund or the Momentum Retirement Annuity Fund (the fund), whichever applies to me, and agree that the provisions contained in the rules of that fund will bind me. The Momentum Group, a registered long-term insurer, underwrites and administers the fund. 57. This application, the fund rules, the contract issued to the fund in relation to this investment

and other business documents govern the legal relationship between me as member of the fund, the fund and Momentum.

58. Momentum may amend the terms of the contract from time to time after giving appropriate and reasonable notice of any changes.

59. If I invest in either the Momentum Pension Preservation Fund or the Momentum Provident Preservation Fund, I may not take more than one full or partial withdrawal before retirement. Conditions that the transferring fund and/or fund rules impose may restrict the amount that is available to me before retirement. All remaining benefits will be payable in the event of death or retirement.

60. A preservation fund or retirement annuity contract may not be cancelled. However, I may transfer my fund benefits to another approved fund, provided that the transfer complies with the applicable regulations that deal with transfers between approved funds. The amount that I transfer will be the prevailing investment value of the underlying assets less any other fees or charges that may be applicable.

References

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