EEA Fund Management Limited. EEA Funds plc. Application Form.

Transcription

1 EEA Fund Management Limited EEA Funds plc Application Form

2 EEA FUNDS plc (the Company ) Application Form Mailing Address EEA Funds p.l.c. c/o Maples Fund Services (Ireland) Ltd Beaux Lane House Mercer Street Lower Dublin 2 Ireland investorservicesdublin@maplesfs.com Telefax: +353 (0) Telephone: +353 (0) Instructions Completed Application forms may be sent to the Administrator by fax or by PDF. Supporting documentation required for Anti-Money Laundering purposes should be sent by with PDF attachment (investorservicesdublin@maplesfs.com) or by fax (+353 (0) ). Failure to provide the documentation required for Anti-Money Laundering purposes may result in the deduction of tax due to the Irish Finance Act requirements outlined in the Anti-Money Laundering section and/or a delay in the acceptance and/or payment of a transfer/redemption request. Subsequent subscriptions may be sent by with PDF attachment (investorservicesdublin@maplesfs.com) or by fax (+353 (0) ) stating your registration details and the amount to be invested. This Application Form should be completed in advance of the relevant Dealing Deadline. In relation to any application for subscription, repurchase or exchange of shares of a Fund, the Dealing Deadline is the day and time specified in the prospectus and related supplement to the prospectus of the Company (together the "Prospectus") for the relevant Fund by which such application must be received by the Administrator on behalf of the Company in order for the subscription, repurchase or exchange of shares of the Fund to be made by the Company on the relevant Dealing Day in respect of each Fund, which is each Business Day on which subscriptions for, repurchases of and exchanges of relevant shares can be made by the Company as specified in the supplement to the Prospectus for the relevant Fund and/or such other dealing days as the Directors shall determine and notify to shareholders in advance, provided that there shall be at least two dealing days in each month. Non Retail Accounts - An authorised signatory list must be provided at the time of account opening for the investing entity in whose name the account is being opened. The Application Form must be signed by no less than two authorised signatories. Any changes to the original account details must be received by with PDF attachment (investorservicesdublin@maplesfs.com) or by fax (+353 (0) ) and signed by no less than two authorised signatories, in the case of a company, on corporate letterhead, and in the case of retail applicants, all account signatories must authorise every instruction. Remittance Details EEA Diversified Trends Collection A/C USD A/C Intermediary Bank : SOCIETE GENERALE NEW YORK Swift Code : SOGEUS33 For further credit; A/C : Beneficiary Bank : SOCIETE GENERALE PARIS Swift Code : SOGEFRPPAFI Account Name : EEA DIVERSIFIED TRENDS SUB/RED AC USD IBAN : FR

3 EEA Diversified Trends Collection A/C EUR A/C Intermediary Bank : SOCIETE GENERALE PARIS Swift Code : SOGEFRPP For further credit; Beneficiary Bank : SOCIETE GENERALE PARIS Swift Code : SOGEFRPPAFI Account Name : EEA DIVERSIFIED TRENDS SUB/RED AC EUR IBAN : FR EEA Diversified Trends Collection A/C GBP A/C Intermediary Bank : NATIONAL WESTMINSTER BANK PLC LONDON Swift Code : NWBKGB2L For further credit; Sort Code : A/C : 440/02/ Beneficiary Bank : SOCIETE GENERALE PARIS Swift Code : SOGEFRPPAFI Account Name : EEA DIVERSIFIED TRENDS SUB/RED AC GBP IBAN : FR Please ensure that your bank quotes the details above in the electronic funds transfer to the appropriate bank. Subscription monies should be received by wire transfer in cleared funds by the relevant settlement date as set out in the Prospectus in the denominated currency of the relevant share class. The Company may accept payment in such other currencies as the Directors and the Administrator may agree at the prevailing exchange rate available to the Administrator. This may result in a delay in processing the application. Details of Investment The Applicant, having received and read a copy of the Prospectus, hereby applies to invest in the Company, as indicated in the table below: FUND NAME SHARE CLASS CURRENCY VALUE OF SUBSCRIPTION EEA Diversified Trends IE00B86V3N61 Class A USD Shares USD EEA Diversified Trends IE00B8NCXV05 Class A GBP Shares GBP EEA Diversified Trends IE00B86JXG34 Class A EUR Shares EUR EEA Diversified Trends IE00B8L77L59 Class B USD Shares USD EEA Diversified Trends IE00B86KNN34 Class B GBP Shares GBP EEA Diversified Trends IE00B7S9LZ93 Class B EUR Shares EUR * The Company may (but is not obliged to) enter into certain currency related transactions in order to hedge the currency exposure of the Classes denominated in a currency other than the Base Currency, as described under the heading Hedged Classes in the Prospectus. Should you have any questions, please contact the administrator of the Company: EEA Funds p.l.c. c/o Maples Fund Services (Ireland) Ltd, Beaux Lane House, Mercer Street Lower, Dublin 2, Ireland investorservicesdublin@maplesfs.com Telefax: +353 (0) Telephone: +353 (0)

