No February Investor details. Surname First name(s) Date of birth ID number (Passport number if foreign national) Income tax number

Transcription

1 No February 2014 etirement Annuity Fund application Please complete this fm if you wish to become a member of the Allan Gray etirement Annuity Fund. Allan Gray Investment Services Proprietary Limited, an approved Fund administrat and authised administrative financial services provider, is the Administrat. 1. Imptant infmation 1. You will need an investment overview to complete this fm. This is available from your financial adviser the Client Service Centre at Based on Exchange Control egulations and the Pension Funds Act, certain unit trusts are subject to availability. Availability can be confirmed with the Client Service Centre. 3. Please complete all relevant sections of this application in der to process this investment. 4. Please read the Conditions of Membership that apply to this investment. This is available from your financial adviser, the Client Service Centre at 5. Please fax the required documents in the checklist below to the Client Service Centre at (0) instructions@allangray.co.za 6. The Administrat will only process this application when all required documents are received and once the money reflects in the Allan Gray etirement Annuity Fund bank account. 7. If you are requesting a unit transfer please ensure that the: - rules of the transferring fund allow this - unit trusts you select and its class are available from Allan Gray at the time of the transfer. If not, you may switch to a unit trust class that is available befe the transfer is completed. Please arrange this with your current fund. Document checklist Completed etirement Annuity Fund application (pages 1-6 of this fm) Copy of your South African bar-coded ID, valid passpt (if feign national) birth certificate (if min) Proof of your bank details (e.g. cancelled cheque bank statement) Proof of bank deposit / transfer into the Allan Gray etirement Annuity Fund bank account Where a unit transfer is required, please provide a recent statement of your investment If a representative is acting on behalf of the invest, we need the following: Proof of authity (e.g.power of attney) Copy of South African bar-coded ID valid passpt (if feign national) 2. Invest details First name(s) Date of birth ID number (Passpt number if feign national) Income tax number / / / esidential address d d / m m / c c y y Country of birth Postal address If the same as above, please tick this box. Business address Page 1 of 6

2 Telephone (h) Fax Please provide your address if you require online access, if you prefer communication. Secure online access I want secure online access to my investments Yes No If yes, the online account will be activated within two business days after processing of this application. If a legal guardian is acting on behalf of the invest, he/she will be given online access to this investment. Communication choice Allan Gray sends two types of communications: 1. Transaction confirmations: Every time we receive an instruction on your account we will send a transaction confirmation containing details of the completed instruction. 2. Quarterly statements and other communications relating to your account. Please indicate how you would like to receive these: Post If you have a financial adviser, you may choose to have your communication sent to you, your financial adviser to both. 1. Send transaction confirmations to: Me My financial adviser Both If no selection is made we will send transaction confirmations to both you and your financial adviser. 2. Send my statements and other communications to: Me My financial adviser Both Telephone (w) If no selection is made we will send these communications to you only. Please note that your annual benefit statement will be sent to you only. Person acting on behalf of the invest Please insert name of legal guardians persons with a power of attney to act on behalf of this invest. First name(s) Date of birth d d / m m / c c y y elationship ID number (Passpt number if feign national) esidential address Cell Telephone (h) Cell Telephone (w) Please provide your address if you require online access, if you prefer communication. Secure online access I want secure online access to this investment Yes No If yes, the online account will be activated within two business days after processing of this application. 3. Contribution details Investment amount The minimum lump sum contribution is per account. The minimum regular monthly contribution is 500 per month. egular contributions are restricted to a maximum of per contribution. Lump sum contribution egular contribution Investment allocation The selected combination of unit trusts must be egulation 28 compliant. Many of the unit trusts that members can select already comply with this requirement. Please see the latest Allan Gray Investment Platfm fund list to confirm your selection of unit trusts and which class and fee structure applies. What is egulation 28? These are the guidelines that set, amongst other things, the maximum exposures that retirement fund savings may have to various asset classes, f example: 75 in equities, 25 in property and 25 in feign assets. Page 2 of 6

