C WorldWide Biotechnology Appendix 1. C WorldWide Medical Appendix 2. C WorldWide Nordic Appendix 3. C WorldWide Sweden Appendix 4

Transcription

1 To: Institution ( Applicant ): Carnegie Fund Services S.A. Institution name Acting as Administrator for Address PO Box 1141 L-1011 Luxembourg Postcode /City Luxembourg Country Fax Contact person Phone Fax funds@carnegie.lu Telephone Name of contact at The Original of this Agreement should be sent to address above upon initial subscription. Please complete the appropriate appendix corresponding to the Sub-Fund(s) of initial investment: 1. INITIAL Sub-Fund Name Appendix Biotechnology Appendix 1 Medical Appendix 2 Nordic Appendix 3 Sweden Appendix 4 Sweden Small Cap Appendix 5 Global Equities Appendix 6 Asia Appendix 7 Emerging Markets Appendix 8 Global Equities Ethical Appendix 9 Stable Equities Appendix INVESTOR BANK ACCOUNT DETAILS (To be used for redemptions) Name of Bank BIC Name of Account IBAN Payment Reference 3.

2 3. Details of Investor Subscription as nominee Company Stamp: Subscription for the account of the Institution only 4. SETTLEMENT CONTACT (if applicable and different from Institution details) Please provide information for the appropriate party to contact regarding settlement and other notices. Contact Name Company Address Country / Telephone 5. REPORTING Confirmation of the Subscription Orders approval shall be dispatched to: The Applicant A third Party (If third party please provide details) Company Name Address Country Transaction confirmation shall be dispatched to: Contact Name Telephone Fax The Applicant A third Party (If third party please provide details) Company Name Address Country Contact Name Telephone Fax Position statement dispatch method: None Normal Post Position statements dispatch frequency: Monthly Quarterly on demand Position statements dispatch currency: Page 2 of 15

3 Position statements shall be dispatched to: (If third party please provide details) Company Name Address Country The Applicant A third Party Contact Name Telephone Fax 6. DOCUMENTATION (Required for initial subscription) Certificate of incorporation, together with all certificates of incorporation upon change of name (if any) or extract from the applicable trade register, as appropriate (less than one month old) Certified true copy of articles of association or other relevant documentation Authorised signature list AML/KYC Comfort Letter Wolfsberg Questionnaire Proof of Regulation Completed CRS and FATCA Self-Certification form W8BENE / W9IMY All original certified true copies of the identification documents and the list of authorised signatories referred to above must be sent directly to the Administrator. Certification may be made either by notary, public authority or a financial institution subject to equivalent regulation concerning the fight against money laundering and terrorist financing. 7. DECLARATION We acknowledge that the subscribed amount including all fees is payable, at the latest 3 Luxembourg bank business days after the Valuation Day on which the Net Asset Value is used to determine the Subscription Price. I the signatory and Investor, confirm that I have received and am fully acquainted with the latest versions of the Prospectus, which were furnished to me, including: i. Disclaimer Section of the Prospectus; ii. Section Issue of Units, Redemption of Units and Market Timing Policy of the Prospectus providing that requests to subscribe to the units of the Fund may be rejected when they are considered as representing a pattern of market timing activity; iii. Risk Warning paragraph in Section Objective and Investment Policy of the Sub-Funds and Sub-Fund particulars of the Prospectus; iv. Section Net Asset Value of the Prospectus, providing that the calculation of the Net Asset Value may be suspended, and v. Section Charges and Expenses of the Prospectus. I have fully understood and reviewed the Prospectus of the Fund and that I agree with the provisions, terms and conditions stipulated in such documents and that I nonetheless wish to make my Subscription Order. Page 3 of 15

