Application and Additional Investment Form

Transcription

1 Application and Additional Investment Form This Application and Additional Investment Form ( Application Form ) applies to PSG Global Equity Sub-Fund PSG Global Flexible Sub-Fund (the Funds and each a Fund ) The Funds are segregated sub-funds of PSG Global Funds SICAV p.l.c. and of PSG International Funds SICAV p.l.c., respectively (the Umbrellas and each an Umbrella ). The Umbrellas and the Funds qualify as Maltese UCITS Funds and are each managed by PSG Fund Management (Malta) Ltd. Applicants must read the Umbrella s Prospectus (including the Fund s Offering Supplement) and the relevant Key Investor Information Document before completing this Application Form. Defined terms used in this Application Form have the same meaning as in the Prospectus. A. ACCOUNT DETAILS (existing investors) Investor Number First Name and Surname [Authorized contact person] Corporate Entity Name B. INVESTOR DETAILS (new investors) Investing Entity type (Please see Know Your Client concerning supporting documentation) Individual Investor Trust Unlisted Company Listed Company Close Corporation Unincorporated Entity (partnership, sole proprietor, body corp.) Other (please specify) Title First name and Surname [Authorized contact person] Corporate Entity Name of Citizenship (Individuals) / Incorporation (Corporate) Method of identification Identity document Founding document/trust deed Passport ID no/registration no/ Passport no. Passport Expiry Date Physical Address or principal place of business Postal Address (Mail relating to your investment will be sent to this address) Code Code Please indicate whether you would prefer to receive correspondence either by or post Post Telephone Fax Work Cell

2 Gender Male Female Date of birth / / Marital Status Single ANC In-Community Divorced Widow/Widower I consider myself to be, or to be associated with a Politically Exposed Person Yes No If yes, please give details C. TAX DETAILS Registered Tax Payer Yes No of Tax Residency Other Income Tax Numbers Income Tax Number Tax Foreign Account Taxation Compliance Act (FATCA) declaration Are you a citizen of or tax resident of the United States of America? Yes No If yes, please complete the following Place of birth in the USA Tax Ref No Declaration: I/We hereby confirm that the information on my tax status above is correct. I/We undertake to forthwith inform PSG Fund Management (Malta) Ltd should there be any change in the tax status indicated in this application form. Signature of Investor / Joint Investor Sign Here Date / / D. AUTHORISED REPRESENTATIVE DETAILS* / JOINT NAME REGISTRATION** * Only to be completed if the Investor is being represented by their Guardian or another third party in terms of a Power of Attorney. ** Insert second name if joint name registration - Complete Annexure C for each joint applicant. I am acting on behalf of the investor This is a joint investment I/we instruct PSG Fund Management (Malta) Ltd or the Umbrella to act upon instructions placed by any one investor on behalf of all joint investors to this holding only action instructions signed by all joint investors named Entity type (Please see Know Your Client concerning supporting documentation) Individual Investor Trust Unlisted Company Listed Company Close Corporation Unincorporated Entity (partnership, sole proprietor, body corp.) Other (please specify) Title First name and Surname [Authorized contact person] Corporate Entity Name of Citizenship (Individuals) / Incorporation (Corporate) Method of identification Identity document Founding document/trust deed Passport

3 ID no/registration no/ Passport no. Passport Expiry Date Physical Address or principal place of business Postal Address (Mail relating to your investment will be sent to this address) Code Code Please indicate whether you would prefer to receive correspondence either by or post Post Telephone Home Work Fax Cell Gender Male Female Date of birth / / Marital Status Single ANC In-Community Divorced Widow/Widower I consider myself to be, or to be associated with a Politically Exposed Person Yes No If yes, please give details E. INVESTMENT DETAILS Fund Name Lump Sum Amount Min USD 5,000 Initial Advice Fee- Max of 2.00% Fund Class Referral Fee Included in Unit Price and Sale of Units Advice Fee Fund Class Sale of Units Advice Fee Max of 0.70% Max of 1.20% PSG Global Funds SICAV plc: PSG Global Equity Sub-Fund (USD) A 0.50% NA NA NA PSG International Funds SICAV plc: PSG Global Flexible Sub-Fund (USD) A 0.50% B Please note each Umbrella is constituted as a multi-fund SICAV under Maltese law each having a number of sub-funds. Each Fund constitutes a distinct and separate patrimony of the related Umbrella and additional sub-funds may be created from time to time. Investors are expressly requested to inform themselves of the specific risks attributable to their proposed investment in order to ascertain whether an investment suits their own risk profile and criteria. I/We, the investor, hereby confirm to PSG Fund Management (Malta) Ltd and the Umbrella that is my appointed financial adviser and authorize the payment of the fees stipulated above to him/her. I/We understand that the Financial Adviser Fee may be facilitated by the repurchase of units on a monthly basis from my/our investment before being paid to my/our appointed financial adviser. I/We understand that the selected financial adviser fees are negotiated between the Investor and the Financial Adviser and I/we cannot hold PSG Fund Management (Malta) Ltd or the Umbrella liable for acting on these negotiated instructions. First named signatory Sign Here Print name Date / / Second named signatory Sign Here Print name Date / /