4 Account Registration Details Registered Name (Holder 1) Account Designation (if any) Registered Address (PO or C/O will not be accepted) Country Mailing Address (if different) Contact Name Contact Details Tel: Fax: Joint Applicant(s) Details of up to 3 additional holders may be added to the application. Please complete details in block capitals below. Holder 2 Registered Name Registered Address PO or C/O will not be accepted Contact Name Contact Details Tel: Fax: Holder 3 Registered Name Registered Address PO or C/O will not be accepted Contact Name Contact Details Tel: Fax:

5 Holder 4 Registered Name Registered Address PO or C/O will not be accepted Contact Name Contact Details Tel: Fax: **Correspondence will only be sent to the first named applicant/correspondence address. Additional applicants will be required to provide confirmation of residential address details for anti-money laundering verification purposes. Intermediary Details (if applicable) Broker ID Branch ID Broker Name Broker Address Representative Name Representative ID Commission/Trail Fee requirements Contact Details Tel: Fax:

6 Bank Account Details for Redemption and Distribution Payments Please list 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. Redemptions will not be processed on non cleared/verified accounts. In no event shall redemption proceeds be paid until all of the necessary anti-money laundering checks have been carried out, verified and received in original form (where necessary). IBANS Codes should be quoted for all banks within the EU/EEA. Amendments to investors payment instructions will only be effected upon receipt of an instruction which has been duly authorised. In the case of joint accounts, instructions will only be made upon receipt of 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 Correspondent Bank Address Correspondent Bank Sort Code/ ABA/Fedwire Beneficiary Bank Name Beneficiary Bank Address Beneficiary Bank Sort Code/ ABA/Fedwire Beneficiary Account Name Beneficiary Account Number Reference

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, 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. 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 (strike out as applicable) B. Are Applicant s profits taxed under general arrangements for business taxation? YES or NO (strike out as applicable) 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 (strike out as applicable) 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 Company 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 Applicant s address in section 1. YES or NO (strike out as applicable) C. Applicant s date, place, and country of birth: 1 Also applicable to residents of 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. 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.

8 Data Protection Company 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 Irish Financial Regulator 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 and/or Investment Manager s and/or the EEA group of companies, 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. Declarations and Signatures Company 1. I/We, having received and considered a copy of the KIID and Prospectus, hereby confirm that this application is based solely on the current KIID and Prospectus and the material contracts therein referred to together (where applicable) with the most recent annual report or semi-annual report and accounts of the Company and that I/we have not relied upon any representations or statements made or information provided by or on behalf of the Company other than in such material. 2. I/We hereby acknowledge that I/we have been offered the Prospectus and Memorandum and Articles of Association of the Company as may be amended from time to time and where applicable the most recent annual report or half-yearly report of the Company. Furthermore I/we hereby acknowledge that this application is made on the terms thereof and subject to the provision of the Prospectus and Memorandum and Articles of Association of the Company and I/we am/are bound by the terms of the Prospectus and Memorandum and Articles of Association of the Company and apply for the shares issued in relation to this application to be entered in the register of shareholders in my/our name(s) (or in the name of a nominee or agent). 3. I/We hereby represent and declare that I/we am/are fully informed as to: (i) the legal requirements within my/our country for the purchase of shares and are permitted to purchase the shares under the laws and regulations of my/our home country in the manner in which the shares have been offered and sold to me/us; (ii) any foreign exchange restrictions applicable to me/us; and (iii) any relevant tax considerations relating to me/us arising out of my/our purchase and ownership of shares. 4. I/We have such knowledge and experience in business and financial matters that I/we am/are capable of evaluating the merits and risks of an investment by me/us in the shares and have considered the risk factors as set out in the Prospectus. 5. I/We have made arrangements for payment to be made to the relevant bank account(s) specified above for subscriptions. 6. I/We acknowledge that the Company reserves the right to reject any application in whole or part without assigning any reason therefore. 7. I/We acknowledge that, owing to anti-money laundering requirements operating within their respective jurisdictions, the Company, its Directors, the Administrator, the Investment Manager and any distributor which may be appointed ( as the case may be) may require further identification of the applicant(s) before the application can be processed and the Company, its Directors, the Administrator, the Investment Manager and any distributor which may be appointed 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 requested by the parties referred to and has not been provided by me/us. 8. I/We hereby authorise the Company and the Administrator 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, or by electronic means. 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, 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. The Company and the Administrator may rely conclusively upon and shall incur no liability in respect of any action taken upon any Instructions believed in good faith to be genuine and to be signed by properly authorised persons. I/we acknowledge that redemption proceeds may not be paid out until all documentation required by the Company and the Administrator, including all documentation required for anti-money laundering purposes has been received by the administrator.

