POPI Consent
PROTECTION OF PERSONAL INFORMATION ACT 4 of 2013 (POPIA) -POPI DECLARATION
CLIENT CONSENT FORM
We understand that your personal information is important to you and that you may be apprehensive about disclosing it.
Your privacy is just as important to us and we are committed to safeguarding and processing your information in a lawful manner. We also want to make
sure that you understand how and for what purpose we process your information.
You can request access to the information we hold about you at any time and if you think that we have outdated information, please request us to update or correct it.
Purpose for Processing your Information
We collect, hold, use and disclose your personal information mainly to provide you with access to the services and products that we provide. We will only process your information for a purpose you would reasonably expect, including:
Providing you with advice, products and services that suit your needs as requested
To verify your identity and to conduct credit reference searches
To issue, administer and manage your insurance policies
To process insurance claims and to take recovery action
To notify you of new products or developments that may be of interest to you
To confirm, verify and update your details
To comply with any legal and regulatory requirements
Some of your information that we hold may include, your first and last name, email address, a home, postal or other physical address, other contact information, your title, birth date, gender, occupation, qualifications, past employment, residency status, your investments,
assets, liabilities, insurance, income, expenditure, family history, medical information and your banking details.
Consent to Disclose and Share your Information We may need to share your information to provide advice, reports, analyses, products or services that you have requested.
Where we share your information, we will take all precautions to ensure that the third party will treat your information with the same level of protection as required by us. Your information may be hosted on servers managed by a third-party service provider, which may be located outside of South Africa.
I hereby authorise and consent to the organisation sharing my personal information with the following persons:
All the employees of Iron Horse Risk Consultants cc and/or insurance companies, underwriters, investment managers and fiduciary
agents associated with Iron Horse Risk Consultants cc endeavor to provide clients with proper advice and services.
Name & Surname: ________________
ID Number: ____________________
Signature Date_________________
Complaints Resolution
In the event of a complaint regarding the advice given and or the product provided, this must be submitted in writing to the Compliance Officer of the FSP: Compliance
Officer : Leona Prinsloo. FSB Ref Nr: 4920, 149 Kristal Avenue, Lyttelton Manor Ext 3, Centurion, 0157. Fax Nr: 0880126646257. The service provider does not hold
any shares in the insurer. The service provider holds Personal Indemnity underwritten by Chartis Iron Horse Risk Consultants cc is a juristic representative of Tshenolo Insurance Brokers (Pty) Ltd An Authorised Financial Services Provider FSP No: 40763