4 SOUTH AFRICAN INVESTORS WITH FUNDS ALREADY OFFSHORE: Please return this application form together with a copy of your completed Bank Instruction Letter (available from page 10 of this Application Form). The original Bank Instruction Letter has to be sent to your bank. The subscription amount must be transferred to PSG Fund Management (Malta) Limited CLT account ( PSG CLT account ) in USD. If the currency of origin is not USD then you have two options. 1) arrange with your bank to convert the amount to USD based on an exchange rate you are comfortable with before making the deposit, or 2) deposit the currency of origin directly into the PSG CLT account in which event Sparkasse Bank Malta plc will automatically convert the currency of origin to USD at the Bank s standard exchange rate on that day. ANNUAL MANAGEMENT FEE Fund Name Annual Management Fee* Performance fee PSG Global Funds SICAV plc: PSG Global Equity Sub-Fund - Class A 1.50% 20% of outperformance of benchmark PSG International Funds SICAV plc: PSG Global Flexible Sub-Fund - Class A 1.00% 7% above high watermark PSG Global Flexible Sub-Fund - Class B 0.50% 7% above high watermark * Please see the relevant Key Investor Information Document and Offering Supplement for details For other costs and considerations, please see the Prospectus of the respective Umbrella. All applications and subscription monies must be received and cleared prior to 12h00 noon CETon the Business Day preceding the relevant Dealing Day. F. BANK ACCOUNT DETAILS Please note that in all cases where telegraphic transfer of funds is requested the costs of remittance will be deducted from the redemption proceeds. The account must be in the name of the investor, as no third party payments are allowed. (Proceeds from the realization of investments will only be paid to the account as specified in this section. We may write to your bankers to assist in satisfying our compliance procedures). Bank Name Branch Address Account Name Account number Please attach a cancelled cheque or original copy of your bank statement. Sort / swift code G. SOURCE OF CONTRIBUTION (Proof of source may be requested) EMPLOYMENT INCOME Estimated earnings per annum Client 1 Estimated earnings per annum Client 2 GIFT OR INHERITANCE Name of benefactor Name of beneficiary Relationship between benefactor and Client Amount Date received / / DISPOSAL OF A BUSINESS OR SALE OF A SIGNIFICANT ASSET Details of business/significant asset Name of owner Relationship between owner of the business/asset and Investor Amount of proceeds following disposal Date received / /

5 OTHER - Please provide details H. DECLARATION AND FINANCIAL SERVICE PROVIDER (FSP) AUTHORISATION The Client(s) has/have been known to me for years months and has been identified, verified and risk rated. I have verified the identity of the Client(s) and confirm that identity checks have been undertaken to confirm that the Clients name, address, date and place of birth, nationality and permanent residential address as shown on this Application Form are correct. I undertake to comply with due diligence requirements set by PSG Fund Management (Malta) Ltd and the Umbrella from time to time and to provide the relevant documentation, as listed in the Know Your Client section, to PSG Fund Management (Malta) Ltd. I acknowledge that incomplete documentation may, at the discretion of PSG Fund Management (Malta) Ltd or the Umbrella, be returned and may, also at the discretion of PSG Fund Management (Malta) Ltd or the Umbrella, lead to a delay in processing this Investment Application and/or to the return of the Clients funds. I have ticked the appropriate boxes and supplied relevant information above as confirmation of the original source of the funds being used for this investment (i.e. the activity that generated the funds). I confirm that to the best of my knowledge and belief the Client(s) is/are of good standing and the information provided in relation to the source of the funds is true and complete. I am unaware of any activities in which the Client(s) is/are involved which lead me to suspect that the Client(s) is/are involved in any criminal activity and/or money laundering/terrorist financing. I confirm that the Client(s) is/are applying on his/her/their own behalf and NOT as nominee, trustee or in a fiduciary capacity for another person. I confirm that there is no secrecy or data protection legislation that would restrict me from providing PSG Fund Management (Malta) Ltd or the Umbrella or their appointed nominee with information concerning the Client(s) freely on