Tax Emigration Questionnaire

1

Residency & Departure

Questions 1–3 · Physical departure and intention

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Q1What is the exact date you physically left South Africa with the intention not to return?Key *

Are you certain of this date? *

Yes, confirmed Approximate only Uncertain

Q2Did you leave South Africa with the clear intention of making the foreign country your permanent home?Key *

Yes — permanent relocation from the outset No — departure was initially temporary Intention evolved over time

Please describe the circumstances and when your intention changed:

Q3How many days have you spent in South Africa since your departure date? (Per tax year if possible)

South African tax year runs 1 March – 28/29 February

⚠ High SA day-count may indicate continued tax residency under the physical presence test. Please flag for detailed review.

2

Foreign Country Status

Questions 4–6 · Visa, tax residency & DTA

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Q4What country have you emigrated to, and what visa / permit do you currently hold?

Country of Emigration *

Visa / Permit Type *

Q5Have you obtained formal tax residency in the new country?Key *

Yes No In process

Do you have a Tax Residency Certificate (TRC) from the foreign revenue authority?

Yes — can provide No Applied for

Q6Is there a Double Tax Agreement (DTA) between South Africa and your new country of residence? *

Yes No Not sure

Additional notes on DTA applicability:

3

Ties to South Africa

Questions 7–10 · Property, business, family & social ties

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Q7Do you still own property in South Africa? *

Yes No

How is the property currently used?

Rented out to third parties Occupied by family members Vacant Available for personal use

Property address(es):

Q8Do you still have any business interests, directorships, investments, or employment income in South Africa? *

Yes No

Please describe (business name, nature, your role):

Directorship / shareholding in SA company SA employment income SA investment portfolio (JSE, unit trusts) SA rental income Other SA-sourced income

Q9Do any immediate family members (spouse or minor children) still reside in South Africa?Key *

Yes No

Please specify who remains in South Africa:

Spouse / partner Minor children (under 18) Adult children Other dependants

Is there a plan for them to join you abroad? If so, when?

Q10Do you still hold memberships to clubs, gyms, professional associations, or other social institutions in South Africa?

Yes No

Please list all active memberships:

4

Assets & CGT Exposure

Questions 11–12 · Worldwide assets and tax filing status

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Q11What worldwide assets did you hold on the date of your departure from South Africa?CGT *

This is required to assess the deemed disposal / CGT exit charge under s9H of the Income Tax Act.

Please indicate which asset classes apply: *

SA listed shares (JSE) Unit trusts / CIS Foreign listed shares SA immovable property Foreign immovable property Cryptocurrency Business interests / unlisted shares Loan accounts Other foreign assets

Please provide approximate values as at departure date (ZAR or foreign currency):

Do you have a base cost / cost statement for these assets? *

Yes — available Partial records only No records

Q12Have you filed all outstanding SA tax returns up to and including the year of departure?CGT *

Yes — fully compliant Some returns outstanding No — multiple returns outstanding Unsure

Which tax years are outstanding?

5

Retirement Funds

Question 13 · RA, pension & provident funds

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Q13Do you have any retirement annuities, pension, or provident fund savings in South Africa? *

Yes No

Retirement Annuity (RA) Pension Fund Provident Fund Preservation Fund Living Annuity

Have contributions to these funds been discontinued since departure?

Yes — all contributions stopped Some still active Contributions still ongoing

Approximate total value of SA retirement funds (ZAR): Fund administrator / product provider names:

6

Prior Compliance & SARS Notification

Questions 14–15 · Previous financial emigration & SARS status

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Q14Did you previously complete financial emigration through the South African Reserve Bank (SARB) prior to March 2021?Key *

Yes No Unsure

Important: SARB financial emigration (pre-March 2021) changed your exchange control status but did NOT automatically cease your SA tax residency. A formal cessation via the RAV01 process with SARS may still be required.

Do you have documentation of the SARB emigration?

Yes — can provide No

Approximate date of SARB financial emigration:

Q15Has SARS been notified of your emigration in any form? *

Yes — indicated on ITR12 Yes — RAV01 submitted No — this is first formal notification Unsure

Please provide details of any prior SARS communication or notifications:

7

Additional Information

Any other relevant details for your advisor

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—Is there anything else you believe is relevant to your tax emigration that has not been covered above?

—Declaration

I confirm that the information provided in this questionnaire is accurate and complete to the best of my knowledge. I understand that my advisor will rely on these answers to determine the appropriate course of action for my tax emigration and that any omissions or inaccuracies may affect the outcome of the process.

I confirm the above declaration

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