NOMURA INVESTMENT SOLUTIONS PLC APPLICATION FORM

Transcription

1 NOMURA INVESTMENT SOLUTIONS PLC APPLICATION FORM This Application Form should be read in the context of and together with the Prospectus & Supplement(s) of Nomura Investment Solutions plc(the Fund ) (collectively the Prospectus ), and save where otherwise defined in this Application Form, all capitalised terms shall have the same meaning as in the Prospectus. Neither the Prospectus nor this Application Form constitute an offer or solicitation in the United States of America, to anyone who is a US Person or in any other jurisdictions in which such offer or solicitation is not authorised. ORIGINAL completed Application Forms should be sent by post to the following address: (Subsequent Applications for Shares may be faxed to the number below. Please note that redemption payments will not be made prior to receipt of the original of this form and supporting documentation) Nomura Investment Solutions plc Tel: C/o BNP Paribas Fund Services Dublin Limited Fax: George s Dock IFSC Dublin 1 All relevant sections must be completed in order to validate this application Please read this form carefully before signing 1. Account Registration Please print exactly how the shareholder account is to be registered including any account designation First Registered Share holder Designation (if applicable) Registered/ Permanent Address (include postcode and country) Correspondence Address (if different) Tax Identification Number (for individuals) Telephone Number (include country code) Fax No (include country code) Address Joint Registered Shareholder Registered/Permanent Address (include Postcode and country) Tax Identification Number (for individuals) Telephone Number (include country code) Fax Number (include country code) Address 1

2 2. Initial Subscription Details I/We the undersigned having received, read and carefully considered a copy of the current Prospectus / Key Investor Information Document (KIID) and the most recent annual report of the Fund, and having had an opportunity to review the material contracts referred to in the Prospectus / KIID, hereby apply for Shares in the Fund at the subscription price calculated in accordance with the Prospectus, as may be issued for with the monetary amount indicated below: Name of Fund Minimum Initial Subscription as per the Prospectus* Base Currency ISIN Indicate class for investment Enhanced Core Euro Sovereign Bond Fund Class A EUR 10,000 EUR IE00B3XBYP30 Enhanced Euro Equity Fund Class A EUR 10,000 EUR IE00B3XT2X12 Nomura Interest Rate Investment Strategy Fund Class I EUR 5,000,000 EUR IE00B431YN85 Nomura Interest Rate Investment Strategy Fund Class A EUR 100,000 EUR IE00B3VW2214 Nomura Interest Rate Investment Strategy Fund Class D EUR 1,000 EUR IE00B442JV32 Nomura Interest Rate Investment Strategy Fund Class I GBP 5,000,000 GBP IE00B3YW7Y59 Nomura Interest Rate Investment Strategy Fund Class A GBP 100,000 GBP IE00B3YX0495 Nomura Interest Rate Investment Strategy Fund Class D GBP 1,000 GBP IE00B3YZ8S59 Nomura Interest Rate Investment Strategy Fund Class I USD $5,000,000 USD IE00B3XBYX14 Nomura Interest Rate Investment Strategy Fund Class A USD $100,000 USD IE00B3XT3496 Nomura Interest Rate Investment Strategy Fund Class D USD $1,000 USD IE00B3VW5W26 Nomura Interest Rate Investment Strategy IRISx4 Fund Class I EUR 5,000,000 EUR IE00B6636D96 Nomura Interest Rate Investment Strategy IRISx4 Fund Class A EUR 100,000 EUR IE00B63RXR79 Nomura Interest Rate Investment Strategy IRISx4 Fund Class D EUR 1,000 EUR IE00B5N6NJ99 Nomura Interest Rate Investment Strategy IRISx4 Fund Class I GBP 5,000,000 GBP IE00B638QY83 Nomura Interest Rate Investment Strategy IRISX4 Fund Class A GBP 100,000 GBP IE00B63Y3T01 Nomura Interest Rate Investment Strategy IRISx4 Fund Class D GBP 1,000 GBP IE00B5LYM769 Nomura Interest Rate Investment Strategy IRISx4 Fund Class I USD $5,000,000 USD IE00B663SF58 Nomura Interest Rate Investment Strategy IRISx4 Fund Class A USD $100,000 USD IE00B641ZY95 Nomura Interest Rate Investment Strategy IRISx4 Fund Class D USD $1,000 USD IE00B5N6PB53 Nomura Macro Commodity Strategy Fund Class I EUR Nomura Macro Commodity Strategy Fund Class A EUR Nomura Macro Commodity Strategy Fund Class D EUR Nomura Macro Commodity Strategy Fund Class I GBP Nomura Macro Commodity Strategy Fund Class A GBP Nomura Macro Commodity Strategy Fund Class D GBP Nomura Macro Commodity Strategy Fund Class I USD Nomura Macro Commodity Strategy Fund Class A USD Nomura Macro Commodity Strategy Fund Class D USD Nomura C10 Fund Class I EUR Nomura C10 Fund Class A EUR Nomura C10 Fund Class D EUR Nomura C10 Fund Class I GBP 5,000,000 EUR IE00B5VGX ,000 EUR IE00B5NWG985 1,000 EUR IE00B5W7RB36 5,000,000 GBP IE00B5M3CW74 100,000 GBP IE00B5N ,000 GBP IE00B5KKZW16 $5,000,000 USD IE00B5VTLG36 $100,000 USD IE00B5NFVC59 $1,000 USD IE00B5M39Q04 5,000,000 EUR IE00B3Q1FL31 100,000 EUR IE00B68Y8Y57 1,000 EUR IE00B67BM125 5,000,000 GBP IE00B3P9L989 2

