I have been identified as not being allowed to provide “financial advice or insurance advice” therefore I am not a “Representative” as defined in terms of FAIS. I hereby undertake to refrain from giving “financial advice or insurance advice”, discussing the merits of the products or comparing to other financial product. I fully understand that failure to adhere to this undertaking may result in appropriate action against me. I hereby acknowledge the abovementioned points.

I acknowledge that any Personal Information supplied to UIA in terms of this form is provided according to the Applicable Laws. Unless consented to by yourself, we will not sell, exchange, transfer, rent or otherwise make available your Personal Information to any other parties and you indemnify UIA from any claims resulting from disclosures made with your consent. Such Personal Information provided (voluntarily, unconditionally, and specifically) will be utilised by UIA or by any appointed third parties, on our behalf, and will be kept for such period as legislated according to the Applicable Laws.