Traditional Funds PLC Application Form

Transcription

1 Traditional Funds PLC Application Form This Application Form, and the application procedures contained herein, should be read in conjunction with the relevant Key Investor Information Document and Prospectus for Traditional Funds plc (the Company ). Capitalised terms not otherwise defined in this Application Form shall have the meaning provided in the Prospectus. The Applicant is applying for Shares of the Classes referred to in this Application Form on the terms and conditions set out in this Application form, the Memorandum and Articles of Association of the Company, the most recent Prospectus and relevant Fund Particulars Supplement and Annual Report and Accounts of the Company. By completing and signing this Application Form, the Applicant represents, warrants and undertakes to the Company and the Administrator in the terms set out in this Application Form. Please complete this Application Form which constitutes your Agreement to subscribe for Shares in the Company and send/fax (in which case the original must also be forwarded) to: Traditional Funds plc c/o The Administrator State Street Fund Services (Ireland) Limited Transfer Agency Department 78 Sir John Rogerson s Quay Dublin 2 Ireland Telephone: Facsimile: General enquires: BMOGAM@statestreet.com Registration enquires: BMOGAMreg@statestreet.com Please tick here if this has already been sent by facsimile transmission Part 1 Details of Applicant(s) Please register Shares* pursuant to this application in the name(s) and address(es) set out below: First holder (Company/Nominee Name) Joint holders Title and full name or Title (Mr/Mrs/Miss/Other) Address ( PO Box or Care of will not be accepted) Forenames Surname Address ( PO Box or Care of will not be accepted) Telephone Fax Telephone Fax Title and full name Address ( PO Box or Care of will not be accepted) Mailing address (If different from the address of the first named holder) Telephone Fax Title and full name Address ( PO Box or Care of will not be accepted) Telephone Fax *Share Registration: All shares issued are non-certificated Page 1

2 Part 2.1 Choose your investment Please choose the sub-fund/s and state the subscription amount or the number of shares you wish to invest. For further information including fees please see the F&C Portfolios Fund Prospectus. Fund Name ISIN Share Class Base Currency Subscription amount (please include currency)* No. of shares * Please note If the currency of investment is different from the currency denomination of the relevant sub-fund, the necessary currency conversion will be arranged on behalf of, and at the risk and expense of, the shareholder. Part 2.2 Select Settlement Currency Tick currency denomination in which investment will be made. Euro ( ) Sterling ( ) US Dollar (US$) Norwegian Krone (NKr) Swiss Franc (SFr) Singapore Dollar (S$) If payment is not being made in the Fund s base currency, then please note that foreign exchange will be arranged by the Administrator of the Company in accordance with the procedures employed by the Administrator for foreign exchange transactions. Application Forms in respect of all Funds except F&C Global Emerging Markets Fund and F&C Emerging Asia Fund, duly completed, and cleared funds in respect of the subscription must be received by the Administrator in the account(s) referred under 4. Payment Method below no later than 1pm (Dublin time) on the Business Day preceding the relevant Dealing Day (Business Day and Dealing Day are defined in Note 1 below), or such earlier or later day and/or time as the Directors shall from time to time determine generally or in respect of specific applications. Applications in respect of F&C Global Emerging Markets Fund and F&C Emerging Asia Fund must be received by the Administrator no later than 3pm (Dublin time) on the Business Day preceding the relevant Dealing Day or such earlier or later day and/or time as the Directors shall from time to time determine generally or in respect of specific applications. NOTES 1. A Business Day is any day (excluding Saturdays, Sundays and public holidays) on which banks are open for business in both London and Dublin and/or such other or further places as the Directors may from time to time determine. A Dealing Day for Shares is any Business Day on which the Directors have determined to give effect to applications for subscriptions and/or requests for redemptions of Shares of each Fund subject to there being not less than two Dealing Days in each calendar month. The Dealing Days in respect of Shares of each Fund are set out in the Fund Particulars Supplement to the Prospectus applicable to the relevant Fund. Page 2

3 Part 3.1 Bank Details Please provide the details of the account to which redemption proceeds and/or dividend distributions should be paid. Payments will only be made to a bank account held in the name of the registered shareholder. No payments will be made to third parties. Both IBAN and SWIFT (BIC) codes should be quoted for all banks within the EU/EEA. Amendments to investors payment instructions will only be effected upon receipt of an original instruction which has been duly authorised. In the case of joint accounts, instructions will only be made upon receipt of an instruction duly signed by all applicants. The Administrator does not accept any responsibility for the bank account details quoted and any payments made using these details will be at your risk. Correspondent Bank Name Beneficiary Bank Name Correspondent Bank Address Beneficiary Bank Address Correspondent Bank Sort Code/SWIFT (BIC)/ABA/Fed wire Beneficiary Bank Sort Code/SWIFT (BIC)/ABA/Fed wire Beneficiary Account Name Beneficiary Account Number Payment Type (please select) MT202 MT103 Currency Reference Part 3.2 Intermediary/Broker Details Name of Intermediary/Broker (and Broker ID if available) Mailing Address Contact Details Telephone Facsimile Front End Load % Commission %Total Investing as an intermediary or on own behalf Please indicate below whether the investment is being made on own behalf or as an intermediary: I/We confirm that I am/we are applying for the Shares on my/our own behalf. I/We confirm that I am/we are applying for the Shares as an intermediary on behalf of underlying shareholders/beneficiaries. Part 3.3 Dividend option Please tick: Reinvest Option (automatic purchase of additional shares of the same class equivalent to monthly dividends) or Cash Option (pay all dividends to the bank account listed above) Please indicate currency of payment if different from base currency Should this section not be completed, dividends will be automatically reinvested in additional shares. Any income distribution payable in respect of any Shares issued will be paid in the currency of investment, unless otherwise requested. Page 3

