Ramsey Crookall. Company / Trust / Pension Execution Only Registration Form

Ramsey Crookall Company / Trust / Pension Execution Only Registration Form

Company / Trust / Pension Execution Only Registration Form This Application Form is for a Company, Trust, Pension, Charity, Partnership or Foundation. PLEASE COMPLETE IN BLOCK CAPITALS AND KINDLY NOTE THAT ALL QUESTIONS ARE MANDATORY. Section 1. Registration details Registered / trading name Introduced by (if applicable) Entity type Company Trust Pension SIPP Charity Foundation Partnership Other (please specify) Place and date of incorporation / formation / creation Entity registration number Nature of Entity, background information Section 2. Contact details Telephone number 1 Telephone number 2 Email address 1 Email address 2 Registered address Correspondence address (if different from registered address) Post/ZIP Code Post/ZIP Code ALL CORRESPONDENCE WILL BE SENT TO YOU BY EMAIL If you wish to receive correspondence by post, please tick box For internal use only Account Reference Nominee Reference Account Executive 1

Section 3. Entity control PLEASE COMPLETE THE FOLLOWING FOR ALL DIRECTORS, TRUSTEES AND AUTHORISED SIGNATORIES Name and address (Individual 1) Name and address (Individual 2) / / / / Country of tax residence 1 Country of tax residence 1 Country of tax residence 2 Country of tax residence 2 Director / Trustee / Authorised Signatory Director / Trustee / Authorised Signatory Name and address (Individual 3) Name and address (Individual 4) / / / / Country of tax residence 1 Country of tax residence 1 Country of tax residence 2 Country of tax residence 2 Director / Trustee / Authorised Signatory Director / Trustee / Authorised Signatory Please print this page as many times as required. 2

Section 4. Ultimate Beneficial Owners and related parties PLEASE COMPLETE THE FOLLOWING FOR ALL SHAREHOLDERS, SETTLORS AND BENEFICIARIES Name and address (Individual 1) Name and address (Individual 2) / / / / Country of tax residence 1 Country of tax residence 1 Country of tax residence 2 Country of tax residence 2 Shareholder / Settlor / Beneficiary Shareholder / Settlor / Beneficiary Name and address (Individual 3) Name and address (Individual 4) / / / / Country of tax residence 1 Country of tax residence 1 Country of tax residence 2 Country of tax residence 2 Shareholder / Settlor / Beneficiary Shareholder / Settlor / Beneficiary Please print this page as many times as required. 3

Section 5. Authorised signatory list Please complete the following for all persons authorised to place instructions on behalf of the entity. Alternatively please attach a copy of your corporate signatory list. If you are attaching a corporate signatory list, please tick this box. (If yes, please proceed to Section 6) Unless otherwise stated below in the restrictions field, all persons on this list will be authorised to place instructions, add and remove money and make amendments to the account Name Specimen Signature Position held/ signing authority Please specify any restrictions or limits on any of the above named in relation to the operation on account. Please be advised that it is your ongoing responsibility to notify us immediately if there are any changes to this list of authorised persons. We cannot accept any responsibility for any losses or possible delays in implementing instructions or the timely execution of trades resulting in your failure to comply with these requirements. Please print this page as many times as required. 4

Section 6. Source of wealth IMPORTANT: Ramsey Crookall are required to understand the Entity s wealth and how this was acquired. Please complete this section with details of how the Entity s wealth was generated. i.e. sale of property, beneficial owners salary etc. Generic answers such as investments or savings are not acceptable*. *We may require you to supply evidence to support the information you have provided. Beneficial owner s investment from salary Inheritance please provide details Proceeds from sale of a business (date of sale) Proceeds from sale of property or assets (date of sale) Funds from a parent company / trust Transfer of holdings from another company / trust Pension investment Sale of shares / share save scheme (please indicate company) Other (please specify) Section 7. Source of funds Please state where the initial funds are coming from i.e. Bank, solicitors, parent / group company etc. and how you will send them to us (evidence may be requested) Section 8. Expected size and frequency of transactions Anticipated frequency of trading OR Please tick if transaction is a one-off Anticipated monetary value of each transaction Section 9. Valuation and copy contracts Do you wish to receive formal valuations Yes No If yes, please state valuation frequency and date you would like to receive first valuation. (Please note that the charge is 5 per holding with a minimum charge of 50.) Do you wish to have copy contract notes on all purchases and sales sent to another address Yes No Date: If Yes, please provide the details of the individual or company that you wish us to send copy contracts to: If you would like to receive copy contracts by email, please supply the email address: Post/ZIP Code 5

