NEDBANK Requester Details (Office Use) Employee Number Applicant / Employes Select Mentifcation Type Sumame Forenamets) Binh Date Gender LD Aseney? 0 Details 1 Diumber [] Passport Number External PIMS Request Form Request Owner Nationality Cellphone No mall Address Address Line 1 Address Line 2 Suburb cry Province Country code Application Details (Office Use) Type of Screening Job Description Job Requisition No Line Manager EmpINo Nedbank HREP Emp No [Appointing Branch Code Billing Branch Code [Unstructured Address [| Secondary Qualification Details County sued ‘Year Obtained Highest Grade Employment Category Regulatory Compliance Qualification Name ec /Cert Number subject C1 subject DiffrentSumame — [] Yes Symbol Percentage symbol Percentage1 subject Symbol Percentage 1 subject symbol Percentage subject Symbol Percentage C1 subject Symbol Percentage 1 subject Symbol Percentage 1 subject Symbol Percentage 1 subject Symbol Percentage Post Matric Qualifications sof Qualifcations [fF Quaifcation Type sraus Qualifeation oc /Cert Number Country sued Different uname [] Yes Qualification Type Status Qualifiation oc /Cert Number Country sued Different Surname [] Yes Qualification Type Qualifiation oc /Cert Number County sued Different uname [] Yer Qualification Type Qualifeation Doc /Cert Number Country sued DiferentSuiname ] Yer Required Documentation SignedindemnityForm — [] Yes Please note that these documents shouldbe atached wit the emall tthe PM department Arefeence number willbe generated and be eae backto you, Please ‘ecily thi reference number or any fate communion documents Print indemnity Form Print FormNEDBANK Consent and Indemnity Form Employer: NEDBANK LIMITED. ‘Authorised Agent: Position Applied For Surname: 1D / Passport / DOB: Forenames: Gender: (fullname and uname) of (adres) 1. have applied for employment from / am employed by Nedbank Limited (‘Nedbank’), in the capacity of 2. ive consent to Nedbank, or its authorized agent, Afisitch (ty) Ld, Managed Integrity Evaluation MIE) (collectively refereed to as "you") collect and process my persona information, including my fingerprints, name, surname, and ID number. This information can be shares with the South African Police Service (SAPS). understand that Afswitch and/or MIE dees not guarantee the accuracy ofthe information have provides 4. give consent to the Afswitch to provide my personal information including my criminal background, history, previous convictions, and any other relevant information, to you or Aiswitch and/or MIE. understand that you do not guarantee the accuracy ofthe information provided by the fis 4 agree to unconditionally indemnity and hold harmless you, the switch, ME their diectors, officers, members, employees, and the ‘government of South Ais, against any liablty that may arse from providing or relying on this information, except in cases of gross negligence by us, the SAPS or Aswitch andlor MI, ‘understand thatthe Afiswitch requires the following contions ‘3 Theinformation i provided only forthe purpose of my potential or ongoing employment with your and b. Theinformation given to you or Afiswitch and/or ME wil be shared with me fr my comments before any decision is made regarding my potential employment or continuous employment with you. 6, ive consent to you and Afiswitch and/or MIE to forward the information to verficaion information suppliers acting an your behalf. ‘necessary, the information may be sent or transferred to foreign countries by electronic or ather means, to verify the information. Afiswitch andlor MIE and Nedbank’s verification information suppliers will alvays keep the information confidential and use tony forthe agreed purpose. 17, understand and accept that my potential emplayment /engoing employment with you requires trust and honesty, and may hancle your ‘or your clients’ cash or finances. Therefore, give consent for you to obtain a report from any credit bureau to ensure that Lam/remaina suitable candidate for employment ata financial institution, according to your policies and procedures. lalo consent to you verifying my educational qualifications, identity document, passport, driving license, professional employment record, Financial Advisory and Intermediary Services debarment, acts of cishonestyon the Register of Employee Dishonesty and the South African Fraud Prevention Scheme, and any other relevant information not specified here. You will keep any confidential information gathered and not esclose it Without my prior writen consent, unless legally required todo so 8, give consentfor you to use thir-party providers to abtai, store, and process my personal information, including my fingerprints, name, surname, address, ana 1D number, for background verfication checks. This includes storing the information in your database and Afiswitch andlor Ml's database. These checks may be done for any potential employment and ongoing employment with you.understand this process will include eesubmitting ay personal information curently inthe Afiswitcn and/or ME database. 9. understand that Afiswitch and/or MIE may share the information | have submitted with thir parties and that you have the ight to host this Information in your database or Aswitch andor MIE's database. Igive consent to Afiswitch andar MIE to share this information with third partes, but only for background verification checks elated to potential employment and ongoing emplayment.| understand this process ‘will inlude resubmiting any personal information currently in Afiswitch andor MIE database 10. unconditionally waive any andall claims against you that may arise from providing the information, unless such claims result from your negligence. Signed at: on: (place) loommvrrn Full Nam