4 Part 4 Payment method Please indicate how payment has been or will be made. Payment is normally due in the currency of the denomination of the Shares of the relevant Class subscribed. If payment in full is not received by the Company within three (3) Business Days of the relevant subscription Dealing Day, the application may be refused and the allotment or transfer of Shares cancelled, or, alternatively, the Company may treat the application as an application for such number of Shares as may be purchased or subscribed with such payment received. 3 Payment by telegraphic transfer to the following account (please tick): Euro Payment US Dollar Payment Beneficiary Bank Bank of America N.A., London Beneficiary Bank Bank of America N.A., New York BIC/SWIFT Code BOFAGB22 BIC/SWIFT Code BOFAUS3N IBAN GB62 BOFA Beneficiary Account Number ABA Beneficiary Account Number Beneficiary Account Name Traditional Funds plc Beneficiary Account Name Traditional Funds plc Reference Name of Fund Applicant Reference Name of Fund Applicant Sterling Payment Norwegian Krone Payment Beneficiary Bank Bank of America N.A., London Beneficiary Bank Bank of America N.A., New York BIC/SWIFT Code BOFAGB22 BIC/SWIFT Code ESSENOKX IBAN GB09BOFA IBAN NO Beneficiary Account Number Beneficiary Account Number Beneficiary Account Name Traditional Funds plc Beneficiary Account Name Traditional Funds plc Reference Name of Fund Applicant Reference Name of Fund Applicant Swiss Franc Payment Singapore Dollar Payment Beneficiary Bank Bank of America N.A., Zurich Beneficiary Bank Bank of America N.A. BIC/SWIFT Code BOFACH2X (Bene. Bank) SWIFT Code BOFAGB22 ABA Correspondent Bank Bank of America N.A., Singapore Beneficiary Account Number CH (Corr. Bank) SWIFT Code BOFASG2X Beneficiary Account Name Traditional Funds plc IBAN GB40BOFA Reference Name of Fund Applicant Beneficiary Account Number Beneficiary Account Name Reference Traditional Funds plc Name of Fund Applicant Part 5 US Person Confirmation Please complete EITHER Section A or Section B as applicable. Section A Please tick box and delete as applicable if the statement below is correct: I/We confirm that I am/we are a US Person (as defined in the Prospectus) and am/are acquiring Shares in the Fund on behalf of, or for the benefit of, a US Person, OR I/We intend to transfer any Shares which I/we may purchase to any US Person. Please supply a copy of the US internal revenue service form W-9 or an original W-8 BEN if the beneficial owner is a non-us person. Section B Please tick box and delete as applicable if the statement below is correct: I/We confirm that I am/we are not a US Person (as defined in the Prospectus) or a resident (for tax purposes). I am/we are not acquiring Shares in the Fund on behalf of, or for the benefit of, a US Person or resident (for tax purposes). I/we do not intend to transfer any Shares which I/we may purchase to any US Person or resident (for tax purposes). Page 4

5 Part 6 Declarations By signing and completing this Application Form I/we represent, warrant and undertake on a continuous basis to the Company and the Administrator as follows: (1) I/We certify that I/we have legal capacity to enter into this agreement. I/We warrant that I/we have the right and authority to make the investment pursuant to this Application Form and that I/we will not be in breach of any laws or regulations of any competent jurisdiction and I/we hereby indemnify the Company, the Investment Manager, the Administrator and other Shareholders for any loss suffered by them as a result of this warranty/ representation not being materially accurate in every respect. I/We agree to provide these representations to the Company and its Directors at such times as either of them may request and to provide on request such certifications, documents or other evidence as the Company and/or its Directors may reasonably require to substantiate such representations; (2) If I am/we are acting as agent, representative or nominee for the account of a third party (the Beneficial Owner ), I/we acknowledge and agree that the agreements, representations and warranties made by me/us herein are also made for and on behalf of (to the fullest extent possible) the Beneficial Owner and I/we represent and warrant that I/we have all requisite power and authority to execute this Application Form and the transactions contemplated hereby and that, in doing so, I/we will not be in breach of any laws or regulations of any competent jurisdiction; (3) I/We hereby acknowledge that I/we have received and considered the current Prospectus of the Company and that I am/we are applying for Shares of the Class(es) referred to in the Application Form on the terms and conditions set out in this Application Form, the Memorandum and Articles of Association of the Company, the most recent Prospectus and the relevant Fund Particulars Supplement. I/We undertake to observe and be bound by the provisions of the Articles of Association of the Company (as amended from time to time) and apply for the Shares issued in relation to this application to be entered in the register of Shareholders in my/our name(s); (4) I/We hereby irrevocably apply for such number of Shares at a price determined in accordance with the Prospectus and the relevant Fund Particulars Supplement. I/We acknowledge that the Company reserves the right to reject any application in whole or in part for any or no reason; (5) I/We warrant that: (a) I/we understand and are willing to accept the risks of investing in the Company and have the knowledge, expertise and experience in financial matters, and/or have taken independent advice where appropriate, to evaluate the risks of investing in the Company and to make an informed decision with respect thereto; (b) I am/we are aware of the risks inherent in investing in the