3 How to check if your investment is egulation 28 compliant After submitting this instruction an administrat will contact you if your investment is not compliant. Alternatively, please use the egulation 28 calculat on contact your financial adviser, our Client Service Centre on us at to confirm whether your selection is compliant. Unit trust name You may phase-in your lump sum contribution. The amount to be phased in must be me. Do you require a phase-in? Yes No If yes, please attach a completed 'Phase-in instruction' to this application. If you select a unit trust with a fixed financial adviser fee, please complete the 'Fixed financial adviser fee' fm. These fms are available from your financial adviser, the Client Service Centre at Preferred fee unit trust You may choose to have your annual administration and annual financial adviser fees deducted from your Allan Gray Money Market Fund. This will be known as your preferred fee unit trust. Do you require a preferred fee unit trust? Yes No If the preferred fee unit trust does not have sufficient funds to pay fees, the Administrat will: 1. Deduct fees from the unit trust(s) where the fees have accrued, 2. If there is an insufficient balance in that unit trust the Administrat will deduct fees proptionately from the remaining unit trusts with balances. 4. Payment details Will this be a unit transfer? Yes No Unit transfers are subject to the rules of the transferring fund. Estimated amount Transfer from a pension provident fund Transfer due to pension interest in a divce der Transfer from another retirement annuity fund If you are transferring from another retirement fund, please complete the 'Transferring fund details' section below. Transferring fund details egistered name egistration number Policy number Contact telephone number Source of contribution Existing Allan Gray Account Transferring fund Bonus Savings Salary Other (please specify ) Unit trust class Lump sum contribution egular contribution Page 3 of 6

4 Method of payment Cheque deposit Electronic / Internet transfer Electronic collection by the Administrat Debit der 5. Bank debit authity I authise the Administrat to draw direct debits against the bank account below. Bank accountholder details Name of accountholder Name of bank Branch name Account number Type of account Electronic collection by the Administrat Total amount All cheques must be endsed as non-transferable and deposited directly into the Fund's bank account. Units bought with cheque deposits can only be disinvested after 14 days. Electronic / internet transfers may take up to two days to appear in the Fund's bank account. This is only available f lump sum contributions. Electronic collection is restricted to a maximum of per day. The Administrat will debit your account within two business days of receiving the application fm and all relevant documents. If your investment amount exceeds we will debit your bank account in multiples until we have collected the full amount. Multiple debits may result in additional bank charges. Your investments will be processed, proptionately across the unit trusts you have selected once each collection has occurred. Please specify the amount in the 'Bank debit authity' section below. Units bought with a direct debit can only be disinvested after 32 days. Please complete the 'Bank debit authity' details section. Units bought with a debit der can only be disinvested after 32 days. Current Transmission Savings Branch code Debit der details Total amount commencing on 1st 15th of m m / c c y y Debit ders are applied on the first the 15th of each month. If the selected day falls on a weekend public holiday it will be effective on the next business day. The cut-off f all debit der notices to be processed in a particular month is by 14:00, three business days befe the selected day. If you wish to increase your contribution annually, please select an escalation rate below: Escalation rate per annum If no escalation rate is completed a 0 escalation will be applied If the bank accountholder is a third party individual, a copy of their South African bar-coded ID and the proof of bank account is required. If the bank account holder is a third party legal entity we require proof of bank details, copies of all the signaties' identity documents and either a copy of the resolution of signaties signed by all signaties a letter from the bank listing the authised signaties on the account. Signature of bank accountholder Date d d / m m / c c y y 6. The Fund's details Allan Gray etirement Annuity Fund FSB egistration Number 12/8/37186/ SAS approval number 18/20/4/41566 Bank account details Cheque deposits, electronic transfers and internet transfers should be made to the bank account below, also see the crect reference number to use f the Administrat to identify your money. Electronic transfers may not reflect immediately. If you have selected to pay via electronic transfer, certain banks list 'Allan Gray etirement' as a pre-approved beneficiary. Account name: Allan Gray etirement Annuity Fund Bank: First National Bank Branch: Global Transactional Services Cape Town Branch code: Account type: Current Account number: eference number: South African residents - Your 13 digit South African ID number/feign nationals - Your passpt number Page 4 of 6

