Application Form. Subscription in EUR Direct via TARGET II Swift Code: BSUILULL

Transcription

1 Application Form This form is for the exclusive use of investors (the Investor ) subscribing to Amundi Money Market Fund which has appointed AMUNDI Luxembourg as Management Company and CACEIS Bank Luxembourg as Custodian, Administrative and Register Agent. Please fax and send by post the original Application Form to: AMUNDI Attn: Corporate Client Servicing Dept. 90 boulevard Pasteur - CS Paris Cedex 15 FRANCE Tel.: (33) Fax: (33) liquidity@amundi.com I. Investment Information This application form is subject to the provisions set out in the Fund s Prospectus. Orders received after the cut-off time specified in the Prospectus will be processed on the following NAV calculation date. Incomplete or illegible orders will be accepted only after such orders have been received with complete and legible information by the Register Agent. No monies will be transferred to the Fund unless the order is accepted. II. Subscription Information a) Subscription payment: Details of accounts to which subscription payments are to be transferred (the transfer description should include the name and reference of the transferring entity, the name of the Fund and, if applicable, the name of sub-fund and category): Subscription in EUR Direct via TARGET II Swift Code: BSUILULL Subscription in USD Correspondent Bank JP Morgan Chase New York Swift Code: CHASUS33 Beneficiary Account Name: CACEIS BANK Luxembourg Swift Code: BSUILULL Beneficiary Acc. N CHIPS Nr.0002 ABA Nr Subscription in GBP Correspondent Bank HSBC Bank Plc Intl., London Swift Code: MIDLGB22 Beneficiary Account Name: CACEIS BANK Luxembourg Swift Code: BSUILULL Beneficiary Acc N Page 1

2 Details from the bank that will effect the wire Bank Name Bank Address Swift / BIC Code Account Name Account Number IBAN Futher Credit b) Redemption payment Details of the bank account to which redemption payments are to be transferred: Bank Name Bank Address Swift / BIC Code Account Name Account Number IBAN Futher credit c) Dividend Policy: Dividend payment Dividend reinvestment Compulsory for dividend payment: Details of the bank account to which dividend payments are to be transferred: Bank Name Bank Address Swift / BIC Code Account Name Account Number IBAN Further Credit If you wish to change dividend policy, please address your request by fax, duly signed, to the Corporate Client Servicing Dept. at fax number (33) III. Information concerning the prevention of money-laundering As required by the Prospectus and the applicable laws of Luxembourg, particularly regarding the prevention of money laundering, documents that will allow the Fund's Register Agent to identify the subscriber and, if applicable, all the economic beneficiaries of the investment, must be enclosed to this Application Form. The following identification documents are required for the investor s first subscription in the Fund. Further subscriptions in the same fund do not require the documents to be sent again, if the investor s situation has not changed : - the constitutional documents (i.e. memorandum and/or articles of association) - the recent extract from trade registry (less than 3 months) Page 2

3 - the latest Minutes of Board Meeting electing Directors and their binding powers - the valid ID card or passport of the Company's "Legal Representatives" - the list of authorized signatories with their specimen of signature and binding powers - the full identification of the Economic Beneficiaries (Shareholders who own more than 25% of the capital)* - the Company's latest audited annual report* * Except if the company is listed on a regulated stock exchange IV. Information concerning subscribers > For multiple choice sections, please tick the appropriate box Subscription on behalf of any corporate entity (or an alternative entity such as a trust) must be signed by an individual duly authorized to act in that capacity. If the subscription form is signed on the basis of authorization, this authorization or a duly certified copy there of must be enclosed with the subscription form (trust deed, management authorization). Subscriber acting on its own behalf Subscriber acting on behalf of third parties* Company Name Company Objects If your activity falls within one of the following economic sectors, please tick the appropriate box: Casino, games Religious financial institution Charity Diamond merchant, lapidary Real estate agency Art dealership Date of incorporation D M Y Articles of incorporation (if applicable) D M Y Place of listing (if applicable) Signatory 1 SURNAME FIRSTNAME Capacity of Signatory Identification ( select type & enter no ) ID Card Passport No Country of delivery If applicable Signatory 1 Capacity of Signatory Identification ( select type & enter no ) ID Card Passport No Companies listed on official stock exchanges and professionals from the financial sector acting on behalf of third parties and domiciled in a FATF country can skip the following section and go to a). *A subscriber acting on behalf of third parties, regulated or registered with a Regulatory Authority and domiciled in an Equivalent Country, can skip page 4 and go directly to a) Primary address on page 5. Page 3

