Transfer request. Information sheet. When to use this form. What you need to do. Important information. (Series 1 Investment Options)

Transcription

1 Flexible Lifetime Investments (Series 1 Investment Options) Transfer request Information sheet When to use this form Use this form to transfer all or part of your units to another person or entity (this includes transfers by way of a gift). For assistance in completing this form, speak to your financial adviser or call customer service on Important information You should be aware that transferring your units to another person may have a capital gains tax effect. We recommend you discuss your own circumstances with your financial adviser or tax adviser before you decide to transfer your units. Note: If you re currently invested in a closed investment option, your units will have to be transferred into an investment option that is open to new investors. What you need to do Complete the attached transfer request form with details of the transferor(s)/original unit holder and transferee(s)/buyer and return to AMP. Note: The application form is to be completed by the transferee(s)/buyer(s). Mailing address: Flexible Lifetime Investments Reply Paid PARRAMATTA NSW 2124 Issue date: 13 August 2018 AMP Capital Funds Management Limited ABN , AFSL No Registered trademark of AMP Life Limited ABN of 2

2 This page has been left blank intentionally. Please keep this information sheet for your records don t return it with your completed form(s). 2 of 2 NS2889A 06/18

3 Flexible Lifetime Investments (Series 1 Investment Options) Transfer request Use this form to transfer all or part of your units to another person or entity (this includes transfers by way of a gift). For assistance in completing this form, speak to your financial adviser or call customer service on Please print in CAPITAL LETTERS and place a cross in any applicable boxes. 1. Fund details To Flexible Lifetime Investments: Fund name in full 2. Personal details continued Details of transferor / original unit holder 2 continued Client number Account name Number of units (in words) Account reference Details of transferee / buyer 1 Number of units (in figures) All holdings Title Date of birth Surname/Company/Partnership name 2. Personal details Details of transferor / original unit holder 1 Title Date of birth Surname/Company/Partnership name Given name(s) Given name(s) Tax File Number (TFN) OR Australian Business Number (ABN) Address for communications Client number Account reference Account name Suburb State Postcode Country Details of transferor / original unit holder 2 Title Date of birth Surname/Company/Partnership name Given name(s) Contact phone number Fax number address Mobile number Issue date: 13 August 2018 AMP Capital Funds Management Limited ABN , AFSL No Registered trademark of AMP Life Limited ABN of 3

4 2. Personal details continued Details of transferee / buyer 2 Title Surname/Company/Partnership name Given name(s) Tax File Number (TFN) OR Australian Business Number (ABN) Address for communications Date of birth 3. Acknowledgement and signature continued Transferor(s) / Executor(s) I declare that: I, the registered holder(s) and undersigned seller(s) for the above consideration do hereby transfer to the above named buyer(s) the units specified in section 1 of this form. Transferor / Executor 1 signature Name Signature Company seal Suburb State Postcode Country Contact phone number Fax number Mobile number Date Transferor / Executor 2 signature Name address 3. Acknowledgement and signature Important: On this form I, my and me also means we, our and us respectively. If you re signing as a trustee, you warrant that, at the time of signing, you are authorised under the relevant trust deed to apply and do all things necessary as a result of becoming a unit holder. If you re signing under Power of Attorney, you verify that, at the time of signing, you had not received notice of revocation of that Power of Attorney. In the event that a certified copy of the Power of Attorney has not been previously provided, you must submit this with the completed application form. Signature Company seal Date 2 of 3

5 3. Acknowledgement and signature continued Transferee(s) / Buyer(s) I declare that: I the buyer(s) do hereby agree to accept the said units subject to the same conditions and agree to be bound by the relevant constitution(s) and the current Flexible Lifetime Investment product disclosure statement (PDS). Where to send this form Mail (no stamp required) this completed form to: Flexible Lifetime Investments Reply Paid PARRAMATTA NSW 2124 Transferee / Buyer 1 signature Name Signature Company seal Date Transferee / Buyer 2 signature Name Signature Company seal Date Office/Financial adviser use only Client number Request ID Financial adviser ID 3 of 3 NS2889A 06/18