request or similarly from providing such information on request to a law enforcement agency of the jurisdiction of PSG Fund Management (Malta) Ltd or the Umbrella under court order or relevant mutual assistance arrangement. I acknowledge that the Client(s) is/are not a resident, national, or citizen of the United States of America and is/are not a US Person (within the meaning of the definition of that term contained in Regulation S of the US Securities Act 1933 (as amended)), nor are they a resident for tax purposes in any country that is a member of the European Union. I have provided all necessary product information in connection with this Application Form to my Client(s) and have assessed the suitability of all the investments for my Client(s) and have advised my Client(s) accordingly. I understand the risks for clients associated with investing in International Funds and have conducted a thorough investigation on the suitability of these investments for my Client(s). I confirm that I have only promoted to my Client(s) funds that I am aware may be lawfully promoted to them in my jurisdiction. I do not consider the Client(s) to be, or to be associated with a Politically Exposed Person. Yes No If yes, please provide details Client risk rating Name of Financial Adviser Name of Intermediary Firm FSP / Regulatory Reference PSG Asset Management Adviser Code address Financial Adviser s Signature Sign Here Date / /

6 I. AUTHORIZATION, DECLARATIONS AND ACKNOWLEDGEMENT A. Key Investor Information Document Declarations I/We the undersigned hereby acknowledge that I/We have been offered the choice of receiving the Prospectus and Key Investor Information Document ( KIID ) on paper or in electronic form by means of a website and hereby specifically consent to receiving the KIID in electronic form by way of accessing the latest version of the document online at (or such other website address as may be notified to me/us from time to time). I/We hereby represent that I/We have regular access to the internet. The KIID will be available on and I/We hereby confirm that I/We have also been notified electronically of this website address and the place on the website where the KIID can be accessed. I/We hereby acknowledge that I/We have received or accessed by electronic means the KIID. I/We hereby also confirm that I/We will access the relevant KIID by electronic means before making any subsequent and/or future subscriptions for Shares in any share class and/or Sub- Fund. B. General Subscriber Declarations I/We the undersigned, having received and read a copy of Prospectus, hereby irrevocably subscribe for the Investor Shares as specified in this Application Form as may be determined in accordance with the Memorandum and Articles at the Initial Offering Price or, if this Application is made after the Closing Date, at the prevailing Subscription Price per Share on the next Subscription Day following acceptance of this application by the Umbrella. I/We understand that fractional Shares may be issued. I/We acknowledge that Investor Shares will be issued on the applicable Subscription Day following receipt of this Application Form which must be received by the Umbrella at the offices of the Administrator no later than the Closing Date and thereafter within the deadlines stated in the relevant Offering Supplement. Unless otherwise specified in the Offering Supplement for a particular Fund, applications will not be accepted unless Cleared Funds have also been received. I/We acknowledge that the subscription monies must be received by the Umbrella in Cleared Funds by no later than the Settlement Date and undertake to ensure that full payment is received by such date. I/We further acknowledge and accept that if payment in full in Cleared Funds in respect of an application has not been received by the relevant Settlement Date or in the event of non-clearance, any allotment or issue of Shares made in respect of such application shall be cancelled and the Directors may charge the Subscriber for any expense incurred by the Umbrella and for any loss to the Sub-Fund arising out of such non-receipt or non-clearance. Monies returned will be at the risk and expense of the Subscriber. I/We agree that subscriptions and redemptions made in currencies other than the Base Currency of the relevant class of Investor Shares will be sold or purchased by the Umbrella or the Investment Manager at market rates for the said designated currency and Investor Shares will be issued, or payment of redemption proceeds will be made, to the value of the said designated currency proceeds and the I/We accept the exchange risk and costs relating to that transaction. I/We acknowledge and confirm receipt of, and that I/We have read, are familiar with and understand the Prospectus, the related Offering Supplement and the latest annual financial statements. I/We recognize that an investment in a Fund of the Umbrella may involve a high degree of risk and I/We have taken full cognisance of and understand all of the risk factors related to the purchase of Investor Shares, including but not limited to those set forth in the Prospectus under