5 7. Details of dependants If there are me dependants, please attach a signed copy of this section to the application fm. Please refer to the 'Nominate Beneficiaries' section in the Conditions of Membership f me infmation. Date of birth d d / m m / c c y y Address and amount spent on dependant per month elationship Date of birth d d / m m / c c y y Address Contact telephone number and amount spent on dependant per month elationship Date of birth d d / m m / c c y y Address Contact telephone number and amount spent on dependant per month elationship Contact telephone number 8. Beneficiary nominations You may nominate beneficiaries to receive the benefit on your death. Legislation requires the Trustees to use their discretion when allocating a death benefit. Please refer to the Conditions of Membership f me detail. You need to change this as necessary when your circumstances change. If you are already a Member of the Fund, this nomination will apply to all your investment accounts in the Fund. Please attach a letter of explanation to this application fm if there are any special facts that you would like the Trustees of the Fund to take into account. If there are me beneficiaries, please attach a signed copy of this section to the application fm. Total number of beneficiaries elationship Benefit ID number (Passpt number if feign national) elationship ID number (Passpt number if feign national) Benefit elationship Benefit ID number (Passpt number if feign national) elationship Benefit ID number (Passpt number if feign national) Page 5 of 6

6 If you wish to nominate a trust other legal entity please complete the details below: Name egistration Master's reference number Name egistration Master's reference number Benefit 9. Financial adviser details If you have a financial adviser, please complete the section below: Full name and surname Practice name (FSP) Financial adviser code Adviser assistant dealing with this transaction I confirm that this financial adviser, as authised representative of the FSP above, is my appointed financial adviser. Negotiable financial adviser fees I agree to the following negotiated fees on this and all future transactions unless otherwise specified: Please specify the percentage (excluding VAT). Initial. Maximum 3.0 (excluding VAT) deducted pri to each investment being made. If it is agreed that no fee is payable, please insert 0. Where the annual fees are me than 0.5, fees are capped at 1.5. Initial fees are not paid on transfers from another etirement Annuity Fund in terms of Section 14 of the Pension Funds Act, Annual. Maximum 1.0 (excluding VAT) of the investment account. Where the fee is me than 1.5, the maximum annual fee is 0.5. If no annual fee is payable, please insert 0. Discretionary mandate declaration This section is only applicable if the FSP above holds a 'Categy II' license with the FSB and is therefe an approved discretionary FSP. I confirm that I have entered into a mandate with the above approved discretionary FSP. Yes No Benefit egistration Master's reference number Benefit Name I agree and understand that in terms of the mandate the FSP may give Allan Gray investment instructions directly and I authise Allan Gray to accept all instructions submitted by the FSP on my behalf. Signature of invest Date d d / m m / c c y y Financial adviser FAIS declaration 1. I have made the disclosures required, in terms of the Financial Advisy and Intermediary Services Act 37 of 2002, to the invest. 2. I have explained all fees that relate to this investment to the invest. I understand and accept that the invest may instruct the Administrat to cancel my fees at any time. Signature of financial adviser Date d d / m m / c c y y 10. Invest declaration 1. I confirm that all infmation provided in this fm and all other documents signed by me in connection with this application, whether in my handwriting not, is crect. 2. I am responsible f the accuracy and completeness of all answers, statements other infmation provided by me on my behalf. 3. I have not received advice from the Administrat in respect of this application. 4. I confirm that the Administrat may accept instructions in the prescribed fmat by facsimile via other electronic means. 5. I confirm that the Administrat may accept instructions from my financial adviser any authised third party who has been appointed and authised by me in writing. 6. I confirm that my appointed financial adviser will have access to my investment details via the secure section of the Allan Gray website via a secure electronic channel at my adviser's request. 7. I have read and understood the investment overview. The version number is compulsy f the application to be processed. Investment overview version number 8. I have read, understood and agree to the Conditions of Membership. Signature of invest Date d d / m m / c c y y Page 6 of 6 Allan Gray Proprietary Limited is an authised financial services provider.

