INVESTMENT PLATFOM APPLICATION FO INDIVIDUAL INVESTOS BEFOE YOU INVEST Make an informed decision: ead our Product ange brochure to make sure you have chosen the right product to suit your needs. efer to the fund factsheets (minimum disclosure documents) and the Allan Gray Investment Platform Fund List for information on the unit trusts offered on our platform. Certain unit trusts are subject to availability. Consider getting financial advice: Allan Gray does not provide financial advice. However, we believe in the merits of good independent advice. If you are not comfortable making your own investment decisions, consider using the services of an independent fi nancial adviser (IFA). To locate an IFA in your area, refer to the Find an adviser section of our website. STEP 1 COMPLETE THE FOM & AGEE TO THE Ts & Cs Make sure you have your tax identifi cation number on hand. Complete all the information on the form to ensure that there is no delay in processing your investment. ead and agree to the Investment Platform Terms and Conditions to understand the rules of your investment. You may need to complete additional forms, depending on the specifics of your investment: Are you representing the investor or opening an investment for a minor (younger than 18) where your details are different from that of the minor? Complete the 'Acting on behalf of investor' form. Would you like to phase in your investment? Complete the 'Phase-in' form. STEP 2 SEND DOCUMENTS Send us the documents listed below: Email: instructions@allangray.co.za or Fax: 0860 000 655 or +27 (0)21 415 2492 Completed 'Investment Platform application for individual investors' form Copy of your South African bar-coded ID, valid passport (if foreign national) or birth certifi cate (if minor) Proof of your residential address less than three months old (refer to Annexure A for examples) Proof of your bank details (e.g. cancelled cheque or bank statement) Any related instructions (e.g. 'Acting on behalf of the investor' form) and supporting documents for those forms STEP 3 MAKE PAYMENT CUT-OFF TIMES Please make payment into the following Allan Gray bank account and send us proof of payment Pre-approved benefi ciary: Allan Gray Platform Account name: Allan Gray Investment Services Proprietary Limited Bank: First National Bank Branch code: 20-41-09 - Global Transactional Services Cape Town Account type: Current Account number: 620 830 933 11 eference number: 13 digit SA ID number (South African residents)/passport number (if foreign national) Swift code: FINZAJJ Please note that if instructions and documents are received: Before 14:00 on a business day, we will start processing on that day. After 14:00 on a business day, we will start processing on the next business day. On a weekend or public holiday, we will start processing on the next business day. The cut-off for debit order processing is three business days before your selected debit order date. Electronic collections occur on the next business day after we begin processing your application. egular withdrawal payments are scheduled for the 27th of each month. The cut-off for regular withdrawal processing is six business days before the scheduled withdrawal payment date. If the instruction is received after the cut-off, the first withdrawal payment will be scheduled to take place the next month. WHAT HAPPENS NEXT? We will process your instruction once we receive the required completed documents and the money refl ects in the Allan Gray Investment Services bank account. You will receive confi rmation once your instruction has been processed. You will receive an Allan Gray Online account with this investment and will be contacted to activate your Allan Gray Online account within two business days of your instruction being processed. Contact us if you need help: Call 0860 000 654 between 07:30-17:30 (Mon - Fri) or Email: info@allangray.co.za
INVESTMENT PLATFOM APPLICATION FO INDIVIDUAL INVESTOS Allan Gray Investment Services Proprietary Limited ( The Administrator ), an authorised administrative financial services provider, is the administrator of this investment. 1. Please provide us with your details Title Surname First name(s) Date of birth D D M M Y Y Y Y Country of birth ID number (passport number if foreign national) Nationality Email Mobile Fax esidential address Telephone (h) Telephone (w) Postal address If the same as residential address please tick this box Postal code Postal code 2. How much would you like to invest? You must invest a lump sum of at least 20 000 and/or commit to a debit order of at least 500 per month. Debit orders are restricted to a maximum of 1 000 000 per debit. Lump sum amount and/or Monthly debit order amount How would you like to invest your money? You must allocate your lump sum and/or monthly debit order into one or more unit trusts. Indicate the rand amount/percentage per unit trust in the table below: Unit trust Unit trust class Lump sum allocation Monthly debit order allocation or % or % or % or % or % or % or % or % or % or % or % or % or % or % or % or % or % or % or % or % Please ensure that the amounts or percentages allocated across unit trusts add up to your total lump sum or monthly debit order amounts, or to 100%. Allan Gray Proprietary Limited is an authorised financial services provider. 1 of 8