3 Nomura C10 Fund Class A GBP Nomura C10 Fund Class D GBP Nomura C10 Fund Class I USD Nomura C10 Fund Class A USD Nomura C10 Fund Class D USD Nomura C10 Fund Class I CHF Nomura C10 Fund Class A CHF Nomura C10 Fund Class D CHF Nomura Quadra Fund S EUR* Nomura Permal Alpha Japan Neutral Fund Class A JPY** Nomura Permal Alpha Japan Neutral Fund Class A EUR** Nomura Permal Alpha Japan Neutral Fund Class A USD** Nomura Permal Alpha Japan Neutral Fund Class M USD** 100,000 GBP IE00B3NM9M89 1,000 GBP IE00B3TLYS07 $5,000,000 USD IE00B3Q5BP11 $100,000 USD IE00B3SBF779 $1,000 USD IE00B3PHVK32 CHF5,000,000 CHF IE00B3P4KC91 CHF100,000 CHF IE00B3NDPW32 CHF1,000 CHF IE00B3R2ZK43 20,000,000 EUR IE00B8J4G ,000 JPY IE00B ,000 EUR IE00B70DMB28 $1,000 USD IE00B78RS851 $5,000,000 USD IE00B5T4H735 In respect of a Subscription Dealing Day, the Dealing Deadline is 3.00 pm (Irish Time) on any given Business Day, or any such time as set out in the Prospectus / KIID. *Please note that Nomura Quadra Fund S EUR dealing deadline is 9AM T-1 *Please note that with respect to the Nomura Permal Alpha Japan Neutral Fund the Dealing Day is each Thursday or if such day is not a Business Day, the immediately following Business Day. *Kindly refer to the Prospectus / KIID regarding subsequent subscription minimum requirements. 3

4 Please confirm cash amount or number of shares to be purchased. Tick as appropriate: SHARE SUBSCRIPTION: or CASH SUBSCRIPTION: Using Numeric Characters:,,,. Using Alphabetical Characters: Please also indicate if you would like to avail of Clearstream or Euroclear settlement by ticking the relevant box below: Clearstream Settlement: Euroclear Settlement: 3. Bank Details Subscriptions should be lodged in base currency by electronic transfer in the following account: EUR Bank Account Details: Bank: ABN Amro Bank, Frankfurt SWIFT: ABNADEFFFRA Account number: IBAN: DE Name of account: Nomura Investment Solutions PLC USD Bank Account Details: Bank: ABN Amro Bank NV, New York Fedwire: ABA SWIFT Code: ABNAUS33 Account Number: Name of account: Nomura Investment Solutions PLC GBP Bank Account Details: Bank: ABN AMRO N.V, London SWIFT Code: ABNAGB2L Sort Code: Account Number: IBAN: GB96ABNA Name of account: Nomura Investment Solutions PLC JPY Bank Account Details: Bank: ABN Amro Bank, Tokyo SWIFT: ABNAJPJT Account number: IBAN: N/A Name of account: Nomura Investment Solutions PLC Please supply bank or building society account details in the section below. These payment details will be used for all future redemption and dividend payments (if applicable) unless changed in writing by the investor. Beneficiary Bank Details: Bank/Building Society: Account Currency: IBAN: SWIFT/Sort Code: Account Number: Account Name: Bank Address: Correspondent/Pay Through Bank: Account Name: SWIFT/Sort Code: Bank Address: Account Number: IBAN: 4