9 9. I/We acknowledge that measures aimed at the prevention of money laundering and terrorist financing will require verification of my/our identity, address and source of funds and where applicable other persons including but not limited to any beneficial owner on a risk sensitive basis and the ongoing monitoring of my/our business relationship with the Company. I/we also acknowledge that politically exposed persons ( PEPs ), and immediate family members, and close associates of such persons (as such terms are defined below), must also be identified. I/We further acknowledge that the Company or Administrator reserves the right not to issue shares until such time as the Company or Administrator has received and is satisfied with all the information and documentation requested to verify my/our identity, address and source of funds and where applicable other persons including but not limited to any beneficial owner. I/We acknowledge that the Company and Administrator shall be held harmless against any loss arising as a result of a failure to process my/our application for shares if such information and documentation as has been requested by the Company or Administrator has not been provided by me/us. 10. I/We understand and agree that the Company prohibits the investment of funds by any persons or entities that are acting, directly or indirectly, (i) in contravention of any applicable laws and regulations, including anti-money laundering regulations or conventions, (ii) on behalf of terrorists or terrorist organisations, including those persons or entities that are included on the List of Specially Designated Nationals and Blocked Persons maintained by the U.S. Treasury Department's Office of Foreign Assets Control ("OFAC"), as such list may be amended from time to time, (iii) for a politically exposed persons, any member of a politically exposed persons immediate family or any close associate of a politically exposed persons, unless the Company, after being specifically notified by me/us in writing that I/we am/are such a person, conducts further due diligence, and determines that such investment shall be permitted, or (iv) for a shell bank, or (v) for US Person (as defined in the Prospectus) (such persons or entities in (i) - (v) are collectively referred to as "Prohibited Persons"). 11. I/We represent, warrant and covenant that: (i) I/we am/are not, nor is any person or entity controlling, controlled by or under common control with me/us, a Prohibited Person, and (ii) to the extent I/we have any beneficial owners, (a) I/we have carried out thorough due diligence to establish the identities of such beneficial owners, (b) based on such due diligence, I/we reasonably believe that no such beneficial owners are Prohibited Persons, (c) I/we hold the evidence of such identities and status and will maintain all such evidence for at least five years from the date of my/our complete redemption from the Company, and (d) I/we will make available such information and any additional information that the Company and / or Administrator may require upon request. 12. If any of the foregoing representations, warranties or covenants ceases to be true or if the Company, the Investment Manager and /or Administrator no longer reasonably believes that it has satisfactory evidence as to their truth, notwithstanding any other agreement to the contrary, the Company, the Investment Manager and / or Administrator may be obligated to freeze my/our investment, either by prohibiting additional investments, declining or suspending any redemption requests and/or segregating the assets constituting the investment in accordance with applicable regulations, or my/our investment may immediately be redeemed by the Company, and the Company, the Investment Manager and / or the Administrator may also be required to report such action and to disclose my/our identity to OFAC or other authority. In the event that the Company, the Investment Manager and /or the Administrator is required to take any of the foregoing actions, I/we understand and agree that I/we shall have no claim against the Company, the Investment Manager or the Administrator, and their respective affiliates, directors, members, partners, shareholders, officers, employees and agents for any form of damages as a result of any of the aforementioned actions. 13. I/We acknowledge that the Company, the Investment Manager or the Administrator also reserves the right to refuse to make any redemption payment or distribution to a shareholder if any of the Directors of the Company, the Investment Manager or the Administrator suspects or is advised that the payment of any redemption or distribution moneys to such shareholder might result in a breach or violation of any applicable anti-money laundering or other laws or regulations by any person in any relevant jurisdiction, or such refusal is considered necessary or appropriate to ensure the compliance by the Company, its Directors, the Investment Manager or the Administrator with any such laws or regulations in any relevant jurisdiction. I/We hereby hold the Company, the Investment Manager and the Administrator harmless and indemnify them against any loss arising as a result of a failure to process the application if such information has been required and has not been provided by me/us. 14. I/We consent to any notice or other document to be sent by the Company, the Investment Manager or the Administrator to me/us as a shareholder, by electronic means including but not limited to , swift or posting such notice or other document on a website notified to me/us by post or by I/We confirm that I/we have the capacity and am/are duly authorised to complete this form and to make the representations and give the indemnities referred to herein. 16. I/We agree to supply the Company and its Directors, the Investment Manager or the Administrator with such documentation, information or other facts, including the nationality and residence of relatives, as from time to time are deemed necessary or desirable, as may be required for the Company to comply with its obligations under Sections 1471 through 1474 (inclusive) of the United States Internal Revenue Code and any regulations or administrative pronouncements promulgated thereunder ( FATCA ) and under any agreement entered into by the Company pursuant to FATCA, and in order to avoid the loss of a contemplated tax benefit to the Company or any Shareholder and in order to ascertain that no violation by the Company shall occur of any securities laws of the United States or any other relevant jurisdiction, including the Securities Act, the Investment Company Act, and the U.S. Investment Advisers Act of 1940, as amended. The Investor agrees to update such information if and when such information is no longer true or correct, and to provide any additional information required pursuant to any change in law, or the application or interpretation thereof. 17. I/We agree to provide these representations to the Company and its Directors, the Investment Manager and the Administrator 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. 18. I/We declare that the KIID(s) has/have been provided to us in good time prior to making the application for shares and that I/we have read, reviewed and understood the nature and the risks of the investment product that is being offered to me/us.