4 I authorise the Administrator to accept and execute any future instructions received by fax until written notice of the contrary. The applicant will assume all risks e.g. those arising from an error in communication or comprehension as well as those arising from fraud, resulting from the use of this communication means and relieve the Administrator from any and all responsibility in this respect. I understand that any instructions received by or on behalf of the Fund after the cut off time mentioned in the Offer Documents will be carried out at the price calculated at the next dealing day. I have been informed that I will, directly or indirectly, pay all fees, costs, charges and expenses associated with an investment in the Fund. I understand that the Administrator reserves the right in its sole discretion to reject this Subscription Order in whole or in part. I am not a US Person within the meaning of Regulation S of the United States Securities Acts and that I am not subscribing the Shares/Units for or on behalf, whether directly or indirectly of a US Person. I represent that I will not offer or sell the Shares/Units (i) to the public in any jurisdiction and (ii) to US Persons or to persons residing in the US. I confirm that I understand that further details or documentation may be required prior to acceptance of this application. I will promptly provide to the Fund or its designees all information which the fund may reasonably request in order to comply with relevant laws and regulations relating to money laundering. I hereby expressly instruct and authorise the Fund to transfer all or part of such information to other legal entities to the extent that such transfer is necessary to enable the fund to fulfil its legal and contractual duties, including in particular anti-money laundering provisions. Tick the corresponding box: Institution regulated by a supervisory authority in the country of incorporation A wholly owned subsidiary of regulated entity in the EU. Please state regulated entity: Other Please state supervisory authority regulated by: Details of license or other designation by regulatory body (please provide copy if not already provided) Is the institution listed in an FATF/EU/EEA Country? Yes No Page 4 of 15

5 Tick the following boxes to confirm: I am subject to the supervision provided for in Section 2 of Chapter V of Directive 2005/60/EC I perform customer due diligence and keep records as required in Directive 2005/60/EC I will get involved and without unreasonable delay make all required information on the identity of the ultimate beneficial owners of the Shares/Units available to the Fund to the extent permissible by law. In the event that I am prevented by local laws from supplying the above information to the Fund, I will only release such information on the request of a competent authority. I hereby expressly instruct and authorise the Fund to transfer all or part of the information on the identity of the ultimate beneficial owners of the Units to other legal entities to the extent that such transfer is necessary to enable the Fund to fulfil its legal and contractual duties, including in particular anti-money laundering provisions. 8. DISCLAIMER The Fund or its agents reserves the right to refuse or to reject any identification document supplied in accordance with the instructions and conditions set out in this annex and to refuse or to reject opening any account or completing any transaction relating to the application by the undersigned to subscribe for shares/units of the Fund where, in its reasonable opinion, the relevant identification documents have not been provided or the relevant identification procedures complied with. The Fund or its agents may at any time (acting reasonably) request that further and/or additional documents be supplied to it in connection with the verification of the identity of applicant and the ongoing application of anti-money laundering procedures and regulations to the Fund and for the updating of its records in this regard. Failure by the undersigned to provide promptly upon reasonable request by the Fund or its agents any document requested by it in accordance with this annex may result in the entry of the undersigned to the register of Share/Unit holders of the Fund and the payment of any distribution to the undersigned being delayed until such documentation is provided in such form as the Management Company/ Fund or its agents may in its absolute discretion accept. Carnegie Fund Services is authorised by the Minister in charge of the Supervisory Authority of the Financial Sector in Luxembourg, the Commission de Surveillance du Secteur Financier (CSSF) located at 283, route d Arlon, L-1150 Luxembourg (mailing address: L-2991 Luxembourg), and is registered on its official list of companies. Prior to having recourse to any legal proceedings against Carnegie Fund Services, the Investor can address its claims in writing to the Compliance Officer at the mailing address here above. The Investor is also entitled to address its claims to the CSSF which is empowered to intervene with the entities it supervises in order to resolve amicably. This procedure is published on the Funds Services area of Page 5 of 15