the heading Risk Factors and such other specific risk factors that may be set out in the Offering Supplement of the relevant Fund. In evaluating the suitability of an investment in the Umbrella, I/We confirm that I/We have not relied upon any representations or other information (whether oral or written) other than as set out in the Prospectus. I/We confirm that I/We have taken the advice of professional advisors who have sufficient knowledge and experience in financial and business matters to be capable of evaluating the merits and risks of this investment and I/We are fully capable of assessing and bearing the risks involved in my/our own right or with the benefit of such professional advice received. I/We acknowledge the Minimum Investment and Minimum Holding applicable to the relevant Fund as outlined in the related Offering Supplement. I/We warrant that I/We have the knowledge, experience, and expertise in financial matters to evaluate the risks and understand the relevant Fund s investment policy, have received, read and understood the Prospectus and the Offering Supplement relating to the relevant Fund and I/We are aware of the risks inherent in investing in the Investor Shares relating to the Fund and the method by which the assets of the Fund are held and traded, as described in the Prospectus and the related Offering Supplement and I/We can bear the risk of loss of my/our entire investment. I/We agree that the Investor Shares hereby subscribed for will be held subject to the terms and conditions of the Memorandum and Articles of the Umbrella as amended from time to time and that the Umbrella will fully protect and indemnify its Directors, the Investment Manager and the Custodian including their delegates, against liability for all acts taken on his or its behalf, except for acts involving negligence or misconduct. I/We fully appreciate the Umbrella s rights to accept or reject all applications for subscription in its sole discretion. I/We agree that no Investor Shares hereby subscribed for may at any time be transferred to any other person without first seeking the approval of the Umbrella in accordance with the provisions of the part entitled Transfer of Investor Shares under the Section entitled Purchase, Exchange and Transfer of Investor Shares in the Prospectus. I/We acknowledge and accept that no share certificates will be issued. I/We acknowledge and accept that this Application Form is governed by Maltese law and hereby submit to the non-exclusive jurisdiction of the Courts of Malta. I/We confirm that, to the best of my/our knowledge and belief, my/our subscription monies are not, in whole or in part, the proceeds of drug trafficking or any other criminal activity, nor do they represent, in whole or in part, directly or indirectly, such proceeds. If a Subscriber is an individual person, or is a nominee for an individual person, I/We warrant that I/We are, and the beneficial owners (if applicable) are, at the date of execution of this Application Form, greater of 18 years of age, or the minimum age permitted to enter into a legally binding and irrevocable contract, such as this Application Form, in my/our, or the beneficial owner s country of residence. I/We acknowledge that I/We have read and understood the part headed Prevention of Money Laundering and Data Protection in the Prospectus and further acknowledges that the Umbrella, the Administrator or other service provider to the Company may be required by applicable laws and/or regulations to take further reasonable steps to establish the identity of the Subscriber or of any other person whom the Umbrella, the Administrator or other service provider knows or has reason to believe is a person for whom or on whose behalf the Subscriber is acting and I/We undertake to co-operate with and assist the Umbrella, the Administrator

7 or other service provider in relation to such steps and I/We acknowledge that the Umbrella, the Administrator or other service provider shall be held harmless and indemnified by me/us against any loss arising as a result of a failure to process this Application Form if any information required by the Umbrella, the Administrator or other service provider has not been provided by me/us. In this context, I/We hereby agree that I/We will provide the relevant information requested in terms of this Application Form. I/We acknowledge that if the I/We wish to redeem my/our Investor Shares, but certain requested information has not been provided to the Umbrella or the Administrator, the redemption will be acted upon but no monies will be paid to me/us. Instead, the monies will be held in my/our name at the Umbrella s account and I/We will bear all associated risks. If a Subscriber is a bank, insurance company, or other financial institution, or financial intermediary, which is domiciled in an EU, OECD or FATF approved jurisdiction and is regulated by an approved regulated body, subscribing for on behalf of another person as nominee, I/We confirm that I/We have verified the identity of that other person in accordance with applicable anti-money laundering laws and/or regulations. I/We consent to the