10 19. We hereby acknowledge and agree that the updated KIID for each share class is available from the Investment Manager's website at and that I/we will read and review the most up-to-date version of the relevant KIID(s) prior to making any subsequent application for shares. 20. I/We are aware that copies of the Prospectus, latest annual and semi-annual reports, KIID(s) and other information may be obtained from the Administrator at Maples Fund Services (Ireland) Limited, 2nd Floor, Beaux Lane House, Mercer Street Lower, Dublin 2, Ireland. I/We give full consent to receiving this information and the Prospectus, latest annual and semi-annual reports and KIID(s) by means of electronic communication. 21. Where I/we are investing as nominee, we shall provide our client(s) with the KIID issued in respect of the relevant Share class and we shall ensure that we do so in compliance with Commission Regulation (EU) No. 583/2010, as amended from time to time or by any supplemental legislation and in compliance with the applicable legislation in any jurisdiction in carrying out this activity. We shall maintain records of our provision of the KIID to our clients and shall furnish such records to the Company, or its delegates, upon request. In respect of joint shareholdings only; 22. I/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). I/We acknowledge and agree that in the event of the death of one or more of us the Administrator will require further documentation in relation to any proposed change of name or authority to act in respect of the shares for which we hereby apply including without limitation a copy of the relevant Grant of Probate or copy of a will. 23. I/We understand 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, and I/we agree to notify the Company or the Administrator immediately, if any representation or warranty are no longer accurate and to abide by any directions from the Company or the Administrator arising as a result. 24. I/We understand that the confirmations, representations, declarations, indemnities and warranties made or given herein are continuous and apply to all subsequent purchases of shares by me/us in the Company. 25. If a natural person, I/we confirm that I am/ we are over 18 years of age. 26. I/We confirm that I am/we are not a US Person (as defined in the Prospectus) and am/are not acquiring shares in the Fund on behalf of, or for the benefit of, a US Person, nor do I/we intend to transfer any shares which I/we may purchase to any US Person. 27. I/We hereby certify that I am/we are aware of the risks involved in the proposed investment as set out in the Prospectus. 28. I/We confirm that I am/we are in agreement with the distribution policy and all other policies as outlined in the Prospectus. 29. I/We hereby acknowledge that any notice or document may be served by the Company 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 Company 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 Company 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 Company 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 Company of written notice of such revocation. 30. In respect of corporate entities, I/we confirm that the persons listed on the attached authorised signatories list and whose specimen signatures appear on that list are duly authorised to give Instructions with respect to shares held by us in the Company. 31. In the event that I/we, subject to prior written agreement with the Administrator, decide to send subsequent applications, redemptions and instructions electronically: i. I/We acknowledge that electronic communications whether by , swift or otherwise are an unsafe method of communication and s and swift messages may be lost, subject to delays, interference by third parties, viruses and their confidentiality, security and integrity cannot be guaranteed. ii. iii. iv. I/we acknowledge that electronic communications cannot be guaranteed to be error-free. I/We hereby confirm that I/we will not hold the Company, the Investment Manager, the Administrator and the Custodian or any of their directors, officers, employees or agents liable now or at any time for any loss, damage, financial or otherwise which I/we may suffer as a result of any interception or breach of confidentiality or integrity or as a result of any delays, inaccuracy, imperfection, lack of quality, ineffective transmission, viruses, alteration or distortion howsoever arising affecting such electronic communication. I/We undertake to keep each of the Company, the Investment Manager, the Administrator and the Custodian indemnified at all times against, and to save each of the Company, the Investment Manager, the Administrator or the Custodian harmless from all actions, proceedings, claims, losses, damages, costs and expenses which may be brought against any of the Company, the Investment Manager, the Administrator or the Custodian or suffered or incurred by any of the Company, the Investment Manager, the Administrator or the Custodian and which shall have arisen either directly or indirectly out of or in connection with me /us sending electronic communications. v. I/We confirm that I/we, shall not send or transmit or arrange for any sending or transmitting on my/our behalf, any electronic communication which contains a virus or other media damaging to your property or computer systems or which may be defamatory,