7 Invest declaration / recd of advice: isk profiler: I have completed the 5 questions on the Investonline.co.za risk profiler questionnaire by myself and understand what my personal client risk profile tolerance level f unit trust investment risk is; and understand that this is the recommended risk profile f me to select an Investonline.co.za pre-determined risk-profiled unit trust ptfolio. Clients investment objective: I have a medium to long-term capital growth objective with an investment time hizon of months and longer. Financial situation: I have little debt, want to create wealth in the medium to long term and am prepared to accept a certain level of risk and volatility accding to my risk profile. Client s product experience: I have been on Investonline.co.za s website and have read the various tutials on unit trusts, the relevant unit trust fund fact sheets of the Investonline.co.za recommended ptfolio and have familiarised myself with the mechanics of how unit trust investments operate and am now comftable to invest my funds into a dedicated ptfolio. Products considered: I have done the Investonline.co.za risk profiler and have considered all of the recommended unit trust ptfolios listed and have selected the ptfolio best suited to my risk profile, financial needs and my long-term investment objectives and goals and have carefully read the unit trust fund fact sheets on each of the funds in my recommended ptfolio. Investonline.co.za s motivation f recommendation: I understand that the Investonline.co.za team have significant experience with compiling unit trust ptfolios and that they have recommended a diversified range of funds in their risk profiled ptfolios and have labelled each ptfolio with the respective risk rating from 1 (low) to 5 (high). Imptant infmation highlighted to the client: The imptant infmation regarding investment risk, reasons f diversification, liquidity, period of investment, tax status of unit trusts and all the fees involved regarding unit trusts have been highlighted to me the client, clearly via the website. Guarantees / risk profile / terms & conditions: I understand that my funds will NOT be guaranteed under any circumstances and that I have read the definition of the risk profile that I qualify f via the Investonline risk profiler and have read each one of the unit trust fund fact sheets that I have invested into and have signed them off. Financial needs analysis: I understand the imptance of a full financial needs analysis, however, due to insufficient time; I have postponed this event to a later date, by arrangement. Own unit trust ptfolio: I understand that if I elect to choose my own ptfolio of unit trust funds and NOT one of the Investonline pre-determined risk profiled ptfolios then I do so entirely at my own risk. This client declaration signed at on this day (month) of (year) Client signature: Client name: [Pg 1 of 3] Fax ( / 16 / 17) (invest@investonline.co.za) along with your application documentation.

8 CLIENT SEVICE AGEEMENT Between (Full Name & I.D. number of client) And INVESTONLINE.CO.ZA the online website division of Tchway Investments (Pty) Ltd. FSB authized financial services provider - FSP In accdance with the Financial Adviss and Intermediary Services Act and the General Code of Conduct f Financial Services Intermediaries it is our duty as an authized financial services provider to infm you, as a valued client of our business, of some of your principal rights in terms of the afementioned legislation: 1.1 As a client of the financial services industry you have a right to a full analysis of your financial objectives befe entering into any financial services related transaction. 1.2 As an authized financial services provider we are compelled to perfm this analysis with the necessary due skill, care and diligence and to then in consultation with you priitize your needs and provide you with objective advice to address these needs. 1.3 At Tchway Investments (Pty) Ltd. T/A Investonline.co.za FSP we embrace these requirements as being in the interest of our valued clients and the financial service industry as a whole. As a client you do however have the right to specify which needs you require to be focused on. 2.1 We respect this right, but should you decide to consult with us only regarding a certain need, we require that you take full cognizance and responsibility of the following when providing focused advice there may well be needs in your personal financial planning which require me urgent attention than the need being addressed at your request; and that therefe there may well be limitations on the appropriateness of the advice being provided. 2.2 It is your explicit responsibility to ensure that the advice provided is appropriate given your current financial situation. At Tchway Investments (Pty) Ltd T/A Investonline.co.za we provide financial advice and intermediary services regarding the following aspects of financial planning: ISK POFILED DIVESIFIED UNIT TUST POTFOLIOS 3. By selecting any option other than a full financial needs analysis you hereby accept the responsibilities and risks associated with focused advice as set out in point 2 above as well as the following: 3.1 You acknowledge that you have been made aware of the services provided by Investonline.co.za and have declined advice regarding the other planning services offered by Investonline.co.za. 3.2 You acknowledge that due to you exercising your rights as a client of the financial services industry that you might well have needs that require urgent addressing, but have chosen to not have them addressed at this stage due to insufficient time to complete a full financial needs analysis 3.3 That you have voluntarily exercised your right and have not been unduly influenced by Investonline.co.za - to do so and are aware of your right to a full needs analysis and that Investonline.co.za has encouraged you to have such an analysis perfmed at a later date by arrangement. 3.4 In all instances you as a client have been infmed and have acknowledged that any analysis of your personal financial situation can only be perfmed if you as client provide all relevant infmation to Investonline.co.za. 3.5 In all instances you have been infmed and are aware that the accuracy of any analysis is critically dependent on the infmation provided by you to Investonline.co.za - in particular reference to the completion & accuracy of the isk Profiler tool. 3.6 You have been infmed of Investonline.co.za s status as an accountable institution in terms of the Financial Intelligence Centre Act and its responsibilities in term of this act. 3.7 You hereby certify that any funds that Investonline.co.za is required to deal with on your behalf is not obtained from an illegal source and that you are not involved in any money laundering activities. This client declaration signed at on this day (month) of (year) Client signature: Client name: [Pg 2 of 3] Fax ( / 16 / 17) (invest@investonline.co.za) along with your application documentation.