release by the Remitting Bank from which the subscription was made to the Umbrella and/ or the Administrator or other service provider of all evidence of my/our identity which said bank/ financial institution shall have retained. I/We agree that such evidence may further be furnished by the Umbrella and/or the Administrator to any other service provider to the Umbrella upon request, to enable such other service provider to meet its obligations under applicable laws and/or regulations. I/We hereby authorize the Umbrella and the Administrator to obtain verification of any information provided by me/us as part of my/our subscription application. I/We agree to provide any other information that may be required from time to time in compliance with relevant regulations. I/We acknowledge that suspicious events are reportable, under the Maltese prevention of money laundering laws and regulations and, by way of example, failure to provide justification for the change of bank account, or a request to pay the proceeds into a bank account in a jurisdiction which I/We are not a resident in could be deemed suspicious and therefore would be reportable under the regulations and may cause the payment to be delayed or refused. I/We agree that, where redemption requests made by I/We are sent to the Umbrella at the office of the Administrator by facsimile, I/We shall immediately send the original such notice to the Umbrella at the office of the Administrator by post or by courier but that the Administrator shall, nonetheless, be entitled, but not obliged, to treat such facsimile notice at face value and to act thereon if the original has not arrived by the relevant Subscription Day. Exceptions are made where the delivery of the communication has been acknowledged by a signed receipt. I/We further agree to indemnify and hold harmless the Umbrella, the Investment Manager, the Administrator, their directors and other officers, servants, employees and agents from and against any and all liabilities, obligations, losses, damages, penalties, actions, judgements, suits, costs, expenses or disbursements of any kind or nature (other than those resulting from the gross negligence, fraud or willful default of the Umbrella, the Investment Manager, the Administrator, the Custodian their directors or other officers, servants, employees or agents in its treatment of such facsimile notice) which may be imposed on, incurred by or asserted against the Company, the Investment Manager, the Administrator, the Custodian their directors or other officers, servants, employees or agents in its treatment of such facsimile notice. C. Data Protection Declarations By subscribing for Investor Shares, investors shall agree to allow the Umbrellas, the Custodian, the Administrator, and the Investment Manager and their agents, in accordance with the Data Protection Act (Cap. 440, laws of Malta) as may be amended or otherwise enacted, and other relevant data protection legislation which may be applicable (collectively the Data Protection Law ), to process personal data relating to their business affairs. Details of any personal data stored may be requested subject to the provision of an administration charge in accordance with the provisions of the relevant legislation. I/We acknowledge and agree that o o Information provided by me/us to the Administrator, the Umbrella, the Investment Manager, the Custodian, and/or their delegates and agents (collectively, the Providers and each a Provider ) may be stored on a computer system operated by a Provider and manually. For the purposes of the Data Protection Law, the Providers are required to specify the purposes for which they will hold personal data. The Providers will only use such information for the purposes set out below (collectively, the Purposes ), being to: process my/our personal data (including sensitive personal data) as required by or in connection with my/our investment in the Fund including processing personal data in connection with my/our affairs and generally in connection with my/our investment in the Fund; communicate with me/us as necessary in connection with my/our affairs and generally in connection with my/our investment in the Fund; provide personal data to such third parties as a Provider may consider necessary in connection with my/our affairs and generally in connection with my/our investment in the Fund or as the Data Protection Law may require, including to third parties outside Malta or the European Economic Area; transfer personal data to other companies within the same group as a Provider (including to any such companies which are outside Malta or the European Economic Area) who wish to use such information for marketing purposes to promote their services to me/us, including by means of electronic communications; and process my/our personal data for a Provider s internal administration. In providing the Providers with information, I/we hereby represent and warrant to the Providers that I/we have obtained the consent of any data subjects other than myself/ourselves to the Providers holding and using their personal data for the Purposes other than the