Shares and the method by which the assets of the Company are held and/or traded; (6) I/We will hold Shares on behalf of a US Taxpayer: Yes No (tick the appropriate box) If the yes box is ticked, then I/we acknowledge that I/we should seek advice from my/our tax advisers regarding the tax implications of my investment in the Company. I/We agree to provide the Company with such additional tax information as it may from time to time request; (7) I/We hereby certify that (a) I/we will not, subject to the conditions set forth in the Prospectus, sell or offer to sell or transfer Shares in the United States or to or for the direct or indirect benefit of a US Person; (b) I/we will be acquiring the Shares for investment, and not with a view to or a present intention of distribution or resale to others; and (c) I/we understand that the Company has not been registered under the US Investment Company Act of 1940, as amended (the 1940 Act ), that the Shares have not been registered and will not be registered under the US Securities Act of 1933, as amended (the 1933 Act ), and that the Shares have not been qualified under the securities laws of any state of the United States and that the Shares may not be offered or sold in the United States or to or for the benefit of, directly or indirectly, any US Person. I/We understand that I/we may not assign my/our Shares, in whole or in part (except by operation of law), to any other person, nor will I/we be entitled to substitute for myself/ourselves as an investor in the Company any other person, except with the prior written consent of the Directors; (8) I/We declare that I am /we are or I am / we are not (tick the appropriate box) a person (including an entity) that has discretionary authority or control with respect to the assets of the Company or a person that provides investment advice with respect to Company assets, or an affiliate of such a person. For purposes of this representation, an affiliate is any person controlling, controlled by or under common control with the Company or any of its investment advisor(s) (including the Investment Manager), including by reason of having the power to exercise a controlling influence over the management or policies of the Company or its investment advisor(s) (including the Investment Manager); (9) (a) I/We declare that the entity hereby subscribing for Shares is or is not (tick the appropriate box) a Benefit Plan Investor or investing on behalf of or with any assets of a Benefit Plan Investor. (b) I/We declare that the entity hereby subscribing for Shares is or is not (tick the appropriate box) an entity whose underlying assets include plan assets by reason of a plan s investment in the entity. If the yes box is ticked, please indicate the maximum percentage of the entity s assets it is anticipated might constitute Benefit Plan Investor assets during the period of its investment: per cent. I/We agree to notify the Administrator within five calendar days in writing if I/we know or expect that such maximum percentage has been or is likely to be exceeded; (c) If I am/we are a Benefit Plan Investor 1, or am/are acting on behalf of, or investing with any assets of, a Benefit Plan Investor or a governmental plan or non-electing church plan, then, to the extent applicable, (i) I am/we are aware of and have taken into consideration the diversification requirements and other fiduciary duties under Section 404(a)(1) of the Employee Retirement Income Security Act of 1974, as amended ( ERISA ) or other similar applicable law; (ii) I/we have concluded that my/our proposed investment in the Company is a prudent one; (iii) the fiduciary or other person signing this Application Form is independent of the investment advisor(s) to the Company, the Directors, any intermediaries who have marketing agreements with the Company, the Investment Manager and any of their affiliates, and has not relied upon any investment advice or recommendation of any such person as a basis for the decision to invest in the Company; (iv) this subscription and the investment contemplated hereby are in accordance with all requirements applicable to the plan under its governing instruments and under ERISA, the Code, and/or other similar applicable law; (v) I/we represent and warrant that my/our acquisition and holding of Shares does not and will not constitute or result in a non-exempt prohibited transaction under ERISA or Section 4975 of the Code, or a violation of any similar applicable law; and (vi) I/we acknowledge and agree that none of the Investment Manager or the Directors shall be a fiduciary (within the meaning of Section 3(21) of ERISA, Section 4975 of the Code or other similar applicable law) with respect to any assets of the plan by reason of my/our investment in the Company; (d) If I am/we are a Benefit Plan Investor, I/we acknowledge that the Company intends to limit the sale and transfer of Shares, and may exercise its right compulsorily to redeem (or transfer) Shares, to the extent necessary to prevent 25 percent or more of the value of any class of equity interests in a Fund from being held by Benefit Plan Investors, and consequently to prevent the underlying assets of a Fund from being treated as plan assets of any plan 2 investing in the Company; 1 For this purpose, Benefit Plan Investor is used as defined in U.S. Department of Labor Regulation 29 C.F.R and Section 3(42) of ERISA and includes (i) any employee benefit plan subject to Part 4 of Title I of ERISA; (ii) any plan to which the U.S. Internal Revenue Code of 1986, as amended (the Code ) Section 4975 applies; and (iii) any entity whose underlying assets include plan assets by reason of a plan s investment in the entity (generally because 25 percent or more of a class of equity interests in the entity is owned by plans). An entity described in (iii) immediately above will be considered to hold plan assets only to the extent of the percentage of the equity interests in the entity held by Benefit Plan Investors. Benefit Plan Investors also include that portion of any insurance company s general account assets that are considered plan assets and (except if the entity is an investment company registered under the 1940 Act) also include assets of any insurance company separate account or bank common or collective trust in which plans invest. 2 Plan refers to employee benefit plans subject to Title I of ERISA, or retirement plans subject to Code Section 4975, such as plans intended to qualify under Code Section 401(a) (including plans covering only self-employed individuals) and individual retirement accounts. Page 5