11 libellous, slanderous, obscene, abusive, offensive, menacing or immoral and will abide with all relevant laws and regulations and international conventions or treaties governing the content of and the transmission of such electronic communications. vi. vii. In the event that I/we are unable to send you instructions by electronic transmission due to either a failure in or shut-down of my/our or the Administrators or other relevant party s internet system whether temporary or otherwise, I/we will send you instructions by facsimile. The Company, the Investment Manager, the Administrator and the Custodian may rely conclusively upon and shall incur no liability in respect of any action taken upon any notice, consent, request, instruction, electronic instructions, electronic subscriptions and redemptions or other instrument believed, in good faith, to be genuine. 32. In the case of Applicants applying for shares on the Applicant s own behalf only, I/we acknowledge that I am/we are hereby obliged to notify the Company or an agent of the Company appointed for this purpose, as the case may be, in writing if I am/we are or I/we become resident or ordinarily resident in Ireland. An individual is ordinarily resident in Ireland if the individual has been resident in Ireland for each of the 3 preceding years of assessment (i.e. calendar years) and that individual continues to be ordinarily resident in Ireland until the individual has not been resident in Ireland in each of the 3 preceding years of assessment. 33. In the case of Applicants applying for shares on behalf of another person, I/we acknowledge that I am/we are hereby obliged to notify in writing the Company or an agent of the Company appointed for this purpose, as the case may be, if I am/we are, or I/we become, aware that any person who is beneficially entitled to any of those shares may be resident or ordinarily resident in Ireland or may have become resident in Ireland. An individual is ordinarily resident in Ireland if the individual has been resident in Ireland for each of the 3 preceding years of assessment (i.e. calendar years) and that individual continues to be ordinarily resident in Ireland until the individual has not been resident in Ireland in each of the 3 preceding years of assessment. 34. I/We declare that the information contained in the declarations completed above is true and correct.

12 Declaration of residence outside Ireland 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 this Prospectus. Declaration on own behalf I/we* declare that I am/we are* applying for the Shares on my own/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 I am/we are/the company is* not currently resident or ordinarily resident in Ireland, and should I/we/the company* become resident in Ireland I will/we will* so inform you, in writing, accordingly. Declaration as intermediary I/we* declare that I am/we are* applying for Shares on behalf of persons: who will be beneficially entitled to the Shares; and, who, to the best of my/our* knowledge and belief, are neither resident nor ordinarily resident in Ireland. I/we* also declare that: 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, I/we* will inform you in writing if I/we* become aware that any person, on whose behalf I/we* holds Shares, becomes resident in Ireland. *Delete as appropriate Registered Name - Holder 1 Registered Address: Date Signed: Holder 1. Signatory Capacity if applicable (i.e. Director/manager) Holder 2. Holder 3. Holder 4.

