Instruction sheet buy-sell deed

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1 Instruction sheet buy-sell deed From: Please phone if you have any queries or require any assistance completing this form #Note: Please print clearly in block letters - errors may incur extra charges Payment details If paying by Visa or Mastercard, a processing fee of 1.27% (inc. GST) will be added to the transaction value. If paying by American Express, a processing fee of 3.12% (inc. GST) will be added to the transaction value. Please debit the following card details by the amount of $ Type of card Visa Mastercard Amex Card number Expiry date Name on card Security code (for Amex customers only located above your card number) Signature of cardholder Contact details address for despatching account and documents Contact and firm name Postal address address Phone Fax Date of instructions Date documents required by Principals of business Individual 1 full name Street address Individual 2 full name Street address Individual 3 full name Street address Insurance policies Individual 1 - Life insured Policy number Policy owner Amount of insurance v3 Instruction sheet - buy-sell deed

2 Insurance policies Type of insurance Death Trauma event Total and permanent disability (as defined in insurance policy) Individual 2 Life insured Policy number Policy owner Amount of insurance Type of insurance Death Trauma event Total and permanent disability (as defined in insurance policy) Individual 3 Life insured Policy number Policy owner Amount of insurance Type of insurance Death Trauma event Total and permanent disability (as defined in insurance policy) Please tick that you have attached the following: Insurance policy for individual 1 Insurance policy for individual 2 Insurance policy for individual 3 Business entity #1 - Structure that holds or owns business assets Company Unit trust Partnership Discretionary trust Other: Business name ACN/ABN Business activities Business valuation Please tick that you have attached the following (as applicable): Company constitution ASIC extract showing directors and shareholders Most recent balance sheet and tax return for Business Entity Trust deed and any deeds of variation for Business Entity and any other trusts involved (e.g as shareholders, unitholders or partners) Constitution and ASIC extract for corporate trustee for Business Entity and any other trusts involved (e.g as shareholders, unitholders or partners) Partnership deed/shareholders or unitholders agreement v3 Instruction sheet - buy-sell deed 2

3 Ownership of Business Entity #1 if owned by an individual or company Name and ACN/ABN Registered office partner 1 partner 2 Name of and details shareholder/unitholder/ partner 3 Ownership of Business Entity #1 if owned by a trust Type of shareholder/unitholder/partner 1 Unit trust Discretionary trust Other trust Type of shareholder/unitholder/partner 2 Unit trust Discretionary trust Other trust Type of shareholder/unitholder/partner 3 Unit trust Discretionary trust Other trust v3 Instruction sheet - buy-sell deed 3

4 Business entity #2 - Structure that holds or owns business assets Company Unit trust Partnership Discretionary trust Other: Business name ACN/ABN Business activities Business valuation Please tick that you have attached the following (as applicable): Company constitution ASIC extract showing directors and shareholders Most recent balance sheet and tax return for Business Entity Trust deed and any deeds of variation for Business Entity and any other trusts involved (e.g as shareholders, unitholders or partners) Constitution and ASIC extract for corporate trustee for Business Entity and any other trusts involved (e.g as shareholders, unitholders or partners) Partnership deed/shareholders or unitholders agreement Ownership of Business entity #2 if owned by an individual or company Company name and ACN or ARBN Registered office partner 1 partner 2 Name of shareholder/unitholder/ partner 3 Ownership of Business entity # 2 if owned by a trust Type of shareholder/unitholder/partner 1 Unit trust Discretionary trust Other trust Type of shareholder/unitholder/partner 2 Unit trust Discretionary trust Other trust v3 Instruction sheet - buy-sell deed 4

5 Ownership of Business entity # 2 if owned by a trust Type of shareholder/unitholder/partner 3 Unit trust Discretionary trust Other trust Financial information. Please provide copies of accounts for the business (last three years if available). What events should trigger business succession buy out? Death Trauma event Total and permanent disability Other (list below) If insurance proceeds are insufficient to cover buy out, how is balance to be repaid? We would usually recommend that the balance is repaid in equal monthly instalments over two years, with the first instalment payable one month after the option is exercised Should interest be payable on the shortfall between the value of an outgoing principal s interest and the insurance proceeds received? We would usually recommend that no interest should be payable on this amount. If you tick yes, interest would be payable on an outstanding payment at the Reserve Bank of Australia unsecured simple interest loan rate. Should interest be payable on any outstanding payments under the deed i.e. where a party has not made a payment within the required timeframe? If you tick yes, interest would be payable on an outstanding payment at the Reserve Bank of Australia unsecured simple interest loan rate. Payable in monthly instalments over two years Other (list below) Yes No Other (list below) Yes No Other (list below) v3 Instruction sheet - buy-sell deed 5

6 Any additional information or comments Please note: Please attach any additional pages or documents (e.g. trust deeds, partnership agreements etc.) as necessary v3 Instruction sheet - buy-sell deed 6

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