6 (10) Except as set forth in the Prospectus, the relevant Fund Particulars Supplement, or the documents referred to therein, no representations or warranties have been made to me/us by the Company or any agent, employee or affiliate of either; and in entering into this transaction, I am/we are not relying upon any information other than that contained in such Prospectus, the relevant Fund Particulars Supplement or the documents referred to therein, and the results of my/our own independent investigation. I/We confirm that the Shares were not offered to me/us by any means of general solicitation or general advertising. I am/we are not purchasing Shares: (i) as a result of or subsequent to becoming aware of any advertisement, article, notice or other communication published in any newspaper, magazine or similar medium, generally available electronic communication, broadcast over television or radio or generally available to the public on the internet; (ii) as a result of or subsequent to attendance at a seminar or meeting called by any of the means set forth in (i); or (iii) as a result of or subsequent to any solicitations by a person not previously known to me/us in connection with investments in securities generally. Moreover, I/we confirm that we have received no representations, warranties or written communications with respect to the offering of Shares other than those contained in the Prospectus and the relevant Fund Particulars Supplement; (11) I/We acknowledge that the Company has afforded me/us the opportunity to ask questions and receive answers to my/our full satisfaction concerning the terms and conditions of this offering and to obtain any additional information to the extent the Company possesses such information or could acquire it without unreasonable effort or expense, necessary to verify the accuracy of the information contained in the Prospectus; (12) I/We acknowledge that the Investment Manager may, in its sole discretion, (i) pay commission to financial intermediaries, including but not limited to sub-distributors, intermediaries and introducing agents, who refer prospective investors out of an initial charge applied (up to 5%) or (ii) waive the initial charge for certain prospective investors based on factors deemed appropriate by the Investment Manager including, but not limited to, the amount of the proposed investment by a prospective investor; and (iii) the Investment Manager may make additional payments at its discretion out of fee income received; (13) I/We acknowledge that the Directors may impose a redemption charge payable out of the proceeds of redemption in respect of redemptions of Shares held for less than twelve months; that the redemption charge, if any, is payable to the Investment Manager; and that the redemption charge may not exceed 3 percent of the proceeds of redemption of the Shares; (14) If I am/we are a commodity pool, my/our investment is directed by an entity which is (i) not required to be registered in any capacity with the CFTC or to be a member of the US National Futures Association ( NFA ); (ii) exempt from such registration; or (iii) duly registered with the CFTC in an appropriate capacity or capacities and is a member in good standing of the NFA; (15) I am/we are or any of my/our affiliates are derivative or structured product providers and I am/we are investing as part of a derivative or structured product program: Yes No (tick the appropriate box) If the Yes box is ticked, I/we have provided on a separate sheet an overview of the key economic terms of the structured product to be supported by this investment and I/we represent and warrant that neither I/we nor any of my/our affiliates will enter into or issue any derivative or structured product (each a Structured Product ), the return on which is based, directly or indirectly, in whole or in part, on the value of the Company or my/our Shares, with or to any entity (each, a Structured Product Investor ), such that (i) the Structured Product Investor (and, where the Structured Product is held by the Structured Product Investor on behalf of any underlying beneficial owner, such underlying beneficial owner) would be: (1) a beneficial owner of Shares for purposes of the 1940 Act, unless such Structured Product Investor (and, where applicable, underlying beneficial owner) is a US Person; or (2) a holder of Shares who is a Benefit Plan Investor; and (ii) the sale of the Structured Product or the purchase of the Structured Product by any Structured Product Investor (and, where the Structured Product is held by the Structured Product Investor on behalf of any underlying beneficial owner, such underlying beneficial owner) would result in any violation by the Company and/or any investment adviser to the Company of any laws or regulations in any jurisdiction. If the No box is ticked, I/we represent and warrant that neither I/we nor any of my/our affiliates will enter into or issue any Structured Product, the return on which is based, directly or indirectly, in whole or in part, on the value of the Company or my/our Shares; (16) I/We acknowledge that due to anti-money laundering requirements operating within their respective jurisdictions, the Administrator, the Company, its Directors, the Investment Manager and/or any distributor which may be appointed may require further identification of the applicant(s) before the application can be processed and the Company, its Directors, the Investment Manager, the Administrator and/or any Distributor which may be appointed shall be held harmless and indemnified against any loss ensuing due to the failure to process this application and any subsequent subscription or redemption request, if such information as has been requested has not been provided by me/us; (17) I am/we are resident for tax purposes in (insert jurisdiction(s) of tax residence). I am/we are responsible for making any filings with the applicable authorities in such jurisdiction(s) as may be required in connection with my/our acquisition, holding