Would you like to pay your annual fees from the Allan Gray Money Market Fund? You may choose to have your annual administration fees and annual financial adviser fees (if applicable) paid from the Allan Gray Money Market Fund. If you choose to do so, please ensure that you have allocated a portion of your investment to the Money Market Fund. If no option is selected, fees will be deducted from your selection of unit trusts. If you would like to pay your annual fees from the Allan Gray Money Market Fund, please tick this box. 3. How are you making payment? Are you making a lump sum payment? Lump sum amount of Select a payment option below: Cheque deposit Electronic/Internet transfer (EFT) Collection by Allan Gray All cheques must be endorsed as non-transferable and deposited directly into the relevant Administrator s bank account. Units bought with a cheque deposit can only be withdrawn after 14 days. Electronic/Internet transfers may take up to two days to appear in the Administrator s bank account. Electronic collection is a once-off direct debit from your bank account and is restricted to a maximum of 1 000 000 per day. Units bought with a direct debit can only be withdrawn after 32 business days. Are you setting up a debit order? Monthly debit order of to start on the 1st or 15th of Indicate by how much you would like your monthly debit order to increase each year: 0% 2.5% 5% 10% 15% 20% M M Y Y Y Y Provide us with permission to debit your bank account Complete this section if you are setting up a debit order or if you would like Allan Gray to collect your lump sum payment from your bank account. I authorise the Administrator to draw direct debits from the following South African bank account: Name of account holder Name of bank Branch code Account number Type of account Current/Cheque Savings Additional documents may be required Is the bank account holder a third party individual? Provide a copy of their ID and proof of their bank account details. Is the bank account holder a third party legal entity? Provide copies of all the signatories IDs and a letter from the bank listing the authorised signatories on the account. Signature of bank account holder Date D D M M Y Y Y Y 4. Where does the money come from? This information is required by legislation and we need it in order to process your investment. Please make a selection below: Existing Allan Gray account Bonus Savings Inheritance Salary Transfer from other financial services provider Other (specify) 2 of 8
5. Please provide us with your tax information This section applies to all investors whether you are registered for tax or not. Please refer to our Tax guide at the end of this form if you need help understanding the terms used in sections 5 and 6. The South African evenue Service (SAS) requires all financial services providers to collect various tax information from their clients. Depending on where you are a resident for tax purposes, Allan Gray may be required to deduct Dividend Withholding Tax (DWT) and/or Interest Withholding Tax (IWT) on your behalf. Please complete either section 5.1 or 5.2. The completed section determines your DWT/IWT rate. 5.1 If you are a South African resident for tax purposes, please tick the box below I declare that I am a resident for tax purposes in South Africa. I will be subjected to the default DWT rate of 20% on local dividends and IWT will not apply. I also understand that distributions from eal Estate Investment Trusts constitute income that needs to be filed in my annual tax return as Allan Gray will not withhold tax on my behalf. Tax Identification Number provided to you by SAS If you are unable to provide a Tax Identification Number, please complete section 5.3 below. 5.2 If you are a non-south African resident for tax purposes, please tick the box below I declare that I am not a resident for tax purposes in South Africa. I have seen and read the Withholding Tax Annexure available on www.allangray.co.za and I will be subject to the default DWT rate of 20% on local dividends and the default IWT rate of 15% on local interest, unless there is a Double Taxation Agreement (DTA) in place between South Africa and my country of tax residence provided below. If there is a DTA in place, Allan Gray will apply the DWT and IWT rates as contained in the article number referenced in the Withholding Tax Annexure. I also confirm that distributions from eal Estate Investment Trusts are exempt from South African income tax but will be subject to the DWT rate applicable to my investment. Country of residence for tax purposes Effective date of tax residency D D M M Y Y Y Y Tax Identification Number provided to you by your tax authority If you are unable to provide a Tax Identification Number, please complete section 5.3 below. 