4 Unlisted corporate entities and alternative entities acting on behalf of third parties must disclose the identities of their final beneficial owners and the following identification information concerning such beneficiary/beneficiaries. Final beneficial owner Representation (each beneficiary must complete this form) Last Name, First Names (s) Date of birth D M Y Country of birth Identification ( select type & enter no ) ID Card Passport No Tax Identification No Profession If your activity falls within one of the following economic sectors, please tick the appropriate box: Casino, games Religious financial institution Other Charity Diamond merchant, lapidary Real estate agency Art dealership Source of invested capital Savings Property income Inheritence Game winning Political mandate/ public office YES NO Details: Last Name, First Names (s) Date of birth D M Y Country of birth Identification ( select type & enter no ) ID Card Passport No Tax Identification No Profession If your activity falls within one of the following economic sectors, please tick the appropriate box: Casino, games Charity Real estate agency Religious financial institution Diamond merchant, lapidary Art dealership Other Source of invested capital Savings Property income Inheritence Game winning Political mandate/ public office YES NO Details: Page 4

5 P.O. Boxes are not permitted Address street ZIP code City Country Telephone n Fax Mailing address (if different from the primary) : P.O. Boxes are not permitted Address street ZIP code City Country Telephone n Fax * Please fill in and sign Appendix III, if you wish to receive contract notes, statements and dividend reporting by V. Key Investor Information ( KIID ) The key investor information document ( KIID ) of the Fund has been relating to each share class has been implemented since June 30, 2012, according to the relevant provisions of the Luxembourg law of December 17, 2010 relating to Undertaking for Collective Investments, implementing Directive 2009/65/EC and its implementation acts (the UCITS IV legislation ). The latest KIIDs in force are available on Such website will be constantly updated as requested by the UCITS IV legislation and access will be continuously granted. In case there is any change in the availability of the KIID, the Fund or its duly authorized representative would contact you and provide you with alternative solutions. Please indicate the address that shall be used for this purpose: Final investors investing in the Fund for their own account, should refer to Point 1 below. Financial intermediaries investing in the Fund for the account of clients, or advising clients to invest in the Fund, should refer to Point 2 below. Page 5

6 a) Final investors The subscriber, investing in the Fund for their own account, hereby expressly accepts to be provided at all times with an up-to-date version of the KIID as published on the above website. However, the subscriber acknowledges being entitled to receive on request to the Fund and free of charge a hard copy of the KIID. The subscriber further confirms that he/she has taken knowledge of the up-to-date version of the KIID as published on the above mentioned website in good time before making the present subscription or switch in the Fund. Furthermore, the subscriber hereby undertakes that for the purposes of subsequent subscriptions or switches in any class of any Sub-Fund of the Fund, the subscriber will refer to the up-to-date version of the applicable KIID as published on the above mentioned website prior to any subscription or switch of shares in the Fund. b) Financial intermediaries The financial intermediaries, investing in the Fund for the account of clients, or advising clients to invest in the Fund (the Subscribers ), hereby confirm that they have provided to such clients or potential clients (the Clients ) the up-to-date version of the KIID as published on the above mentioned website, before making the present subscription or switch in the Fund, that the Subscriber has, in general, fully complied with the provisions of the UCITS IV legislation governing the distribution of the KIID in respect of such subscription or switch and has kept evidence of compliance with such provisions. In particular the Subscriber shall (inter alia): -keep track of the KIID version provided to the Client each time; - where the KIID is provided to Clients using a durable medium other than paper: a. make sure that the provision of the KIID using such a durable medium is appropriate to the context according to the definition of the UCITS IV legislation; b. make sure that the person to whom the KIID is to be provided, has been offered the choice between information on paper or in that other durable medium, and has specifically chosen that other medium; where the KIID is provided by means of a website and that information is not addressed personally to the Client: a. make sure that the provision of that information in that medium is appropriate to the context according to the definition of the UCITS IV legislation; b. make sure that the Client specifically consents to the provision of that information in that form; c. make sure that the Client has been notified electronically of the address of the website, and the place on the website where the information may be accessed; d. keep record of that specific consent and to forward a copy thereof to the Management Company, upon request. Furthermore, the Subscriber hereby undertakes that for the purposes of subsequent subscriptions or switches in any class of any Sub-Fund of the Fund, the subscriber will provide the KIID to the Clients prior to the first investment, the subscriber will, in general, fully and continuously comply with the provisions of the UCITS IV legislation governing the distribution of the KIID, as may be amended in the future, and will keep evidence of compliance with such provisions. VI. Additional information The undersigned acknowledges having received and understood the most recent Prospectus of the Fund and confirms that he/she is authorized to invest monies in compliance with the Prospectus. The Investor represents that the invested funds were not derived from illegal activities as described under the laws of Luxembourg or the recommendations issued by the Financial Action Task Force on Money Laundering (FATF). The undersigned confirms that he/she holds no Political mandate or public office other than specified in this Application Form, or that he/she does not act on behalf of third parties holding Political mandates. Page 6