Purpose set out above (including the explicit consent of the data subjects for the Processing of any sensitive personal data for the purpose set out above) and that I/we will use my/our best endeavors to obtain the consent of the data subjects to the Providers holding and using personal data for the processing of any personal data for the Purpose set out above. For the purposes of this Application Form, data subject, personal data and sensitive personal data shall have the meanings attributed to them in the Data Protection Law. D. Additional Declarations The Subscriber(s) undersigned below (if joint subscribers then jointly and severally) warrants in favor of the Fund that: they have fully familiarized themselves with any applicable income tax and exchange control laws and regulations regarding the purchase of investments in force in their country or domicile or residence; and

8 they are not prevented or restrained legally, commercially or otherwise from subscribing for shares in the Fund in accordance with the terms of this agreement. Furthermore the Subscriber (if joint subscribers then jointly and severally) hereby indemnifies the Funds, the Umbrellas, other Sub-Funds, all shareholders in and the directors of the Umbrellas and holds them harmless against any claims that might hereafter be made against them arising from the subscription and or redemption of Investor shares by the Subscriber(s). IMPORTANT INFORMATION The buying price of Shares may include a non-recurring initial charge and compulsory charges. An annual management fee is levied monthly on the market value of the share portfolio. The fees may vary between sub-funds. A schedule of fees and charges and maximum commissions is available from the Management Company. Statements will be sent on a quarterly basis. I/We hereby acknowledge that I/we have received and considered the latest Prospectus and Offering Supplement in connection with the Fund and that this application is made on the terms enclosed both therein and in the Fund s principal documents. I/We have read and understood the Key Investor Information Document Declarations. First named signatory: Print Name: Source of Funds (the proceeds to be invested need to have been accumulated and invested legitimately) Declaration on the application advising how the funds have legitimately arisen (from which legitimate activity, event or circumstances. Copy documentation to support the above source declaration. CERTIFICATION OF DOCUMENTS The following people are permitted to certify the documentation Lawyer Chartered Accountant Serving Police or Customs Officer Notary Public Member of Judiciary Senior Civil Servant Actuary An Embassy, Consulate or High Commissioner of the country of issue of the document Director, Officer or Manager of a regulated financial services business (e.g. Bank Manager) operating in an equivalent jurisdiction to Guernsey (see below) The certification should contain the following information Signature of the certifier Printed name of the certifier Position title Date Contact details Date: Second named signatory: Print Name: Date: NB: Please note the Joint Account in section D of this form. COMPLIANCE DEPARTMENT Please do not hesitate to contact us if you are not satisfied with this investment or the services from the Administrator. A complaint must be submitted to the Compliance Officer. The contact address of the Compliance Officer is: 11 New Street, St Peter Port, Guernsey, GY12PF or compliance@psgam.co.za. The Compliance Department will acknowledge the complaint in writing and will inform the investor of the contact details of the persons involved in the resolution thereof. PSG Fund Management (Malta) Limited was registered in Malta on the 8 th January 2013 and is a wholly owned subsidiary of PSG Asset Management Group Services (Pty) Limited, a company incorporated in the Republic of South Africa and ultimately owned by PSG Group Limited which is listed on the JSE Securities Exchange. PSG Fund Management (Malta) Limited as UCITS manager as well as each of the Umbrellas as UCITS Schemes are authorized and regulated by the Malta Financial Services Authority (the MFSA ) in each case under the Investment Services Act (Cap. 370, laws of Malta) ( ISA ). Orangefield Legis Fund Services Limited as administrator is licensed by The Guernsey Financial Services Commission ( GFSC ) to conduct controlled investment business under the protection of investors (Bailiwick of Guernsey) Law 1987, as amended. Investors in these funds are not eligible for the payment of any compensation under the Investor Compensation Scheme Regulations issued under the ISA. REPRESENTATIVE OFFICE MANAGER ADMINISTRATOR PSG Collective Investments Limited PSG Fund Management (Malta) Limited Orangefield Legis Fund Services Limited Private Bag X3, Constantia, 7848, SmartCity Malta, SCM01, Ground Floor, Unit G02, 11 New Street, St Peter Port, South Africa Ricasoli, Kalkara SCM 1001, Malta Guernsey, GY1 2PF Telephone: ; Fax: Telephone: Telephone: ; utoffshoreadmin@psg.co.za utoffshoreadmin@psg.co.za Fax: Website: Website: utoffshoreadmin@psg.co.za