Section 10. Client web access and daily market report Ramsey Crookall offers you the ability to view your portfolio online using our secure online service which allows you to monitor holdings and cash balances on your account which details recent trade history, dividends and the current market value as well as a useful sector breakdown to enable you to effectively manage your portfolio. The online service also has a free valuation service which allows you to produce a valuation of your portfolio instantly that can be saved or printed. Do you wish to sign up for Client Web Access (CWA), an online portfolio and valuation service? Yes No If yes, upon completion of the account opening procedure, your user name and password will be emailed directly to the email address provided in section 2. Please note that only one login is issued per account. We also offer the Ramsey Crookall mobile app which utilises the same login details This is available on the App store and Google Play store. Do you wish to receive our twice daily market report via email Yes No Please state your preferred email address if different. Section 11. Bank details Your bank account details, for all payments that are to be made to you. Bank name Account name Account number Sort code Bank address IBAN SWIFT NB. Where the client entity does not have a bank account, payments can be made to the client money account of a regulated service provider or to the beneficial owner. Section 12 (a). Equity dividends / bank interest Shares purchased on your behalf will be held in our nominee. Please provide instructions below in regards to income and how it is to be applied For UK shares only, are dividends to be taken in cash or, where possible, shares in lieu Cash Shares Are cash dividends to be retained on account Yes No If no, payment will be made quarterly into your bank account Section 12 (b). Bond interest Is bond interest to be retained on account Yes No If no, bond interest will be paid upon receipt direct to your bank account 6

Section 12 (c). Confirmation of income payments When an income payment is made, confirmation and tax vouchers should be sent to: Me Registered Agent Registered agent name Registered agent address Relationship to me Post/ZIP Code Section 13. ENTITY TAX RESIDENCY SELF-CERTIFICATION FORM INSTRUCTIONS PLEASE READ THESE INSTRUCTIONS BEFORE COMPLETING THIS SECTION. FAILURE TO COMPLETE WILL DELAY YOUR ACCOUNT BEING OPENED. Regulations based on the OECD Common Reporting Standard ( CRS ) require Ramsey Crookall to collect and report certain information about an account holder s tax residence. Each jurisdiction has its own rules for defining tax residence. In general, tax residence is the country in which you live. The country/countries in which you pay income tax are likely to be your country/ countries of tax residence. For more information on tax residence, please consult your tax adviser or the information at the following link http://www.oecd.org/tax/automatic-exchange/ If your tax residence is located outside of the Isle of Man, we may be legally obliged to pass on the information in this form and other financial information with respect to your accounts to the Isle of Man Tax Office. Ramsey Crookall are also required to report information on US persons under the Foreign Account Tax Compliance Act ( FATCA ). You can find definitions of who is classified as an account holder, and other terms, on our website at www.ramseycrookall.com The information you provide us with will remain valid unless there is a change in circumstances relating to the account holder s tax status or other mandatory fields included on this form. You must notify us if there is a change in circumstances that makes this form incorrect or incomplete and provide an updated self-certification. Please complete this form where you need to self-certify on behalf of an entity account holder. If you are a US person under US Internal Revenue Service ( IRS ) regulations, you may also need to fill in an IRS W-9 form. Where the Account Holder is a Passive NFE, or an Investment Entity located in a Non-Participating Jurisdiction managed by another Financial Institution Please provide information on the natural person(s) who exercise control over the Account Holder (individuals referred to as Controlling Person(s) ) by completing a Controlling Person tax residency self-certification form for each controlling person (please contact us if you require this form). This information should be provided by all Investment Entities located in a Non-Participating Jurisdiction and managed by another Financial Institution. If you are completing the form on the Account Holder s behalf, then you should indicate the capacity in which you have signed in Part 4. For example you may be the custodian or nominee of an account on behalf of the account holder, or you may be completing the form under a signatory authority or power of attorney. As a financial institution, we are not allowed to give tax advice. If you have any questions about completing this section, these instructions or defining your tax residency status, please speak to your tax advisor or domestic tax authority. ENTITY TAX RESIDENCY SELF-CERTIFICATION FORM (Please complete Parts 1-3 in BLOCK CAPITALS) Part 1 Identification of Account Holder A. Legal Name of Entity B. Country of incorporation or organisation C. Registered address Line 1 Registered address Line 2 Country Postal Code/Zip Code 7