6 Flexible Lifetime Investments (Series 1 Investment Options) Application to transfer Information sheet When to use this form Use this form to apply to transfer to Flexible Lifetime Investments (Series 1 Investment options). For assistance in completing this form, speak to your financial adviser or call customer service on Important information Please read the Flexible Lifetime Investments product disclosure statement (PDS) before you invest. A completed transfer request form must be submitted with this application to apply for Flexible Lifetime Investments (Series 1 Investment Options). Please refer to the transfer request information sheet for details. Quick reference guide to help you complete your application If you re: Whose name is required? Account reference Whose TFN (ABN) or exemption code? Who signs KYC information required 1 Individual An individual or investor Your name: Investor A Not applicable Your TFN or exemption code Your signature Included within application to transfer form Joint Joint investors Name of each investor: Investor A and B Not applicable TFN or exemption code of each investor Both investors Included within application to transfer form Registered partnership Investing for a partnership Name of each partner: Investor A and B Name of the partnership TFN or exemption code of each partner Partners Complete a KYC other organisation form Company Investing for a company Name of company: Company investor with company name Not applicable ABN of the company 2 directors, or sole director, or director and company secretary Complete a KYC company form Trust or superannuation fund Investing for a trust or super fund where there are one or more individual trustees Name of each trustee: Investor A and or B Name of the trust or super fund TFN of the trust or super fund All trustees Complete a KYC trust form Issue date: 13 August 2018 AMP Capital Funds Management Limited ABN , AFSL No Registered trademark of AMP Life Limited ABN of 3

7 Quick reference guide continued If you re: Whose name is required? Account reference Whose TFN (ABN) or exemption code? Who signs KYC information required 1 Trust or superannuation fund continued Investing for a trust or super fund where the trustee is a company Name of company: Company investor with company name Name of the trust or super fund TFN of the trust or super fund, or company ABN of the company 2 directors, or sole director, or director and company secretary Complete a KYC trust form Investing for a child under age 18 2 Parent or Guardian Parent or Guardian: Investor A and or B Child s name TFN of Parent/ Guardian Parent/ Guardian Included within application to transfer form Power of attorney Investing on behalf of an individual investor under Power of Attorney The individual investor name: Investor A Not applicable TFN or exemption code of the individual Your signature Included within application to transfer form Deceased estate (executor) Executor Name of investor with executor details: Investor A Estate name TFN of Estate or investor Executor Included within application to transfer form Association/ Registered co-operative/ Government body Investing for an Association, Registered Co-operative or Government Body Name of the entity Not applicable TFN/ABN or exemption code Responsible Officer Complete a KYC other organisation form Sole trader Investing for a Sole Trader Name of investor: Investor A, and the business name of the Sole Trader Not applicable TFN of investor and ABN of the Sole Trader Sole Trader Complete a KYC individual/sole trader form 1 Where indicated, the appropriate Know your customer (KYC) form must be completed. Completion of this form is a requirement under the Anti-Money Laundering/Counter-Terrorism Financing Act We cannot accept applications from minors under the age of 18. Note: All forms are available at amp.com.au or you can call us on to obtain a form. Identification requirements We need to verify your identity and to meet our legal obligations (including those under the Anti-Money Laundering and Counter-Terrorism Financing Act 2006). If you re a company or non-individual applying to be the owner of this account, please refer to the identification procedure in the relevant KYC form. Contact your financial adviser or Customer Service for more details. Verifying a customer s identity We need to verify or confirm your identity by checking that certain details you provide in this form match the details that are in certain documents you need to attach to this form.! Please send us original certified copies of your original documents don t send us the original documents. If the document is not written in English, then you must also attach an English translation prepared by an accredited translator. 2 of 3