5.3 If you are unable to provide a Tax Identification Number, please provide us with a reason below Where you are unable to provide a Tax Identification Number (TIN) or its Functional Equivalent (FE), please tick one of the following reasons: eason A: I have never registered for a TIN/FE with my tax authority eason B: I do not know my TIN/FE, but I will take steps to get this and submit it to Allan Gray eason C: My tax authority does not require me to provide a TIN/FE (does not apply to South African or United States tax residents) eason D: My country does not issue TINs/FEs to its tax residents (does not apply to South African or United States tax residents) eason E: I am unable to obtain a TIN/FE (please specify) 3 of 8
5.4 Are you resident anywhere else for tax? If you have any tax information for countries in addition to the country indicated on the previous page, please list the additional countries and your associated Tax Identification Number, or its Functional Equivalent, below. Please note that the countries listed below will not have an impact on the DWT/IWT rates applied to your investment. If you do not have a Tax Identification Number, please tick a reason (refer to section 5.3 on the previous page). Country Tax Identification Number (TIN) eason for no TIN A B C D E A B C D E A B C D E 6. Are you a US Person? Do you or any controlling persons associated with this investment (e.g. authorised signatory) have a United States tax number, residency or citizenship? Yes No Additional documents may be required If Allan Gray identifies, through the information provided on this application form, that you are considered a US eportable Account, you may be required to submit further documents. For more information, please see www.allangray.co.za. 7. Would you like to start a regular withdrawal? If you would like to receive a regular withdrawal from this investment account, please complete this section. You may only schedule regular withdrawal payments if you have more than 20 000 in your account. You can either withdraw proportionately across your unit trusts (complete table 1), or you can specify the unit trusts you would like to withdraw from and the amount to be withdrawn (complete table 2). Total amount to be withdrawn per frequency Select your payment frequency: Monthly Quarterly Biannually Annually Withdraw proportionately across your unit trusts Table 1 The proportionate split for withdrawals under this instruction will be determined at the processing date of the form. The proportions will only change if you send us an amended instruction Table 2 Unit trust Unit trust class Amount per regular withdrawal 4 of 8
8. Provide us with your bank account details Please complete this section if you have selected to receive a regular withdrawal. We will make all payments electronically to a South African bank account in the investor s name. We will not make any payments to credit cards, market-linked accounts or third party bank accounts. If the same as the bank account details in the previous section, please tick this box. Name of account holder Name of bank Branch code Account number Type of account Current/Cheque Savings 9. How should we communicate with you? We will send all communications to you via email. If you prefer post or do not have an email address, please tick this box. Manage your investments online You will receive an Allan Gray Online account with this investment. Allan Gray Online enables you to view your personal and investment details (e.g. bank account details, account balance, transaction history) and manage your investments (e.g. perform transactions) online. We need an email address to set up your online account. If you do not want online access, please tick this box. 5 of 8
10. Investor declaration I confirm that all information provided in this form and all other documents signed by me in connection with this application, whether in my handwriting or not, are correct. I am responsible for the accuracy and completeness of all answers, statements or other information provided by me or on my behalf. I consent to Allan Gray processing my personal information according to the Terms and Conditions. I have not received advice from the Administrator regarding this application. I confirm that the Administrator may accept instructions from any authorised third party who has been authorised by me in writing. I confirm that the Administrator may accept instructions in the prescribed format by fax or via other electronic means. I have read and understood the Allan Gray Investment Platform fund list or the investment overview as well as the relevant fund factsheet (minimum disclosure document) of the unit trusts I wish to invest in. I have read, understood and agree to the latest Terms and Conditions. I agree that my contractual relationship with the Administrator will be subject to South African law and regulation (including but not limited to Exchange Control