7 For Corporate entities, the original and authenticated list of Signatories, giving their names, powers and original signatures, must be presented. For orders sent by fax, the undersigned releases CACEIS Bank Luxembourg from any liability for any potential financial losses or fees incurred by one of the parties and resulting from the processing of orders made in such form. No order will be accepted via . CACEIS Bank Luxembourg assumes no liability for failure to process an order as a result of incomplete or inaccurate information presented by the subscriber in this form. The investor hereby acknowledges that the subscription is made subject to the provisions of the Fund s prospectus and the Fund s Articles of Incorporation, particularly those involving the Cut-Off time for receiving orders. Investors hereby acknowledge that late trading and market timing practices are prohibited. VI. Documents enclosed with the Application Form Number of documents enclosed Documents enclosed Articles of incorporation and/or Memorandum of association Extract from Trade Registry (less than 3 months Latest audited Annual Report * Latest minutes of Board Meeting electing Directors with their binding powers ID Card or Passport of the Company's Legal Representatives ** List of Authorized Signatories with their specimen of signature and binding powers Full Identification of the Economic Beneficiaries (Shareholders who own more than 25% of the capital)* Other, please specify *Except if the company is listed on a regulated stock exchange. ** Please note that identity cards must be valid and include a photo and a signature. Documents pertaining to clients will be considered valid for CACEIS Bank Luxembourg if they are certified true to original by either: > a public notary > a registered lawyer > the entity s external auditor (the one signing the entity s yearly financial statements) > a FATF Financial Institution > the Director or the Sale of an Amundi Branch For any information concerning your investment, please contact the Corporate Client Servicing Dept. in AMUNDI at the following address: 90 boulevard Pasteur - CS Paris Cedex 15 FRANCE Tel.: (33) Fax: (33) liquidity@amundi.com Page 7

8 Please add a handwritten note Read and approved Date D M Y Date D M Y Signature 1 Signature 2 Appendix I: Letter of Representation Appendix II: Letter of Institutional Investor Status Appendix III : Letter of Consent Page 8

9 Appendix I: Letter of Representation (To be filled in and signed on the Subscriber Letterhead) Dear sirs, Name of company is a : Bank/ Financial Institution Professional of the Financial Sector1 of the type Insurance Company Management Company Investment Fund Pension Fund Commercial company Other Incorporated, formed under the laws of Submitted, without limitation, to the following anti-money laundering and legislation (please insert name and reference of applicable legislation) We act for our own account We act both for our own account and for the account of our t We act solely for the account of our customers As (Custodian, trustee, nominee, transfer agent, registrar, other ) We are not regulated by any authority / regulated by whose website / address is as follows Our company is not quoted on any stock exchange and the following persons/entities hold more than 25% of its Capital is quoted on the Stock exchange 1 In Luxembourg, PFS under the surveillance and regulation of the CSSF (Regulator) are categorized as follows: Investment firms: Investment advisers, Brokers in financial instruments, Commission agents, Private Portfolio managers, Professionals acting for their own account, Market makers, Underwriters of financial instruments, Distributors of units/shares in UCIs, Financial Intermediations firms, Investment firms operating an MTF in Luxembourg / PFS other than investment firms: Registrar agents, Professional custodians of financial instruments, Operators of a regulated market authorized in Luxembourg, Operators of payment of securities settlement systems, Persons carrying out foreign exchange cash operations, Debt recovery, Professionals carrying out (securities) lending operations, Professionals providing fund transfer services, Mutual savings fund administrators, Managers of non-coordinated UCIs / PFS performing a connected or complementary activity of the financial sector: Corporate Domiciliation agents, Client communication agents, Financial sector administrative agents, Primary IT systems operators of the financial sector, Secondary IT systems and communication networks operators of the financial sector, Professionals providing company formation and management services. 2 A commercial or non-financial company acting for its own account can skip page 10. Page 9