or disposal of Shares and I/we will indemnify the Company (on its own behalf and on behalf of the Directors and the Administrator) against any loss of any nature whatsoever arising from my/our failure to do so. I/We further acknowledge and agree that to the extent that the Company is required to undertake any tax or other reporting in such jurisdiction due (whether wholly or partially) to my/our acquisition, holding or disposal of Shares, I/we may be required to share pro rata the cost to the Company of doing so with any other investors resident in such jurisdiction and agree that the Company has the authority to redeem a portion of my/our investments in the Company and to retain the proceeds to cover my/our pro rata portion of such costs; (18) I/We hereby acknowledge and agree that the Company or the Administrator as its delegate may deliver and make reports, statements and other communications available in electronic form, such as , swift or by posting on a web site notified to me/us by post or by ; (19) I/We hereby authorise the Administrator, as transfer agent, to accept and execute any instructions, (including but not limited to any instructions regarding subscriptions, switches, transfers or redemptions of Shares or any payment in relation to same or otherwise) in respect of Shares to which this application relates, given by me/us in written form, by facsimile, by telephone or by electronic means. If the instructions are given by me/us by telephone, I/we undertake to confirm them in writing. I/We hereby agree to indemnify each of the Administrator and the Company and agree to keep each of them indemnified against any loss of any nature whatsoever arising to any of them as a result of either or them acting upon instructions given in written form by me/us, i.e. facsimile, telephone instructions confirmed by me/us in writing. The Administrator and the Company may rely conclusively upon, and shall incur no liability in respect of, any action taken upon any notice, consent, request, instruction or other instrument believed in good faith to be genuine or to be signed by properly authorised persons; (20) I/We consent to details relating to my/our application and holdings being disclosed to the Investment Manager for use in investor servicing duties and to any other company which may carry out our marketing duties in respect of the Company. I/We consent to the disclosure of any information in this application, and any other information furnished to the Company, to any of its service providers, to any of its duly authorised agents, governmental authority, self-regulatory organisation or, to the extent required by law, to any other person; (21) I/We acknowledge that certain laws and regulations may require disclosure of my/our identity and other information under some circumstances, and such disclosures may be a matter of public record. I/We hereby consent to such disclosure; (22) I/We agree that I/we will indemnify and hold harmless the Company, the Investment Manager, the Administrator and their respective directors, members, officers and employees against any loss, liability, cost or expense (including without limitation attorneys fees, taxes and penalties) which may result, directly or indirectly, from any misrepresentation or breach of any warranty, condition, covenant or agreement set forth herein or in any other document delivered by me/us to the Company; Page 6

7 (23) I/We consent to the recording of telephone calls made to and received from me/us by the Company, its delegates, its duly appointed agents and any of their respective related, associated or affiliated companies for record keeping, security and/or training purposes; (24) If the applicant is more than one person, the obligations of the applicant shall be joint and several and the agreements, representations, warranties and acknowledgements herein contained shall be deemed to be made by and be binding upon such person and his respective heirs, executors, administrators, successors, legal representatives and assigns. 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(s) of us or the executor or administrator of such survivor(s); (25) I hereby confirm that the subscription monies paid for my subscription of shares are: Are directly or indirectly sourced from India Are not directly or indirectly sourced from India I undertake to immediately inform you if I intend to invest monies which are directly or indirectly sourced or originate from India and I will submit the original written approval from the relevant Indian authorities prior to the said investment. (26) I/We hereby acknowledge that my/our personal information will be handled by the Administrator (as data processor on behalf of the Company) in accordance with the Irish Data Protection Acts 1988 to 2003, as amended from time to time. I/We also acknowledge that this information will be processed by the Administrator for the purposes of carrying out the services of administrator, registrar and transfer agent of the Company and to comply with legal obligations including legal obligations under company law and anti-money laundering legislation. I/We acknowledge that the Administrator or Company will disclose my/our information to third parties where necessary or for legitimate business interests. This may include disclosure to third parties such as the auditors, the Irish Revenue Authorities pursuant to the EU Savings Directive and the Central Bank of Ireland or agents of the Administrator who process the data for anti-money laundering purposes or for compliance with foreign regulatory requirements. I/We hereby consent to the processing of my/our information, which may include (1) the recording of telephone calls with the Administrator for the purpose of confirming data, (2) the disclosure of my/our information as outlined above to the Investment Manager (3) the disclosure of my/our information where necessary, or in the Company s or the Administrator s legitimate interests, to the MLRO and/or any company in the Administrator s, or (4) the disclosure of my/our information to 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. I/we acknowledge my/our right of access to and the right to amend and rectify my/our personal data, as provided herein. For the avoidance of doubt the Company shall be considered a data