8 Getting your copies certified A copy of a document must be certified to be a true and correct copy of the original document. Only certain people can certify copies including: police officer or sheriff justice of the peace or notary public legal practitioner, magistrate, judge or registrar/deputy registrar of a court pharmacist, physiotherapist or veterinary surgeon optometrist, dentist, medical practitioner or nurse member of the Institute of Chartered Accountants in Australia, the Australian Society of Certified Practicing Accountants or the National Institute of Accountants. You can see the full list of people who can certify documents or extracts at ampcapital.com.au/identification. Example: I certify that this is a true and correct copy of the original document. John Citizen John Citizen, Justice of the Peace 10 Other Street Suburb NSW May 2015 Identification requirements So we can verify the identity of an individual, you need to send us the documents shown under option A or B: Note: Where this is more than one investor, identification is required for each person. Option A One of these: current Australian state or territory driver licence that has your photo Australian passport that is current or expired within the last two years card issued under a state or territory law to prove your age that has your photo current foreign government passport (or similar international travel document) that has your photo and signature current foreign driver licence that has your photo current national identity card that has your photo. Option B One of these: Australian or foreign birth certificate Australian or foreign citizenship certificate birth certificate extract pension card issued by Department of Human Services health card issued by Department of Human Services. Plus! The documents listed below are only valid if they include your full name and residential address. One of these: a document issued by the Commonwealth or a state or territory within the last 12 months that shows financial benefits paid to you a document issued by the Australian Taxation Office (ATO) within the last 12 months that shows money to be paid to you or that you need to pay to them (make sure you cross out your TFN) a document issued by a local government body or utility provider within the last three months that shows the services provided to you at your address if you re under 18 years old, a notice issued by a school principal within the last three months that shows how long you attended that school. What to do next Complete the attached application to transfer form. Ensure you have completed the attached transfer request form. Attach a certified copy of a document confirming your identity. If relevant, complete a separate know your customer (KYC) form if you re a non-individual investor. Complete a separate flexible bonus form if you re applying for the Flexible bonus. Return your forms to the address details provided on each form. Please keep this information sheet for your records don t return it with your completed form(s). 3 of 3 NS2889B 06/18

9 Flexible Lifetime Investments (Series 1 Investment Options) Application to transfer Use this form to apply to transfer to Flexible Lifetime Investments (Series 1 Investment options). For assistance in completing this form, speak to your financial adviser or call customer service on Important: Please read the Flexible Lifetime Investments PDS before you invest. Please print in CAPITAL LETTERS and place a cross in any applicable boxes. 1. Investor type Select the applicable investor type below: Indi v idual Joint investors Comp any 1 Trus t 1,2 Registered partnership 1,3 Sole trader 1 Superannuation fund 1,2,3 E xe cu tor 3 Association/Registered Co-operative/Government body 1 Investing on behalf of a minor(s) aged under Complete a separate know your customer (KYC) form if you re submitting an application under one of these investor types refer to the information sheet quick reference guide for details. 2 Please also complete the trustee type section below. 3 Please complete the details in account reference in section 4 refer to the information sheet quick reference guide for details. Trustee type If you are applying as a superannuation fund or trust please select the trustee type applicable: Individual Joint Company Lending facility Are you using a lending facility? No Yes please provide lender/loan provider name: Note: If you are using a margin loan to purchase units you don t need to complete a KYC form. 2. Investor details Investor A Title Surname Given name(s) Date of birth 2. Investor details continued Investor A continued Residential address (a PO Box is not acceptable) Suburb State Postcode Country Gender Male F emale Tax File Number (TFN)/exemption 4 4 Refer to TFN notes in the checklist in section 15. Occupation (if retired please specify) Industry (if applicable) Country Code for non-resident Country of residency (please specify if not Australia) Australia Other Country of citizenship (please specify if not Australia) Australia Other Are you a foreign tax resident?! If you re a foreign tax resident (or US citizen) and also a taxpayer in Australia, you should answer Yes. No Ye s Issue date: 13 August 2018 AMP Capital Funds Management Limited ABN , AFSL No Registered trademark of AMP Life Limited ABN of 11