D. Mailing address (if different to C above) Mailing address - Line 1 Mailing address Line 2 Country Postal Code/Zip Code Part 2 Entity Type Please provide the Account Holder s Status by ticking one of the following boxes 1. (a) Financial Institution Investment Entity i. An Investment Entity located in a Non-Participating Jurisdiction and managed by another Financial Institution (Note: if ticking this box please also complete Part 2(2) below) ii. Other Investment Entity (b) Financial Institution Depository Institution, Custodial Institution or Specified Insurance Company If you have ticked (a) or (b) above, please provide, if held, the Account Holder s Global Intermediary Identification Number ( GIIN ) obtained for FATCA purposes - - - (c) Active NFE a corporation the stock of which is regularly traded on an established securities market or a corporation which is a related entity of such a corporation If you have ticked (c), please provide the name of the established securities market on which the corporation is regularly traded: If you are a Related Entity of a regularly traded corporation, please provide the name of the regularly traded corporation that the Entity in (c) is a Related Entity of: (d) Active NFE A Government Entity or Central Bank (e) Active NFE an International Organisation (f) Active NFE other than (c)-(e) (for example a start-up NFE or a non-profit NFE) (g) Passive NFE (Note: if ticking this box please also complete Part2(2) below) 2. If you have ticked 1(a)(i) or 1(g) above, then please: a. Indicate the name of any Controlling Person(s) of the Account Holder: b. Complete Controlling Person tax residency self-certification form for each Controlling Person 8

Part 3 Country of Residence for Tax Purposes and related Taxpayer Identification Number or functional equivalent ( TIN ) Please complete the following table indicating (i) where the Account Holder is tax resident and (ii) the Account Holder s TIN for each country indicated. If the Account Holder is not tax resident in any jurisdiction (e.g. because it is fiscally transparent), please indicate that on line 1 and provide its place of effective management or country in which its principal office is located. If the Account Holder is tax resident in more than three countries please use a separate sheet If a TIN is unavailable please provide the appropriate reason A, B or C where indicated below: Reason A The country where the Account Holder is liable to pay tax does not issue TINs to its residents Reason B The Account Holder is otherwise unable to obtain a TIN or equivalent number (please explain why you are unable to obtain a TIN in the below table if you have selected this reason) Reason C No TIN is required. (Note. Only select this reason if the authorities of the country of tax residence entered below do not require the TIN to be disclosed) Country of tax residence 1. TIN If no TIN available enter Reason A, B or C 2. 3. Please explain in the following boxes why you are unable to obtain a TIN if you selected Reason B above. 1. 2. 3. Part 4 - Declarations and Signature 1. I acknowledge that the information contained in this form and information regarding the Account Holder(s) and any Reportable Account(s) may be provided to the tax authorities of the country in which this account is maintained and exchanged with tax authorities of another country or countries in which the Account Holder(s) may be tax resident pursuant to intergovernmental agreements to exchange financial account information. 2. I certify that I am authorised to sign for the Account Holder in respect of all the account(s) to which this form relates. 3. I undertake to advise Ramsey Crookall within 30 days of any change in circumstances which affects the tax residency status of the Account Holder identified in Part 1 of this section or causes the information contained in this section to become incorrect, and to provide Ramsey Crookall with a suitably updated self-certification and Declaration within 60 days of such change in circumstances. 4. I declare that all statements made in this declaration are, to the best of my knowledge and belief, correct and complete. Signature Date Name Capacity 9

Section 14. Identification and verification In financial regulation, politically exposed person (PEP) is a term describing someone who has been entrusted with a prominent public function, or an individual who is closely related to such a person. Are any of the associated individuals classed as a Politically Exposed Person (PEP) Yes No Are any of the individuals related to a PEP in any way Yes No If Yes, please provide further information Section 15. Identification and verification In order to comply with Anti-Money Laundering Guidelines you must provide us with a minimum of 2 documents as evidence of your identity Primary ID and Secondary ID as detailed below for each applicant. You must either: A) Provide us with the original documents so that we can arrange for copies to be taken and certified in the office (the originals will then be returned to you) or B) Arrange for one of the following individuals to certify your documents: a member of the judiciary, a senior civil servant, serving police or customs officer, an officer of an embassy, consulate or high commission of the country of issue, a lawyer or notary public who is a member of a recognised professional body, an actuary who is a member of a recognised professional body, an accountant who is a member of a recognised professional body, a company secretary who is a member of a recognised professional body or a director, company secretary or manager of a business regulated in the Isle of Man or an external regulated business as defined in the IOM Anti-Money Laundering Handbook. The certifier must certify each copy as a true copy of the original stating clearly his / her qualification, position / capacity, organisation s name, address and date certified. Primary ID Passport, Driving Licence or Government Issued National Identity Card Secondary ID Rates, Council Tax or Utility Bill (mobile phone bill is not acceptable) Bank Account Statement, Driving Licence or Income Tax Assessment or Return form. Section 15 (a). Company / Trust / Pension The following must be provided in addition to the above: For a Company Certified copy of the company s Certificate of Incorporation Certified copy of the company s Memorandum & Articles of Association Copy of latest annual return An up to date signatory list for the account detailing those individuals who have signing authority on the account For a Trust / Pension Certified copy of the Trust / Pension deed and any subsequent deeds An up to date signatory list for the account detailing those individuals who have signing authority on the account A trustee resolution of the trustees of the trust to open a trading account with Ramsey Crookall & Co Ltd A board resolution of the directors of the company to open a trading account with Ramsey Crookall & Co Ltd 10

