Avalon Junior ISA APPLICATION FORM

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2 Part A: Applicant details (and registered contact for the Junior ISA) NB. The Applicant must be a person with parental responsibility for the child (if the child below is years old they may also be the Applicant). Please use black ink and BLOCK CAPITALS throughout. o you already have an Avalon product? No es Please give your client reference number: our title (r/rs/iss /s/other): Forename(s) in full: Surname: our permanent UK residential address: Postcode* aytime telephone no: Evening telephone no: (if different): address: I apply to open an for: r Child s title (if any): iss rs Forename(s): Surname: Child s address: Postcode* Child s date of birth: Child s National Insurance (NI) number: OR The Child stated above does not have an NI number: It is an H Revenue & Customs requirement that you supply the Child s date of birth and National Insurance number, if you have one. Type of Junior ISA applied for: Stocks and Shares It is important to note that the Child stated above will be the beneficial owner of the investments held in the. 2

3 Part B: Subscription details I apply to subscribe for an for the tax year ending and, where applicable, each subsequent year as detailed below. 5 The minimum total lump sum/transfer investment is 25 and the minimum monthly payment is 5. Lump sum (ax,128 pa) onthly (Not available for investment trusts) (ax 3 pm) Transfer Approx (If transferring a Child Trust Fund (CTF), please also complete the CTF Transfer Request Form) Please ensure all cheques are made payable to EISL Client oney Account for a Stocks and Shares ISA. 2 of all subscriptions received will be used as a cash reserve to fund ongoing charges. If you have selected regular monthly payments be sure to complete the irect ebit instruction. ou may make the first payment by cheque. Please give details below of how you would like your Junior ISA invested. Part C: Investment details Please give details below of how you would like your Junior ISA invested. The minimum investment in any one fund is: - 1 for lump sum/transfer investments - 1 for monthly payments Name of Fund anagement Company Full name of individual fund/investment trust of lump sum investment of monthly payment Total must be 1 3

4 Part : eclaration Please read this section carefully before signing and dating the declaration. Important - ata Protection Act Embark Investment Services Limited will use the personal information you have given to provide and service the ISA you have applied for. The use of your personal data and a description of the general party(ies) to whom we may disclose it can be found in Embark Investment Services Limited s registration and the ata Protection Register. ou can apply for details of information held by us, although we may have to charge a small fee. If you find any of this information to be incorrect it is your right to require us to correct them. If you do not wish to receive paper valuations and transaction statements please tick this box. I declare that: I am 16 years of age or over, or I am the child/i have parental responsibility for that child (delete which does not apply). I will be the registered contact for the Junior ISA. The child is resident in the UK, or is a UK Crown servant, a dependant of a UK Crown servant or is married to/in a civil partnership with a UK Crown servant. I have not subscribed and will not subscribe to another Junior ISA of this type for this child. I am not aware that this child has another Junior ISA of this type. I am not aware of other Junior ISA subscriptions that will result in this child exceeding the annual limit. I confirm I have read and understood the Key Features, Terms & Conditions and Key Investor Information ocument. I will not knowingly make subscriptions to Junior ISAs for this child that will result in the subscription limit being exceeded. I understand that my identity will be verified for anti money laundering purposes. This may include obtaining information about me from a credit reference agency and this information will only be used for verification of my identity. I authorise Embark Investment Services Limited: to hold the child s subscriptions, Junior ISA investments, interest, dividends and any other rights or proceeds in respect of those investments and cash, and to make on the child s behalf any claims to relief from tax in respect of Junior ISA investments. The Terms and Conditions are those upon which we intend to rely. For your own benefit and protection you should read these terms carefully before signing this eclaration. If you do not understand any point please ask us for further information. I declare that this application has been completed correctly to the best of my knowledge and belief. Applicant s signature ate

5 Instruction to your bank or building society to pay by irect ebit Please fill in the whole form using a ball point pen and send it to: Embark Investment Services Limited The Old Chapel 7 Long Street Tetbury GL8 8AA Service user number 3 8 Name(s) of account holder(s) Reference Instruction to your bank or building society Bank/building society account number Please pay Embark Investment Services Limited irect ebits from the account detailed in this Instruction subject to the safeguards assured by the irect ebit Guarantee. I understand that this Instruction may remain with Embark Investment Services Limited and, if so, details will be passed electronically to my bank/building society. Branch sort code Name and full postal address of your bank or building society To: The anager Bank/building society Signature(s) Address ate Postcode Banks and building societies may not accept irect ebit Instructions for some types of account This guarantee should be detached and retained by the payer The irect ebit Guarantee This Guarantee is offered by all banks and building societies that accept instructions to pay irect ebits. If there are any changes to the amount, date or frequency of your irect ebit Embark Investment Services Limited will notify you 1 working days in advance of your account being debited or as otherwise agreed. If you request Embark Investment Services Limited to collect a payment, confirmation of the amount and date will be given to you at the time of the request. If an error is made in the payment of your irect ebit, by Embark Investment Services Limited to your bank or building society, you are entitled to a full and immediate refund of the amount paid from your bank or building society. If you receive a refund you are not entitled to, you must pay it back when Embark Investment Services Limited asks you to. ou can cancel a irect ebit at any time by simply contacting your bank or building society. Written confirmation may be required. Please also notify us. 5

6 Independent Financial Adviser s details This section should be completed by your Independent Financial Adviser (IFA). IFA s details Contact Name: Company Tel no: Name of Firm: Company Fax no: Company Address: Company Network (if applicable): Postcode* With regard to the istance arketing irective please confirm what type of contract this is: istance Client agreed remuneration: Non istance Adviser Remuneration for establishing the arrangement For ongoing advice Either Either Of the initial contribution or transfer value OR An amount of Of the value of the investments each year OR An amount of ate: Print: FCA Number Signature: Please note the following important information: Embark Investment Services Limited does not give advice on the selection of investments and strongly recommends that you consult your Independent Financial Adviser before making investment decisions. Share/unit prices can go down as well as up. ou may not get back the full amount invested when the account is closed. Any tax reliefs referred to are those that currently apply and their value depends on your individual circumstances. Full details of the can be found in the Key Features document. Past performance is not necessarily a guide to future performance. Part E: Checklist Have you? Read the Key Features, Key Investor Information ocument and Terms and Conditions? Read the Application Form thoroughly, completed all relevant sections, signed and dated the form? Enclosed a cheque made payable to EISL Client oney Account if investing a lump sum or paying the first monthly contribution by cheque? Completed the irect ebit instruction if you are making regular monthly payments, and/or completed the separate Transfer Authority Form if transferring another Junior ISA into your? Included your child s National Insurance number if they have one? If they do not have a National Insurance number then please tick the box to say that they do not have one. Enclosed a completed Identity Verification Certificate. Part F: What to do now Thank you very much for taking the time to apply for a Junior ISA from Avalon. If you are making regular monthly payments, remember to detach and keep the guarantee. Keep the remaining literature safe for future reference. Please return your completed forms to: Embark Investment Services Limited, The Old Chapel, 7 Long Street, Tetbury, Gloucestershire, GL8 8AA 6

7 Web: Tel: Avalon is a trading name of Embark Investment Services Limited, a company incorporated in England (company number ). Embark Investment Services Limited is authorised and regulated by the Financial Conduct Authority (register number ). Registered office: Tyman House, 2 Regent Road, Leicester, United Kingdom, LE1 6J. 7 F JISA APP 5 APR17