and tax requirements). I confirm that if I am not a South African resident, my investment through the Administrator is based on my own initiative and not due to any offer or solicitation by the Administrator. I acknowledge that the Administrator may be required to submit the information provided in sections 5 and 6 to SAS who may share it with my local tax authority to adhere to the Foreign Accounts Tax Compliance Act ( FATCA ) and the Organisation for Economic Co-operation and Development s ( OECD ) Common eporting Standard ( CS ). I acknowledge that if the Administrator identifies through the information provided on this application form that I fall into the definition of a US person, I may be required to submit further documents. I declare that I comply with the relevant provisions in the Income Tax Act and, where applicable, the requirements in terms of the relevant double taxation agreement (DTA) in force between the epublic of South Africa and the country of residence I have specified above as contained in the article number as referenced in the Withholding Tax Annexure. Under penalties of perjury, I declare that I have examined the information completed in sections 5 and 6 on this form and to the best of my knowledge and belief it is true, correct, and complete. I undertake to inform the Administrator in writing if the circumstances referred to in the declaration above change. Signature of investor Date D D M M Y Y Y Y If you have an independent financial adviser for this investment, please tick this box and complete the next section of this form. 6 of 8
11. Complete this section if you have an independent financial adviser Provide us with your financial adviser s details Name and surname of financial adviser Name of Financial Services Provider (FSP) Financial adviser code Financial adviser assistant dealing with this transaction What negotiable fees must be paid to your financial adviser for this investment? I agree to pay the following negotiated fees on this and all future transactions until otherwise specified: Initial. % Annual. % Maximum 3.0% (excluding VAT) deducted prior to the investment being made. Where the annual fees are more than 0.5%, initial fees are capped at 1.5%. If it is agreed that no initial fee is payable, please insert 0%. Maximum 1.0% (excluding VAT) of the investment account. Where the initial fee is more than 1.5%, the maximum annual fee is 0.5%. If no annual fee is payable, please insert 0%. Who should we communicate with? We will send you/your financial adviser confirmation that your transactions have been processed. Who should we send your transaction confirmations to? Me Financial adviser Both If no option is selected, your transaction confirmations will be sent to both you and your financial adviser. We will send you/your financial adviser account statements and other communications. Who should we send your statements and other communications to? Me Financial adviser Both If no option is selected, your communications will be sent to you only. Provide authorisation for your financial adviser to submit instructions on your behalf You may authorise the Financial Service Provider (FSP) to submit instructions for this investment on your behalf, either online or via forms. If the FSP holds a Category II licence with the Financial Services Board (FSB), it is licensed to exercise discretion and submit instructions on your behalf. To do this for all your investments the FSP will need a mandate (instruction) from you. Have you entered into a mandate with this FSP to exercise discretion and submit instructions on your behalf? Yes No Alternatively, if your financial adviser holds a Category I licence with the FSB, they are not licensed to exercise discretion and submit instructions on your behalf. However, you may authorise them to submit online instructions for this investment only on your behalf. Do you authorise this financial adviser to submit instructions (excluding withdrawals and regular withdrawals) on your behalf via Allan Gray Online? Yes No Additionally, do you authorise this financial adviser to submit withdrawal instructions and to set up and change regular withdrawals on your behalf via Allan Gray Online (where applicable)? Yes No In all cases money will be paid into your bank account that Allan Gray has on record and the bank account can only be changed with your prior written consent. 12. Investor declaration for clients with a financial adviser I confirm that this financial adviser, as authorised representative of the FSP above, is my appointed financial adviser. I confirm that the Administrator may accept instructions from my financial adviser who has been appointed by me in writing. I confirm that my appointed financial adviser and any other third parties with whom I have an agreement to manage this investment (e.g. a discretionary investment manager) will have access to my investment details via a secure electronic channel. I understand and agree that all instructions submitted by my financial adviser will be governed by the relevant and latest Terms and Conditions in force as at the date the instruction is submitted. I acknowledge and agree that the Administrator will not be held liable for acting on any instructions submitted by my financial adviser and I indemnify the Administrator from all direct or indirect claims (including claims for consequential damages) in this regard. I have read and agree to the investor declaration in section 10. Signature of investor Date D D M M Y Y Y Y 7 of 8