6 Appendix 1: Biotechnology Subscription in Amount Units Biotechnology Class 1A LU CARBIOA LX EUR Account Biotechnology Account Number: EUR GB68CHAS GB41CHAS GB57CHAS GB30CHAS GB03CHAS GB47CHAS Page 6 of 15

7 Appendix 2: Medical Amount Units Medical Class 1A LU CARMEDI LX EUR Medical Class 7A LU EUR Please note that Class 7A is only available to institutional investors approved by Group. Account Medical Account Number: EUR GB86CHAS GB59CHAS GB75CHAS GB48CHAS GB21CHAS GB79CHAS Page 7 of 15

8 Appendix 3: Nordic Amount Units Nordic Class 1A LU CARNORM LX Nordic Class 5B LU CARNO5B LX Nordic Class 7A LU EUR Please note that Class 7A is only available to institutional investors approved by Group. Account Nordic Account Number: EUR GB66CHAS GB39CHAS GB28CHAS GB98CHAS GB71CHAS GB63CHAS Page 8 of 15

9 Appendix 4: Sweden Amount Units Sweden Class 1A LU CARSWLC LX Sweden Class 5B LU Account Sweden Account Number: EUR GB88CHAS GB34CHAS GB50CHAS GB23CHAS GB93CHAS GB49CHAS Page 9 of 15

10 Appendix 5: Sweden Small Cap Ccy Amount Units Sweden Small Cap Class 1A LU CARSWSC LX Sweden Small Cap Class 5B LU Account Sweden Small Cap Account Number: EUR GB20CHAS GB90CHAS GB63CHAS GB36CHAS GB79CHAS GB55CHAS Page 10 of 15

11 Appendix 6: Global Equities Amount Units Global Equities Class 1A LU CARWLDW LX Global Equities Class 5A LU CARWL5A LX Global Equities Class 5B LU CARWLWU LX Global Equities Class 6A LU Global Equities Class 7A LU EUR Please note that Class 7A is only available to institutional investors approved by Group. Account Global Equities Account Number: EUR GB80CHAS GB53CHAS GB69CHAS GB42CHAS GB15CHAS GB52CHAS Page 11 of 15

12 Appendix 7: Asia Amount Units Asia Class Asia 1A LU CARWA1A LX Asia Class Asia 5A LU Asia Class Asia 7A LU EUR Please note that Class 7A is only available to institutional investors approved by Group. Account Asia Account Number: EUR GB80CHAS GB53CHAS GB69CHAS GB85CHAS GB47CHAS GB39CHAS Page 12 of 15

13 Appendix 8: Emerging Markets Ccy Amount Units Emerging Markets Class 1A LU CAREEUR LX Emerging Markets Class 7A LU EUR Please note that Class 7A is only available to institutional investors approved by C Worldwide Group. Account Emerging Markets Account Number: EUR GB73CHAS GB46CHAS GB51CHAS GB51CHAS GB40CHAS GB57CHAS Page 13 of 15

14 Appendix 9: Global Equities Ethical Ccy Amount Units Global Equities Ethical Class 1A LU CARETHI LX EUR Global Equities Ethical Class 5A LU EUR Global Equities Ethical Class 5B LU CARET5B LX EUR Global Equities Ethical Class 6A LU Global Equities Ethical Class 7A LU EUR Please note that Class 7A is only available to institutional investors approved by Group. Account Global Equities Ethical Account Number: EUR GB76CHAS GB22CHAS GB92CHAS GB65CHAS GB70CHAS GB09CHAS Page 14 of 15

15 Appendix 10: Stable Equities Amount Units Stable Equities Class 1A LU CARNEEQI LX Stable Equities Class 5A LU Stable Equities Class 5B LU Stable Equities Class 7A LU EUR Please note that Class 7A is only available to institutional investors approved by Group. Account Stable Equities Account Number: EUR GB71CHAS GB97CHAS GB59CHAS GB75CHAS GB64CHAS GB74CHAS Page 15 of 15