5 4. Declarations/Representation and Warranties I/We hereby warrant that I/we have read the Prospectus / KIID (as amended from time to time) of the Fund and apply to be entered in the Register of Shareholders as the holder/holders of the Shares issued in relation to this application. I/We hereby represent and warrant to the Fund (for itself and on behalf of all Shareholders in the Fund) that I/we am not a US person as defined in the Prospectus and that I/we are not acting on behalf of or for the benefit of nor do I/we intend transferring any Shares in the Fund which I/we purchase to any US person. The Application Form was executed and forwarded by us from the address set out as Shareholder Address, which is outside of the US and we were not in the US either at the time that the Shares in the Fund were offered to us or at the time such offer was accepted. I/We acknowledge that due to anti - money laundering requirements operating within their respective jurisdictions the Administrator, the Manager, the Investment Manager and the Fund (as the case may be) may require further identification of the applicant(s) before the application can be processed and the Administrator, the Manager, the Investment Manager and the Fund shall be held harmless and indemnified against any loss arising as a result of a failure to process the application if such information has been required by the parties referred to and has not been provided by me/us. I/We hereby agree to indemnify and keep indemnified the Fund against any loss arising to it as a result of any breach of any representation, warranty, covenant or confirmation by me/us in the Application Form or from my/our failure to disclose any relevant details or provide it with all information requested by it or by the Administrator on its behalf. In the case of delay or failure to provide satisfactory information, the Fund, the Manager and the Administrator may take such action (including declining to accept an application) as they see fit. I/We understand that if the application is rejected, the Administrator shall return the full amount tendered herewith on the account mentioned above. I/We am/are fully empowered and have the authority to make this investment whether the investment is my/our own or is made on behalf of another person or institution. I/We confirm that I/we have the right and authority to request redemption or repurchase of Shares and confirm that I/we will comply with the redemption and repurchase procedures set out in the Prospectus. All redemption or repurchase instructions must be given in writing and must be accompanied by an endorsed Share Certificate if such has been issued, or failing which, the appropriate account number must be quoted. I/We confirm that I am/we are 18 years of age or over. I/We agree to provide these confirmations to the Fund at such times as the Fund may request, and to provide on request such certifications, documents or other evidence as the Fund may reasonably require to substantiate such representations. I/We agree to notify the Fund immediately if I/we become aware that any of these confirmations are no longer accurate and complete in all respects and agree immediately either to sell or to tender to the Fund for redemption a sufficient number of Shares to allow the confirmation to be made. I/We hereby accept such lesser number of Shares, if any, than may be specified above in respect of which this application/transfer may be accepted. I/We having received and considered a copy of the Prospectus / KIID hereby confirm that this application is based solely on the Prospectus / KIID for the Fund current at the date of this application and the material contracts therein referred together (where applicable) with the most recent annual report and accounts of the Fund and I/we acknowledge that all of the above documents are available for review following a request to the Administrator. I/We request that the Shares issued pursuant to this application are registered in the name and address set out in Section 1. I/We consent to details of my/our Shareholding or personal data which is revealed on this form or is disclosed by me/us subsequently being disclosed to the Investment Advisor, its affiliated companies and any other service provider to the Fund. I/We consent to the Administrator and Manager, their delegates, authorised agents and associated or affiliated companies using, disclosing, processing and transferring outside the European Union my/our personal data which is revealed on this form or is disclosed by me/us subsequently. In respect of Joint applicants only -We direct that on the death of one of us the Shares for which we hereby apply be held in the name of and to the order of the survivor or survivors of us or the executor of such survivor or survivors and we understand that certain documentation may be required to permit this. I/we agree to notify the Company of any change to my/our tax residency status. I/We hereby acknowledge that any notice or document may be served by the Manager on me/us in the manner specified from time to time in the Prospectus and, for the purposes of the Electronic Commerce Act 2000, if I have provided an address or fax number to the Manager or its delegate, consent to any such notice or document being sent to me/us by fax or electronically to the fax number or address previously identified to the Manager or its delegate which I/we acknowledge constitutes effective receipt by me/us of the relevant notice or document. I/we acknowledge that I/we are not obliged to accept electronic communication and may at any time choose to revoke my/our agreement to receive communications by fax or electronically by notifying the Manager in writing at the above address provided that my/our agreement to receive communications by fax or electronically shall remain in full force and effect pending receipt by the Manager of written notice of such revocation. 5