13. This section must be completed by your financial adviser Financial adviser FAIS declaration I have made the disclosures required in terms of the Financial Advisory and Intermediary Services (FAIS) Act, No. 37 of 2002 to the investor. I have explained all fees that relate to this investment to the investor. I understand and accept that the investor may write to the Administrator to cancel future fees. Financial adviser FICA declaration I have identified all applicable parties to this transaction and verified their details under the requirements of Section 21 of the Financial Intelligence Centre Act (FICA), No. 38 of 2001 ( the Act ). I keep these parties records as is required in terms of Section 22 of the Act and maintain these records as required in regulation 19 of the Act. Yes No I understand that I am the primary accountable institution under the Act. I understand that if I have selected No, the Administrator will be responsible for the primary Know Your Client requirements of the Act and that the application will be delayed until the Administrator receives the necessary documents. Financial adviser online instruction declaration In the absence of a mandate, I acknowledge and agree that I will only act on my client s instruction when submitting instructions via Allan Gray Online. I have read, understood and agree to the Terms and Conditions applicable to submitting instructions via Allan Gray Online. I acknowledge and agree that the Administrator will not be held liable for acting on any instructions submitted by me, and I indemnify the Administrator from all direct or indirect claims (including claims for consequential damages) in this regard. I understand that the Administrator reserves the right, at any time, to review my licence and/or to audit or request copies of my client s consent (whichever applicable) for instructions that I have submitted via Allan Gray Online. Signature of financial adviser Date D D M M Y Y Y Y 8 of 8
Tax guide The following definitions and explanations may help you complete the tax information sections of the form. DWT/IWT Term Definition Explanation DWT Dividend Withholding Tax DWT is a tax imposed on shareholders on receipt of dividends. DWT is categorised as a withholding tax, as the tax is withheld and paid to SAS by the company paying the dividend or by a regulated intermediary. IWT Interest Withholding Tax IWT will be applied to local interest distributed to non-south African residents for tax purposes. IWT is categorised as a withholding tax, as the tax is withheld and paid to SAS by the company paying the dividend or by a regulated intermediary. TIN or its Functional Equivalent Tax Identification Number or the number that functions as a TIN The number that each jurisdiction issues to identify an individual for tax purposes. The Tax Identification Number could be called something different in different countries. Examples: SA: Income tax number issued by SAS. US: For an individual this would be their US Social Security Number. UK: National Insurance Number or Unique Taxpayer eferences. FATCA and CS Term Definition Explanation Additional tax Information Global Tax Information Additional tax Information relates to the disclosure of each tax jurisdiction where the investor could be liable to declare their assets and income - regardless of where the asset is housed, or income is earned. CS Common eporting Standard The Common eporting Standard calls on jurisdictions to obtain information from their financial institutions and automatically exchange that information with other jurisdictions on an annual basis. FATCA Foreign Accounts Tax Compliance Act FATCA stands for the Foreign Account Tax Compliance Act and is a United States (US) initiative aimed at reducing the potential for offshore tax evasion. FATCA requires that financial institutions outside the US provide the Inland evenue Service (IS) with financial account information they hold on US citizens. US Acronym United States (of America) US Citizen US Person US eportable Account A citizen of the United States of America Defines which individuals and organisations fall into the definition Financial account that falls in scope by the FATCA legislation for reporting to the IS The term US citizen means: An individual born in the US An individual who has a parent who is a US citizen A former immigrant who has been naturalised as a US citizen An individual born in Puerto ico An individual born in Guam An individual born in the US Virgin Islands US Person means an individual that is a US citizen or resident in the United States. Any account that is held by one or more Specified US Persons, or by a Non-US Entity with one or more Controlling Persons that are Specified US Persons. If you need more information, please visit the following websites DWT/IWT: http://www.sars.gov.za/ FATCA: https://www.irs.gov/ CS: https://www.oecd.org/