9 KNOW YOUR CLIENT DUE DILIGENCE REQUIREMENTS Additional or updated documentation may be requested in certain circumstances. (Please ensure information is provided in English, or that the relevant sections have been translated. Kindly note that translations must be dated, signed and certified by an independent person of proven competence, confirming that it is a faithful translation of the original). INDIVIDUAL TRUST Identification Identification Certified copy of one of the following confirming the identity: - Current Valid Passport - National Identity Card or similar government-issued Document - Driving License (including photograph) - Armed Forces Identity Card (must be clear) - Please include two (2) specimen signatures at the bottom of the document - Trustees - as per individual requirements, or company requirements for corporate Trustees - Certified copy or extract from Regulator s website of the authorization of the trustee to act in such capacity - All other parties to the trust (Principle Beneficiaries, Settlors and Protectors) - as per individual identification requirements - Authenticated relevant extract or full certified copy of Trust deed pages showing name of trust, the parties to the trust and the signature pages and, the nature and purpose of the trust, and country of establishment Confirmation of address Certified copy of one of the following confirming the residential address: - A utility bill - A council tax bill/assessment - An income tax form/extract - A bank statement from a recognized credit institution - Any government-issued document as listed above, where a clear indication of residential address is provided (All above to be less than 3 months old) Confirmation of address - Trustees - as per individual requirements - Beneficiaries - as per individual requirements - Settlor- as per individual requirements - Protector - as per individual requirements Related Due Diligence - List of names and addresses of all Trustees - Authorized signatory list including specimen signatures - Trustees resolution authorizing the investment CORPORATION PARTNERSHIP Identification Identification - Certified copy of the Certificate of Incorporation - Board resolution authorizing the investment - Latest Annual Reports and Accounts (or for listed companies, details of listing i.e. exchange and company codes) - Authorized signatory list (with specimen signatures) - A certified copy of the Memorandum and Articles of Association - A copy of the Shareholder's Register - A certified copy of the organisational structure and explanation of ownership - If the company is not either listed on a recognized exchange, or a stockbroker, then please also supply the following: - Full name(s), place(s) and date(s) of birth, permanent resident address(es) and nationality of all directors and all shareholders with at least 25% interest, and any other person/entity with control over the company's assets - Each person with at least 25% interest or persons exercising control over the company s assets needs to supply full due diligence as per individual requirements (i.e. Identification and Confirmation of Address) - - Latest Annual Reports and Accounts - Certified copy of the Certificate of Incorporation - A certified copy of the Partnership Agreement - A certified copy of the organizational structure and explanation of ownership - Authorized signatory list (with specimen signatures) - Resolution of the partners - Each beneficial owner with at least 25% interest or persons exercising control over the management of the partnership need to supply full due diligence as per individual requirements (i.e. Identification and Confirmation of Address)

10 BANK INSTRUCTION LETTER Please complete this instruction and return the document to your bank. Please return a copy of the completed instruction to us with your application form. Please note that we may not be able to process payment instruction with insufficient or incorrect details. If the currency of origin is not USD then arrange with your bank to convert the amount to USD based on an exchange rate you are comfortable with before making the deposit; or deposit the currency of origin directly into PSG CLT account in which event Sparkasse Bank Malta plc will automatically convert the currency of origin to USD at the Bank s standard exchange rate on that day. 1. YOUR BANK ACCOUNT DETAILS: To the Manager of Bank/Building Society Address My/our account name My/our account number Please remit the sum of (indicate currency and amount) net of all charges by telegraphic transfer to the account indicated below. When making the payment, please quote my full name as a reference. (Please indicate below the account to which payment is to be made). Payments should be made payable to PSG Fund Management Malta Limited CLT. US DOLLAR DEPOSITS Beneficiary Bank Sparkasse Bank Malta plc Address 101 Townsquare, Ix-Xatt ta Qui-si-Sana, Sliema, SLM3112, Malta Beneficiary Name PSG Fund Management Malta Limited CLT Beneficiary account number USD Giro Account No BIC No / Swift GIBAATWGXXX USD IBAN MT81SBMT YOUR AUTHORISATION: First named Signatory Second named Signatory Sign Here Sign Here Print Name Print Name Date / /