Name *

ID Number *

Surname *

Contact *

Fax Number

Email *

Registration Number

Registered Address

Postal Address

Bank

Account Name

Account Number

Branch

Branch Code

VAT Number

GWK Account Number

Farm Name:

Farm Town:

Farm Municipal District:

Farm Province:

Grazing (ha):

Irrigation (ha):

Water Right (ha):

Total Size (ha):

Type of Farming

Owners of unit:

Title Deed:

Farm Name:

Farm Town:

Farm Municipal District:

Farm Province:

Grazing (ha):

Irrigation (ha):

Water Right (ha):

Total Size (ha):

Type of Farming

Owners of unit:

Title Deed:

Farm Name:

Farm Town:

Farm Municipal District:

Farm Province:

Grazing (ha):

Irrigation (ha):

Water Right (ha):

Total Size (ha):

Type of Farming

Owners of unit:

Title Deed:

Are you a full time farmer?

Which GWK commercial branch is situated near your farm?

What producer’s goods do you intent to purchase from GWK?

Which products do you intent to supply to GWK?

Name

Surname

ID Number

Residential Address

Name

Surname

ID Number

Residential Address

Name

Surname

ID Number

Residential Address

Name

Surname

ID Number

Residential Address

Name

Surname

ID Number

Residential Address

Name

Surname

ID Number

Residential Address

Name

Surname

ID Number

Residential Address

Name

Surname

ID Number

Residential Address

Name

Surname

ID Number

Residential Address

Name

Surname

ID Number

Residential Address

You are requested to take note of the following: *

1. Shares in GWK may only be negotiated according to the mechanism approved by the Board. 2. Ordinary shares are allotted and negotiated in lots of 200. 3. Ordinary shares are allotted and negotiated at par value (R1,00 per share). 4. Should the Board approve your application shares will either be allotted to you or negotiated to you by way of the share-negotiation mechanism. 5. Before your application will be considered, you are required to deposit an amount of R200,00 which will either be applied for the purchase of shares, or be returned to you should your application not be successful. Bank Detail: Standard Bank Account name: GWK Beperk Tak / Branch: 050003 (Douglas) Rekening/ Account: 041663438 6. The acquisition of shares does not automatically entitle you to credit facilities from GWK. 7. Share certificates are not issued automatically. You may make an arrangement with the Secretary to collect your certificate. 8. By submitting this application, you submit to the Statutes / Memorandum of Incorporation of GWK and the terms of the Producer’s Agreement. 9. Furnishing an e-mail address implies that you give your consent to receiving financial statements via e-mail.

You must agree to terms and conditions

VAT certificate (Vat 103) for the Trust

ID copies for all Trustees

Deed of Trust

Letter of Authority from the Master of the High Court

VAT certificate (Vat 103) for the Association

ID copies for all Members

Association Documents

VAT certificate (Vat 103) for the Partnership

ID copies for all Partners

Partnership agreement and distribution

VAT certificate (Vat 103) for the Company

ID copies for all Directors

Certificate of Incorporation

Company Documents from CIPC

VAT certificate (Vat 103) for the CK

ID copies for all CK Members

Certificate of Incorporation

CK Documents from CIPC

VAT certificate (Vat 103)

ID Copy for the individual

Name and surname

I declare that I am a:

Authorisation