10 2. Investor details continued Investor A continued Please provide details in the table below if you re a foreign tax resident: Country of foreign tax residency Taxpayer Identification Number (i) (cross one only) No Taxpayer Identification Number (ii) 1 A B C 2 A B C 3 A B C 4 A B C (i) A Taxpayer Identification Number is an identifying number used for tax purposes which is normally issued by the local tax authority in a country (eg in Australia the ATO issues a Tax File Number (TFN)). (ii) If you can t provide your Taxpayer Identification Number please refer to the following No Taxpayer Identification Number reason table and cross the relevant reason (ie A, B or C) above. No Taxpayer Identification Number reason: A B C The country of my tax residence doesn t issue a Taxpayer Identification Number. The country of my tax residence issues a Taxpayer Identification Number but I currently can t provide it. The country of my tax residence doesn t require my Taxpayer Identification Number to be disclosed. Investor B Title Surname Date of birth Investor B continued Occupation (if retired please specify) Industry (if applicable) Given name(s) Country Code for non-resident Residential address (a PO Box is not acceptable) Suburb State Postcode Country Gender Male F emale Tax File Number (TFN)/exemption 5 Country of residency (please specify if not Australia) Australia Other Country of citizenship (please specify if not Australia) Australia Other Are you a foreign tax resident?! If you re a foreign tax resident (or US citizen) and also a taxpayer in Australia, you should answer Yes. No Ye s 5 Refer to TFN notes in the checklist in section of 11

11 2. Investor details continued Investor B continued Please provide details in the table below if you re a foreign tax resident: Country of foreign tax residency Taxpayer Identification Number (i) (cross one only) No Taxpayer Identification Number (ii) 1 A B C 2 A B C 3 A B C 4 A B C (i) A Taxpayer Identification Number is an identifying number used for tax purposes which is normally issued by the local tax authority in a country (eg in Australia the ATO issues a Tax File Number (TFN)). (ii) If you can t provide your Taxpayer Identification Number please refer to the following No Taxpayer Identification Number reason table and cross the relevant reason (ie A, B or C) above. No Taxpayer Identification Number reason: A B C The country of my tax residence doesn t issue a Taxpayer Identification Number. The country of my tax residence issues a Taxpayer Identification Number but I currently can t provide it. The country of my tax residence doesn t require my Taxpayer Identification Number to be disclosed. Company investor/other entities Company/entity name Contact title 3. Address for communication Note: Joint investors please provide one address to be used for all communications. Address Contact surname Contact given name Tax File Number (TFN) 6 Suburb State Postcode Country 6 Refer to TFN notes in the checklist in section 15. Australian Business Number (ABN) address Phone number Mobile number Is the entity a foreign tax resident? No Ye s Does the entity have any controlling persons who are foreign tax residents?! A Controlling Person is any individual who directly or indirectly exercises control over the entity. For a company, this includes any beneficial owners controlling more than 25% of the shares in the company. For a Trust, this includes Trustees, Settlors or Beneficiaries. For a partnership this includes any partners. Fax number 4. Account reference Please refer to the quick reference guide in the information sheet of this application for details on completing this section. Name No Ye s If you ve answered Yes to either of the preceding questions, please ensure you also complete section 11 foreign tax details of this form. 3 of 11