10 We shall, from time to time, purchase, redeem and hold, Units / Shares of Luxembourg mutual Funds (the Funds) for which you act as Depository Bank and/or Registrar Agent. We hereby represent to you that: 1- We are aware of the terms of the Prospectus of the relevant Funds, we shall observe them and shall not allow the purchase or holding of units or shares of the Funds by persons not authorized to purchase or hold them under the provisions of the Prospectus. In particular, we will not allow U.S. Persons* to become investors in the Funds, or cause the Funds to accept any money directly or indirectly contributed from sources within the United States. 2- We are located in a country that has issued legislation or regulations for the prevention of money laundering and the fight against terrorism in line with: the recommendations of the Financial Action Task Force (FATF member country) the E.U. Council Directive 2005/60/CE of 26 October 2005 (please insert name of any other applicable ruling document). In this respect, we have in place Know Your Customer policies, we perform transaction controls and obtain: a) Information about the formation of the company and copies of constitutional documents, a recent trade register extract, the identity and authorized mandate of the directors, the bank account details and the identity and beneficial ownership of the Shareholders, if a corporate entity, or b) the Shareholder's true name, address and date of birth if a natural person. c) Where an investor is registered as nominee, trustee or in any other fiduciary capacity for another person, we have obtained appropriate documentary evidence to support the identification of the other person(s), which can be produced on request. 3- We confirm that we have checked and will monitor that none of the Investors introduced by us and their underlying beneficiaries (if any) do not appear on the watch lists published by the European Community and/or the US Office for Foreign Assets Control. 4- We confirm that if one of the investors introduced by us is a person holding a legislative, administrative or judicial office or a public function or a senior political figure or one of their family member or close associate we have used all reasonable efforts to verify that the source of Funds are not the proceeds of corruption or other illegal activity; 5- We will retain documentary evidence of the identity of the introduced investor(s) for a period of at least five years from the cessation of our relationship with them. Upon your request we will provide you with all the investor s information and the copies of the documents you deem appropriate in your role of registrar agent, such as proof of the identity of the final beneficiaries of the shares/units of the Fund, to the extent permitted by the laws to which we are submitted; 6- We will inform you immediately if we become aware of any introduced investor engaging in activities which lead us to believe that such investor is involved in money laundering or terrorist activities to the extent permitted by our legislation; 7- We shall not advertise for clients, solicit clients, nor offer or sell any of the Funds, unless we may do so in compliance with the laws and regulations applicable in our country; 8- We confirm that we have stringent rules and policies in place that safeguard the Funds investors against late trading and market timing* practices; 3 A U.S. Person is defined as a citizen or resident of the U.S., a corporation, partnership or other entity created or organized in or under U.S..laws, or any person falling within the definition of the term U.S. Person under Regulation S promulgated under the U.S. Securities Act of 1933, as amended, or under Rule 4.7 under the U.S. Commodity Exchange Act, as amended. 4 Market Timing: Arbitrage technique by which an investor systematically buys and sells or converts units or shares of the same UCI within a short lapse of time to take advantage of the time difference and/or the imperfections or deficiencies of the UCI NAV calculation. Page 10

11 The above representations shall be deemed reiterated at the time of any order placed with you and shall continue throughout the period you will hold investment Funds shares/units for us or our customers. For and on behalf of (Name of Company) Signature Name Date D M Y Title Date D M Y Signature Name Date D M Y Title Date D M Y Page 11

12 Appendix II: Letter of Institutionnal Investor Status (To be filled in and signed on the Subscriber Letterhead) CACEIS BANK LUXEMBOURG Attn: Fund Distribution Services 31 Allée Scheffer L-2311 Luxembourg Luxembourg D M Y Re: Institutional Investor status Dear Sir, With reference to our investments in AMUNDI MONEY MARKET FUND SHORT TERM (EUR) and more generally in the institutional classes of the UCI s created under the law of July 1991 for which CACEIS Bank Luxembourg acts as Register Agent, we hereby confirm that (insert name of company) be regarded as an Institutional Investor in the meaning of that law and more particularly the Guidance Note issued by the Commission de Surveillance du Secteur Financier (CSSF) on December 27, 1999, i.e. companies and organisations which manage large funds and portfolios, either: (please tick one category A credit institution Other Professionals of the Financial Sector (PSF) An insurance or reinsurance company* A social security organisation A pension Fund Management relationship* An undertaking for collective investment (UCI) A local authority investing its own capital A holding company or similar whose partners are institutional investors An industrial and financial group Third parties through a credit institution or other PSF with which they are in discretionary Other structures (Please describe) Should our status of institutional investor change, we would notify you as soon as practicable. Certified to be correct and true on behalf of By Name Position Signature Name Position Signature * If the company is the sole subscriber from the investment Fund s point of view i.e. the beneficiaries of the insurance policies have no direct access to its assets and cannot receive units/shares at maturity. * Provided they have no right to claim against the UCI. Page 12

13 Appendix III: Letter of Consent for sending contract notes, statements and dividend reporting by To CACEIS Bank Luxembourg Attn: Fund Distribution Services Name of investor Account numbers Please note that by signing this letter you agree to apply it to all your existing and future sub-accounts By this letter, in relation to the investments made in the Funds for which CACEIS Bank Luxembourg is acting as Custodian and Administrative Agent, and CACEIS Bank Luxembourg is acting as Register Agent, we consent to receive reports as defined in mutual agreement such as, but not limited to, statements by non-encrypted from CACEIS Bank Luxembourg. The following address(es) should be used in @ We acknowledge that this information will be sent on a non-secured basis through the internet network and that CACEIS Bank Luxembourg will not be held responsible about potential interception of this information for harmful or fraudulous use. We undertake to inform you, through a duly signed letter, of any change in the address(es) to be used. Name Date Name Date Signature Signature Page 13