9 CLIENT DECLAATIONS It is of utmost imptance that you read this section carefully and understand it fully. All 10 client declarations must be marked by the client to indicate understanding & acceptance. I confirm that contact stage disclosure infmation, setting out Investonline.co.za s full particulars, their experience and services offered, has been provided to me via the Investonline.co.za Website. I confirm that I required the Financial Advis (Investonline.co.za) to render the financial services set out in the Client Service Level Agreement, a copy of which has been provided to me. Where I elected not to take up the financial advis s recommendation of a full financial needs analysis, I was advised and understand that I should take particular care to consider whether and ensure that the product (s) purchased selected by me is/are appropriate to my needs, objectives and circumstances. CLIENT AGEES If I did not provide the financial advis with any infmation requested, there was insufficient time to conduct an analysis, I confirm that: a. I clearly understand that there may be limitations on the appropriateness of the advice provided, and b. I will take particular care to consider on my own whether the advice is appropriate considering my own financial objectives and current financial position. I understand that the accuracy of a needs analysis is dependent on the infmation provided to obtained by the financial advis. The advice furnished and product recommendations made by the financial advis are based largely on the infmation I provided to the financial advis via the Investonline.co.za website risk profiler. I thus understand that material non-disclosures and misrepresentations could result in inappropriate product(s) being recommended and purchased by me. In accdance with the Financial Adviss and Intermediary Services Act and the General Code of Conduct f Financial Services Intermediaries, it is our duty as an authized financial services provider to infm you, as a valued client of our business, of some of your principal rights in terms of the afementioned legislation: CLIENT AGEES I confirm that I was provided with copies of all unit trust fund fact-sheets & marketing brochures on the Investonline.co.za website f the product(s) selected. All material terms and conditions of the product(s) selected were explained to me pri to any decision made. I have been infmed of and understand all costs, charges, penalties, liquidity limitations and tax implications where applicable. I understand the risks associated with the product(s) and / underlying fund(s) selected. I understand that there is NO GUAANTEE with unit trusts. I confirm that all documents signed by me were fully completed pri to my signing them. I have also read and signed off the relevant unit trust fund fact sheets that I have invested my money in and accessed these fund fact sheets under the Investonline.co.za "unit trusts available" tab. I understand it is my responsibility to each of the unit trust fund fact sheets and fax/ these to Investonline.co.za as part of their FAIS Act compliance requirements documentation. Notwithstanding the infmation provided by Investonlione.co.za, I acknowledge that I have an obligation to familiarize myself with the terms and conditions of the product(s) that I have purchased which are available on the Investonline.co.za website - under terms and conditions. It is the duty of the client to infm Investonline.co.za of any changes to their factual circumstances as and when they occur. This client declaration signed at on this day (month) of (year) Client signature: Client name: [Pg 3 of 3] Fax ( / 16 / 17) (invest@investonline.co.za) along with your application documentation.

10 UNIT TUSTS MADE EASY.co.za CONGATULATIONS YOU AE NOW AN INVESTONLINE.CO.ZA CLIENT FAX / the following documents to Investonline.co.za to start your Investment: 1. Signed copy of Allan Gray application fm (4 pages) 2. Signed copy of Investonline ecd of Advice (3 pages) 3. Clear copy of your Identity Document (I.D.) (1 page) 4. Clear copy of Utility bill reflecting your physical address (1 page) 5. Proof of your bank details f Allan Gray to do the debit (1 page) (i.e. copy of cancelled cheque bank statment) above documents to: invest@investonline.co.za Fax above documents to: Allan Gray Bank Details f Lump sum deposits Cheque deposits and electronic/internet transfers should be made to the bank account below, also see the crect reference number to use f the Administrat to identify your money. If you have selected to pay via electronic transfer, certain banks list 'Allan Gray Platfm' as a pre-approved beneficiary. Account name: Bank: Branch: Branch code: Account type: Account number: eference number: Swift code: Allan Gray Investment Services Proprietary Limited First National Bank Global Transactional Services Cape Town Current South African residents - Your 13 digit South African ID number / Feign nationals - Your passpt number FINZAJJ