Services
All Services
Debit Orders
DebiCheck
Creditor Payments
Salary Payments
Billing
Payment Gateway
Payment Methods
Payment Request
Payment Button
Subscription Billing
Split Payments
Retail Payments
Scan to Pay
Netcash Shop
Instant Funding
Risk Reports
Partners
Tools
Mobile App
Bank Confirmation
Converter
Logo Centre
Payflex Marketing Material
paymyway Marketing Material
1Voucher Marketing Material
About
Contact
Login
✕
Services
All Services
Debit Orders
DebiCheck
Creditor Payments
Salary Payments
Billing
Payment Gateway
Payment Methods
Payment Request
Payment Button
Subscription Billing
Split Payments
Retail Payments
Scan to Pay
Netcash Shop
Instant Funding
Risk Reports
Partners
Tools
Mobile App
Bank Confirmation
Converter
Logo Centre
Payflex Marketing Material
paymyway Marketing Material
1Voucher Marketing Material
About
Contact
Login
Source of Wealth Form
Δ
Comments
This field is for validation purposes and should be left unchanged.
Application Account number:
(Required)
Application Date:
(Required)
Month
Day
Year
Client / Associated Party name:
(Required)
I, the undersigned,
Full Names:
(Required)
First
Last
Identity Number:
(Required)
Do hereby declare and warrant in favour of Netcash (Pty) Ltd that the information provided below is correct and will advise Netcash of any change(s) in any of the information provided below. Source of Wealth refers to the activities that have generated the total net worth of the client that is, the activities that produced the client’s funds and property. Please select the option below that best describes your source of wealth.
Source of Wealth
(Required)
Asset swap
Business Income / Profits
Casino, lottery, betting winnings
Donation
Gift
Income and/or savings from employment
Inheritance
Maturing Investment
Loan
Passive Income (Dividends, Interest or Rental)
Pension Funds / Retirement Annuity Fund, Preservation Fund
Policy claim / Insurance payment
Sale of Property
Sale of Shares
Savings
Transfer from another Bank account or Financial Services Provider
Trust Donor
Other - third-party source with details of third-party Source of Wealth and funds. Other - relevant official documentation evidencing Source of Wealth and funds.
Please explain “Other” fully
Signed at
(Required)
on this day
(Required)
Month
Day
Year
Signature of Client / Associated Party
(Required)
Upload source of wealth support document
(Required)
Drop files here or
Select files
Max. file size: 60 MB, Max. files: 3.
✕
"
*
" indicates required fields
Δ
Instagram
This field is for validation purposes and should be left unchanged.
Name
*
Surname
*
Company
*
Merchant number
Email
*
Phone
*
Provide more information on your query here