Annexure A: Documents that we accept to verify your details Before we can enter into a transaction with you, the Financial Intelligence Centre Act (FICA) requires that we verify: Your identity - we require a copy of your green bar-coded identity document (South African citizens) or a copy of a valid passport (foreign nationals). Your residential address - we require proof of your residential address (less than three months). Please ensure that all documents you send us clearly show your name, residential address and issue date. What documents will we accept as proof of residential address in your name? We will accept any of the following documents as proof of residential address: Utility bill in your name (e.g. water, electricity, rates and taxes) Utility bill in your name and showing the legal description of the property (erf number) Bank or mortgage statement (including private banks) Transactional statement from other financial institution Telkom or other fixed-line account Statement from a home security company (e.g. ADT and Chubb) Formal lease agreement Informal lease agreement with a utility bill and identity document of the owner Bank letter/declaration that contains client details - name, surname, residential address, identity number and bank account number (on a bank letterhead or stamped with branch details, name, surname and signature of employee) What if you don t have proof of residential address in your name? If the proof of residential address is in the name of your: Spouse Partner or co-habitant Parent(s) Documents we require Valid SABC television license M-Net or DSTV account Valid SA motor vehicle license Deed of transfer Cell phone account Letter from Tribal Authority confirming address in a rural settlement Long or short-term insurance policy document Letter from employer confirming the residence (employee residing on company owned property) Letter from a tertiary institution confirming residence for students etail account statements from retailers registered in terms of Financial Advisory and Intermediary services Act, No.37 of 2002 ( FAIS ) Levy certificate of properties in sectional title, cluster or shareblock developments issued by a body corporate or managing agent Utility bill, or any other acceptable proof of residence in your spouse s name Identity document of your spouse Joint address declaration form * Utility bill, or any other acceptable proof of residence in your partner s name Identity document of the co-habitant Joint address declaration form * Utility bill, or any other acceptable proof of residence in your parent s name Identity document of the parent Joint address declaration form * * You can find this form on our website under the Forms and documents quick link or phone us at 0860 000 654 or +27 (0)21 415 2301 for a copy What if you cannot provide us with any of the above documents? The following scenarios cover special circumstances where we will accept alternative documents as proof of residential address. Scenario Owner of the property is a trust Owner of the property is a company/ close corporation The investment is in the name of a minor You live in a retirement village You live on a farm You are a South African citizen living overseas for longer than 12 months Documents we require Utility bill, or any other acceptable proof of residence in the name of the trust A signed declaration that you do not have the proof of residence in your name A signed declaration by all trustees or authorised representative with a resolution A letter of authority of the trust Utility bill, or any other acceptable proof of residence in the name of the company/close corporation A signed declaration that you do not have the proof of residence in your name A signed declaration by the directors/members or authorised representative with a resolution Company/close corporation documents that show the names of the directors/members Utility bill, or any other acceptable proof of residence Identity document of a parent Minor child s birth certificate reflecting the name of the parent investing on behalf of the minor A declaration by the administrator of the retirement village on their official letterhead stating that you currently live at the retirement village Utility bill or other acceptable proof of residence showing your erf number, please add the erf number on the application form A utility bill reflecting or other acceptable proof of residence showing your overseas residential address If you do not have a utility bill in your name, we would need the same documents that apply to investors who live in South Africa and cannot provide us with a utility bill