Section 16. Board of Directors / Trustees Resolution to open a trading account with Ramsey Crookall Please delete as appropriate and have the following resolution signed by the directors/trustees Company / Trust Name DIRECTORS /TRUSTEES RESOLUTION IN WRITING We, the undersigned, being all the Directors/Trustees for the time being of the above named Company/Trust hereby pass the following Resolution and agree that the said Resolution shall for all purposes be as valid and effective as if the same had been passed at a Meeting of the Directors/Trustees of the Company/Trust duly convened and held. RESOLUTION: That the application form received from Ramsey Crookall & Co to open an account with them is completed and signed by the directors/trustees and forwarded to Ramsey Crookall & Co Ltd. Signature Signature Name Name Position Position Date (dd-mm-yyyy) Date (dd-mm-yyyy) / / / / Signature Signature Name Name Position Position Date (dd-mm-yyyy) Date (dd-mm-yyyy) / / / / 11

Section 17. Declaration and signature 1. We understand that Ramsey Crookall reserve the right to decline this application without being required to provide any reason. 2. We certify the accuracy of the information provided in this form and the legitimacy of the statements made in this Application Form and authorise you to conduct any enquires that you may consider necessary for confirmation of these for risk assessment purposes. 3. We have ensured that any alterations made to this Application Form by us have been signed by us. 4. We will notify Ramsey Crookall of any changes, at any time, to the information that we have provided in this Application Form. 5. We accept full liability and responsibility for any correspondence that is sent from Ramsey Crookall to us and understand that it is done so at our own risk. 6. We have read and understood the Terms of Business, Fee Schedule and Client Money Information Sheet. 7. We agree to be bound by Ramsey Crookall s Terms of Business in addition to this Application Form, Fee Schedule and Client Money Information sheet for the service we have selected. We agree to be bound by the conditions included in these agreements. 8. We agree that those signatories in Sections 3 & 4 have authority to place instruction on behalf of the entity. 9. We acknowledge that as an Execution-Only client we will be treated as a non-retail investor and consequently afforded a lower level of investor protection. Signature Signature Name Name Position Position Date (dd-mm-yyyy) Date (dd-mm-yyyy) Section 19. Where did you hear about us Magazine Newspaper Radio Events Sponsorship Online Recommendation Other Section 18. About us Ramsey Crookall was established in 1946 and is the Isle of Man s longest established independent firm of stockbrokers and investment managers. Over the decades we have developed considerable expertise in offering bespoke services to our private and institutional clients, charities, trusts and pension funds. For more information please feel free to contact us: Address Telephone Number Securities House +44 (0) 1624 673171 38-42 Athol Street Fax number Douglas +44 (0) 1624 677258 Isle of Man /ZIP IM1 1QH Dealers telephone number Nominee holding company +44 (0) 1624 623884 RENE Nominees (I.O.M.) Limited Dealers email address Website dealers@ramseycrookall.com www.ramseycrookall.com Ramsey Crookall & Co Limited is Licensed by the Isle of Man Financial Services Authority 12

Ramsey Crookall & Co Limited is licensed by the Isle of Man Financial Services Authority. Our IOMFSA registration number is: 1183. Our registered address is Securities House, 38/42 Athol Street, Douglas, Isle of Man, IM1 1QH. Our company number is: 046435C. RENE Nominees (I.O.M.) Limited is a wholly owned non-trading subsidiary of Ramsey Crookall & Co Limited, the registered office is the same as above and the company number is: 001751C.