6 KEY INVESTOR INFORMATION DOCUMENT(S) (KIID) I/We hereby acknowledge and confirm that I/We have received, read and understood the KIID for the Fund and Class(es) to which this Application Form relates in good time prior to completing this Application Form. I/We hereby confirm that for any subsequent investments I/we will obtain and read the latest version of the appropriate KIID prior to each subscription. FAX & ELECTRONIC DEALING INDEMNITY Only once an investor has completed and submitted an application form may they use the facsimile and/or electronic dealing facility to place subsequent purchase and/or redemption orders. I/We understand that if I/we choose to give deal instructions by fax or by electronic means I/we do so at our own risk. I/We understand that neither the Company (for and on behalf of the relevant Fund) nor any of its agents (including the Investment Manager and the Administrator) shall be under any obligation to verify the authenticity of any deal instructions sent by fax/electronic means. I/We hereby indemnify the Company (for and on behalf of the relevant Fund) and its agents (including the Investment Manager and the Administrator), against all losses, costs, demands, expenses, actions, proceedings and claims incurred by any such persons or entities as a result of acting on such fax/electronic instructions which they reasonably believed to be a valid instruction. I/We understand that all instructions to change our registered information must be submitted in writing. This includes change of address and/or payment instructions. 1. If you do not consent to facsimile/electronic dealing please tick this box. DATA PROTECTION Your personal information will be handled by the Administrator (as Data Processor on behalf of the Fund) in accordance with the Irish Data Protection Acts 1988 to Your information will be processed for the purposes for carrying out the services of Administrator, Registrar and Transfer Agent of the Fund and to comply with legal obligations including legal obligations under company, tax and anti-money laundering legislation. The Administrator or Fund will disclose your information to third parties where necessary or for legitimate business interests. This may include disclosure to third parties such as auditors, the Irish Revenue Commissioners and the Financial Regulator in Ireland, or agents of the Administrator who process the data for antimoney laundering purposes or for compliance with foreign regulatory requirements. The Applicant hereby consents to the processing of his/her information and the disclosure of his/her information as outlined above and to the Investment Manager and where necessary or in the Fund's or the Administrator's legitimate interests to any company in the Administrator's and/or in the Investment Manager's group of companies or agents of the Administrator including companies situated in countries outside of the European Economic Area which may not have the same data protection laws as in Ireland. THIS SECTION APPLIES TO RETAIL CLIENTS OF INDEPENDENT FINANCIAL ADVISORS ONLY PLEASE TICK BOX IF THIS APPLIES TO YOU: ADDITIONAL DECLARATIONS/REPRESENTATIONS AND WARRANTIES We/I hereby acknowledge that: a. We/I have such knowledge and experience in financial and business matters that We are/i am capable of evaluating the merits, risks and suitability of the relevant Fund for its purposes; b. We are/i am solely responsible for evaluating all information provided to us/me in respect of the Funds; c. We are/i am solely responsible for deciding to purchase the Shares, is relying solely on our/my own financial advisors to determine the appropriate financial, legal, regulatory, tax and accounting treatment of our/my investment in the Funds and the suitability of the Funds for its investment purposes; d. We/I understand that neither Nomura Investment Solutions plc, any member of the Nomura Group, nor any of their representatives has provided or will be deemed to have provided any legal, regulatory, tax or accounting advice, nor accepts any responsibility for the appropriateness of the Funds for us/me or for the performance of the Funds; and e. based solely on our/my own independent review and such professional advice as we/i have deemed appropriate under the circumstances, we/i have determined that the purchase of the Shares is fully consistent with our/my financial needs, objectives and condition; it complies and is fully consistent with all policies, guidelines and restrictions applicable to us/me, and it is fit, proper and suitable for us/me, notwithstanding the clear and substantial risks inherent in investing in or holding the Shares. 6