12 5. Auto-rebalancing Important: Please refer to the PDS for information on auto-rebalancing. Please consult your financial adviser to ensure that the auto-rebalancing facility is appropriate to your personal objectives, situation and needs. Would you like to have your investment automatically rebalanced to your nominated profile as outlined below? No Yes please select the frequency: Quarterly Half yearly Yearly Note: By selecting Yes above, all future contributions, switches, or withdrawals may affect your auto-rebalancing facility. In other words, if you transact outside your nominated investment profile and don t advise us at the time that you want to change your nominated investment profile, we ll automatically cancel the auto-rebalancing facility on your account. Please complete the auto-rebalancing nominated profile column below. If this column isn t completed, we won t rebalance your investment. Investment option name Code Auto-rebalancing nominated profile (%) 6. Regular withdrawal plan Please complete this section if you d like to regularly withdraw an amount from your investment option(s). Please provide the investment options, amounts and payment frequencies, in the table below. Note: You ll need to provide your bank account details in section 7 to activate your regular withdrawal plan. Investment option name (i) The minimum amount per payment is $ or between 0.1% or 5%. Code Regular withdrawal amount How often would you $ (i) or % (i) like to be paid? 4 of 11

13 7. Bank account options Please provide your Australian bank account details to set up your direct debit or direct credit details for the following transactions: Direct debit: Initial investment Regular investment plan Additional investments at any time (which you can access via the InvestEasy 8 facility) Withdrawals at any time (which you can access via the EasyDraw 8 facility). Direct credit Distributions Regular withdrawal plan Withdrawals at any time (which you can access via the EasyDraw 8 facility). 8 These servicing facilities allow you to invest and withdraw funds by phone, or online via amp.com.au using your nominated bank account. If you don t wish to access these services, please write or contact us to request this. 7. Bank account options continued Direct credit bank account details Please cross if same as the direct debit bank account details otherwise complete the section below. Name of financial institution Branch location BSB number Name of account holder/s Account number Direct debit bank account details Name of financial institution Branch location BSB number Name of account holder/s Account number I/We authorise and request AMP Capital Investors Limited (User ID ) to debit the nominated bank account (details provided above) with any amount which AMP Capital Investors Limited may debit or charge me/us through the Direct Debit System, and acknowledge that I/we have read, understood and agree to be bound by the Direct Debit Request Terms and Conditions set out in Part 1 of the PDS. I/We acknowledge that this Direct Debit arrangement is governed by the terms of the Bulk Electronic Clearing System. Name Signature Date Name Signature Date 8. Fee structure Contribution fee Please indicate the contribution fee to be charged on initial and future contributions. Important: If you don t select a contribution fee amount below, the standard 4% contribution fee will be applied to initial and ongoing contributions. Initial contribution:. % (excluding GST) up to 4% Future contribution (including regular investment plan):. % (excluding GST) up to 4% Adviser servicing fee One-Off Adviser servicing fee Indicate the One-Off Adviser servicing fee (if any) to apply on the initial investment amount: (including GST) deducted from $ your initial investment. Ongoing Adviser servicing fee Indicate the Ongoing Adviser servicing fee (if any) to apply on an ongoing basis select one only: (including GST) deducted quarterly from. % pa your account as an ongoing fee. OR per quarter (including GST) $ deducted quarterly from your account. 9. Flexible bonus Are you planning to link accounts under the Flexible bonus? N o Yes please complete the flexible bonus form which is available on amp.com.au. 5 of 11

14 10. Annual report Please select one of the boxes below: I don t wish to receive the annual report for my investment options in Flexible Lifetime Investments. I wish to receive the annual report for my investment options in Flexible Lifetime Investments. Note: If you ve supplied your address in section 3 we ll automatically send you the annual report via . However, if you don t wish to receive the annual report via , please mark this box and we will mail it to you. 11. Foreign tax details for non-individual investor (ie trust, company, association or partnership)! To be completed by the non-individual investor which has answered Yes to one or both of the foreign tax residency questions in section 2. Investor details company investor/other entities. Please select one of the following to indicate the entity type: Financial institution (i) Is the financial institution an Investment Entity located in a non-participating CRS jurisdiction and, managed by another financial institution? Note: Refer to the Organization for Economic Cooperation and Development (OECD) website at oecd.org for the list of participating CRS jurisdictions. Yes go to section 12. No go to section 14. (i) For FATCA/CRS purposes a financial institution includes custodial or depository institution, an investment entity, a specified insurance company. Publicly listed company, majority owned subsidiary of a publicly listed company, government entity, Australian regulated superannuation/retirement fund, international organisation, central bank, Australian registered charity, or deceased estate Go to section 14. Foreign charity or an active Non-Financial Entity (NFE) (ii) Go to section 13. (ii) An active NFE is an NFE that derived less than 50% of its gross income from passive income (eg dividends, interest, and royalties) and less than 50% of the assets held to produce the passive income during the previous reporting period. Note: Refer to the oecd.org website for details on other active NFE categories. Other go to section Foreign controlling person s details A controlling person is any individual who directly or indirectly exercises control over the entity. For a: company, this includes any beneficial owners controlling 25% or more of the shares in the company. trust, this includes trustees, settlors and beneficiaries. partnership, this includes any partners. Does the entity have any controlling persons who are tax residents of countries other than Australia? Yes provide individual details on the next page (where applicable): No go section of 11