13 IMPORTANT NOTES 1. Non-resident declarations are subject to inspection by the Irish Revenue Commissioners and it is a criminal offence to make a false declaration. 2. To be valid, the application form (incorporating the declaration required by the Irish Revenue Commissioners) must be signed by the applicant. Where there is more than one applicant, each person must sign. If the applicant is a company, it must be signed by the company secretary or another authorised officer. 3. 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. 4. If the Applicant is an Exempt Irish Shareholder it should contact the Administrator who will provide it with the appropriate declaration which must be made to confirm its status. IN THE CASE OF JOINT HOLDERS, ALL HOLDERS MUST COMPLETE THIS DECLARATION. Authorisation I/We agree to be bound by the Declarations, Representations, Consents and Indemnities set out in this Application Form Signature Holder 1. Capacity of Authorised Signatory Name Authorised Signatory (1) Signature Holder 2. Capacity of Authorised Signatory Name Authorised Signatory (2) Signature Holder 3. Capacity of Authorised Signatory Name Authorised Signatory (2) Signature Holder 4. Capacity of Authorised Signatory Name Authorised Signatory (4) Date

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 clients. Should documents be provided in a language other than English, an English translation will be required. Please note that the application may not be accepted and redemption proceeds will not be processed until the Administrator is in receipt of the required anti-money laundering documentation and the original Application Form together with the original banking details for the settlement of the redemption proceeds. Additional confirmation of identity or authority of the applicant or the source of funds may be required in certain circumstances. Not all requirements are listed here so please contact the Administrator for complete details of the documentation requirements. Documentation which may be required for all Retail Applicants 1. Personal Verification 2 - ONE official photographic document (Certified 3 ) 2. Address Verification 4 - TWO different address verification documents (Original or Certified) Documentation which may be required for Designated Bodies in certain Countries 5 1. Confirmation of Name and Address 2. Confirmation of Regulatory Body 3. Original Authorised Signatory List 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 6 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. Documentation which may be required for Pension Fund Accounts in certain Countries Documentation for UK/Irish Pension Schemes (Additional documentation will be required for non Irish/UK schemes) 1. Original fully completed Application form 2. Confirmation of name and address AML checks on parent/investment manager of pension fund (who will be entered onto the register) 3. Copy of Revenue Approval 4. CTC Evidence that the person representing the Pension Scheme is empowered to act 5. Original Authorised signatory list Documentation which may required for a Nominee Company 1. Confirmation of Name and Address of Nominee Company 2. Original Authorised Signatory List for the Nominee Account 3. Confirmation of Name and Address of Parent of Nominee 4. Confirmation of Regulatory Body of Parent of Nominee 5. Original Authorised Signatory List of Parent 6. Letter of Assurance (Nominee) Please note that the Administrator can only accept Application Forms from an entity that has legal capacity to enter into contracts on its own right and may require the constitutive document to legitimate legal status.

15 2 Acceptable Personal Verification documents are a certified copy of a Passport or a Driver s License or National Identity Card. The certified documents must be in date, show a picture of the person, full name, date of birth and signature of the person. 3 Verification documents must be certified by a suitable person/entity, such as; the Companies Registration Office (or the equivalent in the investors jurisdiction) with regard to incorporation documentation, a notary public, a police officer, an embassy/consular official, a chartered or certified public accountant, a practicing solicitor, any Designated Body. Documents should be stamped with the official stamp of the person, dated and signed by that person. 4 Acceptable Address Verification documents are any TWO of the following: electricity bill, gas bill, water bill, telephone bill, cable television bill, bank statement or credit card statement, social insurance documents, household/motor insurance certificates. Documents must originate from a different source, show the full name and residential address of the applicant and must be dated within 3 months of submission. 5 Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Gibraltar, Greece, Guernsey, Hong Kong, Iceland, Ireland, Italy, Jersey, Luxembourg, Isle of Man, Netherlands, New Zealand, Norway, Portugal, Singapore, Spain, Sweden, Switzerland,, United Kingdom, United States. (Please note this list is subject to change). 6 In the case of credit institutions and financial institutions, which are regulated in their country of establishment, it is not necessary to verify the identity of those individuals who are entitled to issue instructions on behalf of the institution.

16 EEA Fund Management Limited EEA Funds plc c/o Maples Fund Services (Ireland) Ltd Beaux Lane House Mercer Street Lower Dublin 2 Ireland investorservicesdublin@maplesfs.com Telefax: +353 (0) Telephone: +353 (0)