controller in accordance with the Irish Data Protection Acts and the Administrator shall be considered a Data Processor. I/We also consent to the disclosure of my/our data to the tax authorities in Ireland and to my/our own country of residence where relevant in accordance with the EU Taxation of Savings Directive (2003/48/EC) and applicable local regulations; (27) I/We also acknowledge that my/our personal information will be handled by the Investment Manager, F&C Management Limited and/or Thames River Capital LLP, which are each regulated under UK Data Protection law as a data controller and are each responsible for the proper processing of any personal details held in connection with your investment. This may include the transfer of such data to other members of the F&C Group or Bank of Montreal Group, whose offices are situated outside the EEA. The Investment Manager will ensure that any data processed on its behalf outside the EEA will receive equivalent protection to that under UK Data Protection law including the Data Protection Act I/we authorise the Investment Manager to disclose any information relating to my investment to the Financial Conduct Authority, HMRC or any other governmental, regulatory or competent authorities with jurisdiction over them, or to make such disclosure as otherwise required by any law or regulation applicable to them, including anti -money laundering and anti-terrorism laws. I acknowledge and agree that the Investment Manager, the Fund or the Administrator may be obliged to make disclosures regarding such information to comply with the requirements of applicable law or regulation and/or the requirements of UK and other competent authorities. I also agree that my details may be used by the Investment Manager to send information on other products and services they think might be of interest to me. If you would prefer not to receive such information, please contact our Client Services at the address of Exchange House, Primrose Street, London EC2A 2NY. (28) I/We am/are or am/are not (tick the appropriate box) an executive officer or director 3 of a public company 4 or a covered non-public company, 5 or a person materially supported 6 by such executive officer or director (collectively, Covered Persons ), or an account in which one or more restricted persons as defined in Rule 5130 of the US Financial Industry Regulatory Authority hold, directly or indirectly, a beneficial interest (an Account ) in which any Covered Person has a beneficial interest; and If the response is affirmative, list the names of the applicable public companies and covered non-public companies. Accounts must also indicate the percentage of the Account beneficially owned by Covered Persons in respect of each public company or covered non-public company identified below: (29) I/We hereby agree to notify the Company or the Administrator promptly of any changes in the foregoing representations which may occur prior to or following an investment in the Company and to abide by any directions from the Company or the Administrator arising as a result. I/We further agree that the representations and warranties made herein are continuous and all subsequent subscriptions of Shares in the Fund by me/us shall be governed by them. I/We acknowledge that the Company may from time to time establish entities for investment or other purposes. I/We agree that the representations made herein as well as any notifications or reaffirmations I/we make may be relied upon by such entities in the event that interests in such entities are distributed to me/us by the Company as part of a dividend, distribution, redemption proceeds payment or otherwise as if such representations were made directly to such entity. The above representations, warranties and undertakings shall, where the subscription is being made by joint applicants, be deemed to be given by each of the joint applicants on a joint and several basis and continuing unless notice is provided to the contrary. 3 For this purpose, an executive officer or director includes any (i) person named as an executive officer or director in a US public company s most recent proxy statement filed with the US Securities and Exchange Commission or in an annual report filed with the US Securities and Exchange Commission on Form 10-K or Form 20-F, (ii) executive officer or director of a non-us company that is registered with the US Securities and Exchange Commission under the US Securities Exchange Act of 1934, as amended (the Exchange Act ), or (iii) executive officer or director of a covered non-public company. For entities that are not formed as corporations, the term director should be interpreted to include any person who performs similar functions for such entity. 4 A public company is any company that is registered under Section 12 of the Exchange Act or files periodic reports pursuant to Section 15(d) thereof. 5 Covered non-public company means any US or non-us non-public company that has: (i) income of at least $1 million in the last fiscal year or in two of the last three fiscal years and shareholders equity of at least $15 million; (ii) shareholders equity of at least $30 million and a two-year operating history; or (iii) total assets and total revenue of at least $75 million in the latest fiscal year or in two of the last three fiscal years. 6 Material support for this purpose means directly or indirectly providing more than 25 per cent of a person s income in the prior calendar year. Persons living in the same household are deemed to be providing each other with material support. 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8 Part 7 EU Savings Directive Council Directive 2003/48/EC of 3 June 2003 (the EU Savings Directive ), which deals with the taxation of savings income in the form of interest payments, seeks to ensure that an individual who is resident in a member state of the European Union (an EU Member State ) and who receives savings income from another EU Member State, 7 is taxed in the EU Member State in which he/she is resident for tax purposes. In this regard the Fund is obliged to establish the identity and residence of such individuals. 