15 12. Foreign controlling person s details continued Controlling person 1 details: Full name Title Date of birth Residential address (a PO Box address is not acceptable) Suburb State Postcode Country What is the controlling person type (select one only)? Entity: Legal person Control by ownership Entity: Legal arrangement trust Control by other means Settlor Trustee Beneficiary Other Country of foreign tax residency Taxpayer Identification Number (i) (cross one only) No Taxpayer Identification Number (ii) 1 A B C 2 A B C 3 A B C 4 A B C Controlling person 2 details: Full name Title Date of birth Residential address (a PO Box address is not acceptable) Suburb State Postcode Country What is the controlling person type (select one only)? Entity: Legal person Control by ownership Entity: Legal arrangement trust Control by other means Settlor Trustee Beneficiary Other Country of foreign tax residency Taxpayer Identification Number (i) (cross one only) No Taxpayer Identification Number (ii) 1 A B C 2 A B C 3 A B C 4 A B C (i) A Taxpayer Identification Number (or equivalent) is an identifying number used for tax purposes which is normally issued by the local tax authority in a country (eg in Australia the ATO issues a Tax File Number (TFN)). (ii) If you can t provide your Taxpayer Identification Number (or equivalent) please refer to the following No Taxpayer Identification Number reason table and cross the relevant reason (ie A, B or C) above. No Taxpayer Identification Number reason: A B C The country of tax residence doesn t issue a Taxpayer Identification Number. The country of tax residence issues a Taxpayer Identification Number but I currently can t provide it. The country of tax residence doesn t require my Taxpayer Identification Number to be disclosed. 7 of 11

16 12. Foreign controlling person s details continued Controlling person 3 details: Full name Title Date of birth Residential address (a PO Box address is not acceptable) Suburb State Postcode Country What is the controlling person type (select one only)? Entity: Legal person Control by ownership Entity: Legal arrangement trust Control by other means Settlor Trustee Beneficiary Other Country of foreign tax residency Taxpayer Identification Number (i) (cross one only) No Taxpayer Identification Number (ii) 1 A B C 2 A B C 3 A B C 4 A B C Controlling person 4 details: Full name Title Date of birth Residential address (a PO Box is not acceptable) Suburb State Postcode Country What is the controlling person type (select one only)? Entity: Legal person Control by ownership Entity: Legal arrangement trust Control by other means Settlor Trustee Beneficiary Other Country of foreign tax residency Taxpayer Identification Number (i) (cross one only) No Taxpayer Identification Number (ii) 1 A B C 2 A B C 3 A B C 4 A B C (i) A Taxpayer Identification Number (or equivalent) is an identifying number used for tax purposes which is normally issued by the local tax authority in a country (eg in Australia the ATO issues a Tax File Number (TFN)). (ii) If you can t provide your Taxpayer Identification Number (or equivalent) please refer to the following No Taxpayer Identification Number reason table and cross the relevant reason (ie A, B or C) above. No Taxpayer Identification Number reason: A B C The country of tax residence doesn t issue a Taxpayer Identification Number. The country of tax residence issues a Taxpayer Identification Number but I currently can t provide it. The country of tax residence doesn t require my Taxpayer Identification Number to be disclosed. 8 of 11

