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Please complete every line below. If you do not have any information to submit in a specific line, just enter something like “none” or “n/a”. When you submit the form, your details will go through to our admin department and we will contact you shortly.

Application type

If you have selected to open the account in the name of an individual, then please skip to the 'personal details' in the next section below.

Personal details

To be completed for/by the person responsible for the account:

Contact details

Contact numbers

Employment details

Bank details

We need to link a bank account to your trading account:

Financial information

This is required, but remains confidential with us:

Risk profile

I hereby acknowledge and understand that Courtney Capital Management (‘CCM’) considers it critical that I complete this document - to enable CCM to accurately assess my risk profile to provide me with sound investment advice. I warrant that all the information provided by me is true and complete. And I acknowledge that CCM will not be able to assess my risk profile without this information. I agree that CCM will not be liable for any loss or damage, whether in contract or delict and whether consequential or otherwise, suffered by me as a result of an inaccurate assessment of my risk profile.

And a few questions so we can understand the way you think:

Your profile explained

Low risk ↓ 17 or less. Low Risk investors want stability and are concerned with protecting their current investments than increasing the real value of their investments.

Medium risk → 18 to 35 points. Medium Risk investors want reasonable but relatively stable growth. Fluctuations are tolerable, but investors want less risk than that in a fully equity based investment.

High risk ↑ 36 or more. High Risk investors are long term investors who want high capital growth. Substantial year-to-year fluctuations are acceptable in exchange for a potentially higher return.

Your interests

FICA documents required

  1. Copy of your ID or passport — certified
  2. Proof of address — not older than 3 months
  3. Proof of bank details — not older than 3 months
  4. Tax number — any SARS doc or IRP5

Kindly note that in order to open your account we require originals or certified copies of the above documents. Courtney Capital is an Authorised Financial Services Provider under license number 43057.

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