7 Also applicable to residents of USA, Switzerland, Andorra, Liechtenstein, Monaco, San Marino, Jersey, Guernsey, Isle of Man, Anguilla, Montserrat, British Virgin Islands, Turks and Caicos Islands, Cayman Islands, Netherlands Antilles, and Aruba. Accordingly any reference to EU Member State should be deemed to include these additional countries. For completion by Applicants who are tax resident outside the EU Member States The Applicant confirms by ticking the box to the left that the Applicant is not resident in an EU Member State and has not verified its identity for the purposes of the Fund money laundering verification requirements by use of an EU passport/official identity; Applicants who are tax resident in the EU Member States should complete EITHER Section (1) OR Section (2) below: Section 1 This Section 1 is to be completed by an Applicant resident in an EU Member State who is not a natural person (i.e., not an individual, unincorporated body, unincorporated partnership, or any of the foregoing acting as trustee of a trust): a. Is Applicant a legal person, e.g., an incorporated entity? Yes or No (tick the appropriate box) b. Are Applicant s profits taxed under general arrangements for business taxation? Yes or No (tick the appropriate box) c. (i) Is Applicant a UCITS or (ii) has Applicant been issued a certificate by Applicant s EU Member State allowing Applicant to be treated as a UCITS for the purposes of the EU Savings Directive? Yes or No (tick the appropriate box) Section 2 This Section 2 is to be completed by natural person Applicants (i.e., an individual, an unincorporated body, an unincorporated partnership, or any of the foregoing acting as a trustee of a trust) residing in an EU Member State or who, in completing the Trust s money laundering verification requirements, have verified his/her identity by use of an EU Member State passport/official identity: a. Specify the EU Member State in which Applicant is tax resident Please insert the Tax Identification Number ( TIN ) issued to Applicant by that EU Member State b. Is Applicant s EU passport or official identity issued by the same EU Member State that appears in Part 1? Yes or No (tick the appropriate box) c. Applicant s date, place, and country of birth If Applicant answered Yes to Section 1(c)(ii) above, Applicant must provide a certified copy of the certificate. If Applicant answered NO to Section 2(b) above, then Applicant must provide a certificate of residence for tax issued by Applicant s local taxation authority, otherwise Applicant s EU residency will be decided and reported upon the basis of information contained in Applicant s passport/official identity card and/or other documentation provided for the purposes of satisfying the Company s money laundering verification requirements. Part 8 Personal Portfolio Investment Undertaking (PPIU) I/We* confirm that I am/we are* an Irish Resident or Irish Ordinary Resident who is a director or has a relationship with a director of the fund. *Delete as appropriate Please enter name(s) of PPIU (please tick) Part 9 Politically Exposed Persons Please complete EITHER Section A or B below, with reference to the definitions below: A Politically-Exposed Person ( PEP ) is an individual who has at any time in the preceding 12 months been, entrusted with a prominent public function. This includes the following individuals (but excluding any middle ranking or more junior official): a. a specified official ; b. a member of the administrative, management or supervisory body of a state-owned enterprise; A specified official is (including any such officials in an institution of the European Communities or an international body): a. a head of state, head of government, government minister or deputy or assistant government minister; b. a member of a parliament; c. a member of a supreme court, constitutional court or other high level judicial body whose decisions, other than in exceptional circumstances, are not subject to further appeal; d. a member of a court of auditors or of the board of a central bank; e. an ambassador, chargé d affairs or high-ranking officer in the armed forces An immediate family member of a PEP includes any of the following persons: a. any spouse of the PEP; b. any person who is considered to be equivalent to a spouse of the PEP under the national or other law of the place where the person or PEP resides; c. any child of the PEP; d. any spouse of a child of the PEP; e. any person considered to be equivalent to a spouse of a child of the PEP under the national or other law of the place where the person or child resides; f. any parent of the PEP; g. any other family member of the PEP who is of a class prescribed by the Minister for Justice under section 37(11) of the Act. 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9 A close associate of a PEP includes any of the following persons a. any individual who has joint beneficial ownership of a legal entity or legal arrangement, or any other close business relations, with the PEP; b. any individual who has sole beneficial ownership of a legal entity or legal arrangement set up for the actual benefit of the PEP. As an example, a beneficial owner of a body corporate is any individual who (other than a company having securities listed on a regulated market): a. ultimately owns or controls, whether through direct or indirect ownership or control (including through bearer shareholdings), more than 25 per cent of the shares or voting rights of the body; or b. otherwise exercises control over the management of the body. Section A: Complete this section if, according to the above definitions: the application IS being made by a PEP/immediate family member of a PEP/close associate of a PEP or the applicant DOES have a beneficial owner who is a PEP/immediate family member of a PEP/close associate of a PEP or the application IS being made for the benefit of a PEP/immediate family member of a PEP/close associate of a PEP or it IS intended to transfer the shares to a PEP/immediate family member of a PEP/close associate of a PEP Name of PEP Address of PEP Office of PEP Relationship of Applicant or Applicant s Beneficial Owner to PEP Source of Wealth of the Applicant (e.g. Income from employment, Income from company business, inheritance) Section B: By ticking the box to the left I/we confirm that according to the above definitions: the application IS NOT being made by a PEP/immediate family member of a PEP/close associate