17 13. Country of foreign tax residency details Is the entity a tax resident of a country other than Australia? Yes provide details below (list if more than one country is applicable): No go to section 14. Note: Refer to the ATO website at ato.gov.au for residency test calculators to help you determine your tax residency. Country of foreign tax residency Taxpayer Identification Number (i) (cross one only) No Taxpayer Identification Number (ii) 1 A B C 2 A B C 3 A B C 4 A B C (i) A Taxpayer Identification Number (or equivalent) is an identifying number used for tax purposes which is normally issued by the local tax authority in a country (eg in Australia the ATO issues a Tax File Number (TFN)). (ii) If you can t provide your Taxpayer Identification Number (or equivalent) please refer to the following No Taxpayer Identification Number reason table and cross the relevant reason (ie A, B or C) above. No Taxpayer Identification Number reason: A B C The country of tax residence doesn t issue a Taxpayer Identification Number. The country of tax residence issues a Taxpayer Identification Number but I currently can t provide it. The country of tax residence doesn t require my Taxpayer Identification Number to be disclosed. 14. Acknowledgement and signature Important: On this form I, my and me also means we, our and us respectively. All investors named on this application must sign and date this section. We cannot process your application without these signatures. If you are signing as a trustee, you warrant that, at the time of signing, you are authorised under the relevant trust deed to apply and do all things necessary as a result of becoming a unit holder. If you are signing under Power of Attorney, you verify that, at the time of signing, you had not received notice of revocation of that Power of Attorney. In the event that a certified copy of the Power of Attorney has not been previously provided, you must submit this with the completed application. I declare that: I acknowledge that I have received and been given the opportunity to read the current Flexible Lifetime Investments PDS. I direct AMP Capital Funds Management Limited to complete my investment instructions in accordance with my selections on this form to apply for units in the managed investment scheme(s) which comprise the investment options available in Flexible Lifetime Investments in accordance with the PDS. I acknowledge that: Investments in Flexible Lifetime Investments do not represent deposits or liabilities of AMP Capital Funds Management Limited or any other member of the AMP group. Investments can be subject to investment risk, including possible delays in repayment and loss of income and principal invested. 14. Acknowledgement and signature continued None of AMP Capital Funds Management Limited or any other member of the AMP group or the investment managers of the investment options guarantees the performance of the investment options or any particular rate of return, and I have considered the appropriateness of Flexible Lifetime Investments to my investment objectives and needs and have not received advice from AMP Capital Funds Management Limited. I understand the Adviser servicing fee(s), as shown in section 8, will be paid to my financial adviser in addition to the standard ongoing commission (unless I have agreed to a lower ongoing commission with my financial adviser) as disclosed in the PDS. I understand that where my investment account balance falls below $1,000, AMP Capital Funds Management Limited may close the investment account and terminate my investment. I am not commonly known by any names different to those disclosed in this application, unless I have disclosed otherwise to AMP Capital Funds Management Limited. any document or information to be used for the purposes of this application (whether or not provided on or with this application): is complete and correct if it is about another person, is provided with the authority of that person (if required), and may be used for any other products, services or benefits offered or provided to me/us by or through AMP Capital Funds Management Limited or any other company in the AMP group. Note: If you wish to check any information before signing, you may request a copy of this information from your financial adviser, or AMP Capital Funds Management Limited. 9 of 11