7 THIS SECTION APPLIES TO ALL CLIENTS OF INDEPENDENT FINANCIAL ADVISORS ONLY PLEASE TICK BOX IF THIS APPLIES TO YOU: I hereby acknowledge that I have received marketing material and advice on the Fund through the following Financial Advisor (please insert full legal name as provided by the Financial Advisor*):... * Please note that applications for clients of Independent Financial Advisors will be rejected if the field above remains blank or the name of the Financial Advisor does not correspond to a name of Financial Advisor who has been approved by the Fund Manager to market the Fund to its clients. 5. Declaration of Residence outside the Republic of Ireland and Signatures Applicants resident outside Ireland are required by the Irish Revenue Commissioners to make the following declaration which is in a format authorised by them, in order to receive payment without deduction of tax. It is important to note that this declaration, if it is then still correct, shall apply in respect of any subsequent acquisitions of Shares. Terms used in this declaration are defined in the Prospectus. Declaration on own behalf I/We* declare that I am/we are* applying for the units/ Shares* on my/our own behalf/on behalf of a company* and that I am/we are/the company* is entitled to the Shares* in respect of which this declaration is made and that 1. I am/we are/the company is* not currently resident or 2. ordinarily resident in Ireland, and 3. Should I/we/the company * become resident in Ireland I/we* will so inform you, in writing, accordingly. *Delete as appropriate Declaration as Intermediary I/we* declare that I am/we are* applying for Shares* on behalf of persons: 4. who will be beneficially entitled to the Shares; and 5. Who, to the best of my/our* knowledge and belief, are neither resident nor ordinarily resident in Ireland. I/we* also declare that: 6. unless I/we* specifically notify you to the contrary at the time of application, all applications for Shares* made by me/us* from the date of this application will be made on behalf of such persons; and, 7. I/we* will inform you in writing if I/we* become aware that any person, on whose behalf I/we* hold Shares*, becomes resident in Ireland. * Delete as appropriate If the Applicant is an Exempted Irish Investor as defined in the Prospectus / KIID, it must complete a separate Declaration and should contact the Administrator who will provide it/him/her/them with the appropriate Declaration which must be made to confirm its status. To be valid, this Application Form (incorporating the Non-Irish Residency Declaration) must be signed by the applicant(s) below. Where there is more than one applicant, each person must sign. If the applicant is a company, two authorised signatories must sign, and their names and sample signatures must appear on the company s List of Authorised Signatures. If the application form is signed under power of attorney, a copy of the power of attorney must be furnished in support of the signature. In addition, the applicant must complete the below information. Signature(s) of Applicant(s) or Authorised Person (all applicants must sign) 1 st Applicant Name Signature Date 2 nd Applicant Name Signature Date 7

8 Anti-Money Laundering Requirements Please note that the following list of documentation is required to support an application to purchase Shares in the Fund. These requirements will not be the same for every investor and are generally subject to change with legislation/industry guidance. You will be advised by the Manager/Administrator at the time of making your application should you be required to provide any additional documentation. Private Individual Clients 1. Certified true copy of valid photographic ID (e.g. passport, driving license or national ID card) 2. Two original proofs of residential address (e.g. utility bill, bank statement). Each proof of address must come from a separate source and must have been issued within the last 3 months. 3. Tax Identification Number this should be provided on an original official document (e.g. correspondence from the relevant Revenue Authority or a payslip issued by your employer showing your Tax/Social Insurance Number) Corporate Entities All corporate entities must provide an Original or Certified True Copy of their List of Authorised Signatories. Corporate Entities who are not listed on a Recognised Stock Exchange, or who are not regulated as a Financial Institution in the EU or an equivalent country, must also provide an Original or Certified True Copy of the following documents: 1. Certificate of Incorporation 2. Memorandum and Articles of Association 3. Board Resolution/Board Minutes authorising the Directors to open/operate the account 4. List of Directors Names, Occupations, Dates of Birth, Business and Residential Addresses 5. Proof of Identification and Address Verification for at least two Directors and all persons authorised to operate the account (As per Private Individual Clients requirements above) 6. A list of names and addresses for each shareholder owning 10% or more of the issued share capital of the Corporate Entity Note: Certified true copies of the original documents must be independently certified by a practising Solicitor/Lawyer, Notary Public, Police, or by an official of a designated body (ie an empowered employee of a financial institution in the EU or equivalent country). 8