of a PEP and the applicant DOES NOT have a beneficial owner who is a PEP/immediate family member of a PEP/close associate of a PEP and the application IS NOT being made for the benefit of a PEP/immediate family member of a PEP/close associate of a PEP and it IS NOT intended to transfer the shares to a PEP/immediate family member of a PEP/close associate of a PEP Part 10 Declaration of Residence Outside the Republic of Ireland Applicants resident outside the Republic of 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/units. Terms used in this declaration are defined in the Prospectus. Please select either A or B A - Declaration on Own Behalf i. I/ We* declare that I am/we* are applying for the Units on my own/our own behalf/on behalf of a company* and that I am/we are/the company* is entitled to the Units in respect of which this declaration is made and that I am/we are/the company* is not currently an Irish Resident or Irish Ordinary Resident, and should I/we/the company* become an Irish Resident, I/we will so inform you, in writing, accordingly. B - Declaration as Intermediary i. I/ We* declare that I am/we are* applying for Units on behalf of persons who will be beneficially entitled to the Units, and who to the best of my/our* knowledge and belief, are neither an Irish Resident or Irish Ordinary Resident, and ii. I/ we* also declare that unless I/we* specifically notify you to the contrary at the time of application, all applications for Units made by me/us* from the date of this application will be made on behalf of such persons; and I/we* will inform you in writing if I/we* become aware that any person, on whose behalf I/we* hold Units, becomes an Irish Resident. *Delete as appropriate Part 11 UCITS IV Please tick either A or B: A B I/We* consent to receive any relevant KIIDs for all classes of the umbrella fund prior to making any subsequent investments by accessing the management company website. I/We* understand that the website location will be notified to us by an sent to the address noted by us in this application form. or I/We* understand that we should receive KIIDs as appropriate prior to making any investments for any other classes of the umbrella fund. I/We* wish to receive the KIIDs in paper form and will request these as required. *Delete as appropriate Page 9

10 Part 12 Authorisation I/We agree to be bound by the Declarations, Representations, Consents and Indemnities set out in this Application Form Signature (1) Signature (2) Capacity of Authorised Signatory Capacity of Authorised Signatory Name Authorised Signatory (1) Name Authorised Signatory (2) Date Date Signature (3) Signature (4) Capacity of Authorised Signatory Capacity of Authorised Signatory Name Authorised Signatory (3) Name Authorised Signatory (4) Date Date Part 13 Important Information To be valid, this Application Form must be signed by the applicant and in the case of joint applicants, each must sign. In the case of a corporation, the application must be signed by no less than two authorised signatories as agreed in the corporate signing mandate. If the Application Form is signed under power of attorney, a copy of the power of attorney and their authorised signatory list must be furnished in support of the signature. Non resident declarations are subject to inspection by the Irish Revenue Commissioners and it is a criminal offence to make a false declaration. To be valid, this application form (incorporating the declaration required by the Irish Revenue Commissioners) must be signed by the applicant and in the case of joint applicants, each must sign. In the case of a corporation, the application must be signed by authorised signatories as agreed in the corporate signing mandate. If the Application Form (incorporating the declaration required by the Irish Revenue Commissioners) is signed under power of attorney, a copy of the power of attorney must be furnished in support of the signature. Applicants who are resident or ordinarily resident in the Republic of Ireland or are an Exempt Irish resident as defined in the Prospectus, please contact the Transfer agent immediately. Part 14 Anti-Money Laundering Know Your Customer Requirements Under Irish legislation covering anti-money laundering and the taxation of savings the Company and the Administrator are required to obtain the following documentation to verify the identity, permanent address and tax residency status of all new investors. Please note that the application may not be accepted until all the relevant information has been received. Additional confirmation of identity or authority of the applicant or the source of funds may be required in certain circumstances. Documentation which may be required for all Individual Applicants 1. Personal Verification 8 - ONE official photographic document (Certified 9 ) 2. Address Verification 10 - TWO different address verification documents (Original or Certified) Documentation which may be required for Designated Bodies in certain countries Confirmation of Name and Address 2. Confirmation of Regulatory Body 3. Original Authorised Signatory List 4. Original letter of assurance where investing as an intermediary Documentation which may be required for Non Designated Bodies 1. Confirmation of Name and Address 2. Confirmation of Regulatory Body (if applicable) 3. Certificate of Incorporation or Certificate to Trade (Certified) 4. Memorandum and Articles of Association 5. List of Directors to include full name, dates of birth, occupation, residential and business addresses 6. Authorised Mandate or Board Resolution to establish the business relationship 7. Original Authorised Signatory List 8. ONE Personal Verification and TWO Address Verification documents for at least TWO Directors (original or certified) 9. One Personal Verification and TWO Address Verification documents for ALL 12 persons authorised to operate the account (original or certified) 10. Names and addresses of shareholders holding 10% or more of the issued share capital, and in the case of individual shareholders, names, residential addresses, occupations and dates of birth. Where a body corporate holds 25% or more of the issued share capital, names, residential addresses, occupations and dates of birth of the ultimate beneficial owners of that body corporate should be obtained. Page 10