18 14. Acknowledgement and signature continued I acknowledge that it may be a criminal offence to knowingly provide false or misleading information or documents in connection with this application. I understand that I need to notify AMP when the Account Holder s tax residence changes or any controlling person s tax residence changes. For a customer that is a trust, I understand that I must inform AMP when a distribution from the trust has or will be made to an overseas tax resident and provide to AMP the beneficiary details requested. If an agent is signing this application on my behalf, the last two declarations (above) are also given by and bind the agent in the agent s personal capacity. Investor A/Company investor/other entity Investor A signature/company Director/Power of Attorney Power of Attorney Signature Date Investor B Joint investors signing authorities Please indicate who is to sign: Both investors to sign Either investor to sign. Note: If you do not make a choice, we will assume both investors to sign. Investor B signature/company Director/Power of Attorney Power of Attorney Signature Date 15. Checklist Please ensure you complete this checklist before sending the form back to AMP. Have you completed all relevant sections of the form? Have you signed and dated the application to transfer (this form) where indicated? Note: If you re signing under Power of Attorney, have you provided a certified copy of the Power of Attorney with the completed Application to transfer form? Have you provided your Tax File Number (TFN), Australian Business Number (ABN) or exemption (as applicable)? Note: If this investment is made in the course of carrying on a business, you can quote an ABN or TFN. If you don t provide a TFN, the law requires us to deduct tax from your investment option(s) income at the highest marginal rate, plus Medicare levy. Have you certified your tax residence? You need to complete tax residency details of all applicants and certain individuals who control an entity applicant, including their foreign tax identification numbers. The Australian Taxation Office (ATO) website provides residency test calculators to help you determine your tax residency, and information on the Common Reporting Standard (CRS) and Foreign Account Tax Compliance Act (FATCA). Additional information about CRS and FATCA can be found on the Organisation for Economic Co-operation and Development (OECD) and the Internal Revenue Service (IRS) websites respectively (oecd.org and irs.gov) Note: Failure to do this may delay the processing of your application. If your investment requires an account reference have you provide the account reference details in section 4? Have you provided a certified copy of a document confirming your identity? If relevant, have you completed a separate know your customer form? Please refer to the application to transfer information sheet for details. Have you completed a flexible bonus form if you re applying for Flexible bonus? Where to send this form Mail (no stamp required), fax or this completed form to: Flexible Lifetime Investments Reply Paid PARRAMATTA NSW trustinfo@amp.com.au 10 of 11

19 Office/Financial adviser use only Client number Request ID Adviser name Adviser number Phone number Split Servicing adviser ( one box only) Customer identification Adviser servicing fee Customer identification verified by: Originals Certified copies Register search Customer identification documentation attached Is your supply of advice to your client GST free? No Yes please specify below why the supply is GST free Financial adviser details Adviser name Adviser ID Adviser address Adviser phone number Important: If you are splitting fees, the split will only apply to the initial Contribution fee and One-Off Adviser servicing fee. Split Servicing adviser Adviser servicing rebate (optional) Do you wish to reduce your trailing commission? (AMP Capital Funds Management Limited will rebate your client by an equivalent amount). No Yes please specify what amount you would like your standard trail commission to be reduced by:. % pa (GST exclusive) The servicing adviser as a representative of the licensee agrees and confirms that: 1. The Adviser servicing fee is payable in respect of your supply of advice provided to investor(s). 2. AMP Capital Funds Management Limited will act as your agent in making the supply of that advice. 3. For the purposes of GST law, AMP Capital Funds Management Limited will be treated as making supplies to the Investor(s) and you will be treated as making corresponding supplies to AMP Capital Funds Management Limited. 4. AMP Capital Funds Management Limited will, where appropriate, issue tax invoices and adjustment notes relating to the supplies to the investor(s) and you will not issue tax invoices and adjustment notes relating to those supplies, and 5. Points 2, 3, and 4 above will cease to have effect if either you, AMP Capital Funds Management Limited ceases to be GST registered. In accordance with section 153B of the A New Tax System (Goods and Services Tax) Act 1999, you will be treated as making supplies to AMP Capital Funds Management Limited in return for the Adviser Servicing Fee and this will be included on the Recipient-Created Tax Invoice AMP Capital Funds Management Limited will issue when we pay you. 11 of 11 NS2889B 06/18