CHUBB Chubb Group of Insurance Companies 15 Mountain View Road, P. 0. Box 1615, Warren, NJ 07061-1615 APPLICATION INVESTMENT COMPANY ASSET PROTECTION BOND UNDERWRITTEN IN CHUBB CUSTOM INSURANCE COMPANY Please answer all of the following Inquiries. If the COMPANY agrees to Issue a bond, all of the information which the Applicant provides will become part of any bond issued to the Applicant by Chubb Custom Insurance Company. Any misrepresentation, omission, concealment or incorrect statement of a material fact in this APPLICATION will be grounds for recision. Please note: The term Applicant as used in this APPLICATION refers to all entities for which coverage is desired. It is agreed that coverage is desired only for those entities listed on the SCHEDULE OF PROPOSED NAMED INSURED. 1. a. Name of Proposed First Named Insured: A. GENERAL INFORMATION b. Address of Proposed First Named Insured: 2. Please complete the attached SCHEDULE OF PROPOSED NAMED INSURED. 3. Requested Coverages: INSURING CLAUSES LIMITS 1. Employee Coverage 2. Premises Coverage 3. Transit Coverage 4. Forgery or Alteration Coverage 5. Extended Forgery Coverage 6. Counterfeit Currency Coverage 7. Threats to Persons Coverage 8. Computer Systems Coverage 9. Voice Initiated Transaction Coverage 10. Uncollectible Items of Deposit Coverage 11. Audit Expense Coverage Deductible Amount $ * Not applicable to any insured Investment Company under INSURING CLAUSE 1 EMPLOYEE COVERAGE. ICAP Bond App. - CCIC (8-92) Form 17-03-0069 (Ed. 8-92) Page 1 of 5
B. CONTROLS 1. As respects any Investment Company included in the SCHEDULE OF PROPOSED NAMED INSURED, are all shareholder accounting services performed by the transfer agent? If no, please explain who performs other shareholder accounting services and what those services are: 2. the Investment Company in connection with its duties as redemption or transfer agent? If yes, please attach a copy of the agreement. 3. Would specific Instructions ever be issued by an Applicant to the Transfer Agent requesting it to issue a check for redemption of certificates to other than the registered owner? If yes, under what circumstances? 4. Does the Applicant ever guarantee or witness signatures on Investment Company shares received for transfer or redemption? If yes, under what circumstances? 5. Does the Applicant always require signature guarantees on: (a) redemptions? (b) changes of registration? (c) changes of address? (d) request for additional redemption privileges? If yes, by whom: (a) National Bank? (b) Member of stock exchange? (c) Other: Please explain YES NO NO C. DATA PROCESSING 1. Name(s) of Outside Electronic Data Processor(s) and Function(s) performed by each: Name Function Page 2 of 5
2. If Computer Systems Coverage is desired, please list the name(s) of the Computer System(s) and Function(s) of each system below: Name Function D. INTERNAL CONTROLS 1. Does the Applicant have a formal policy governing procedures for holding customer, shareholder or subscriber items of deposit prior to crediting their accounts? If yes, please state the minimum number of days items are held before dividends are paid or withdrawals permitted from a customer s shareholder s or subscriber s account? days 2. Please attach your standard collection procedures which are pursued in the event that customer, shareholder or subscriber items of deposit are not honored by the drawee financial institution. 3. (a) Are your customers, shareholders or subscribers permitted to request by voice over the telephone transfers or redemptions from their account? If yes, please provide, on a separate sheet, those applicant INSUREDS that permit this activity. (b) Are customers, shareholders or subscribers required to sign a written agreement authorizing the Applicant to rely on telephonic voice instructions? If yes, please attach a copy of the agreement. 4. Are written Designated Procedures in place which outline the steps to be followed when verifying the authenticity of voice requests directed to you over the telephone, instructing transfers or redemptions from an account of your customer, shareholder or subscriber? If yes, please attach these Designated Procedures. E. LOSS EXPERIENCE 1. a. Has any Applicant at any time during the past six (6) years, put its insurance carrier on notice of any potential or actual losses under any bond? If yes, please provide, on a separate sheet, full details, including corrective actions taken as a result of such loss. b. If any Applicant has not had a bond at any time during this period, have there been any losses that would have been submitted under a bond program if the Applicant had such a bond? ICAP Bond App. CCIC (8-92) Form 17-03-0069 (Ed. 8-92) Page 3 of 5
2. Please summarize: a. Any litigation/legal action settled within the past three (3) years or now pending that is not listed in question 1. immediately above; and/or b. Any action which the Applicant has reason to anticipate may be filed against it or any Director, Officer or Employee, which would be a subject of coverage under a bond. If necessary, please provide, on a separate sheet full details. If not, please check NONE. F. OTHER INFORMATION Please attach the following Applicant information with this completed APPLICATION: 1. Prospectus and Statement of Additional Information for each Investment Company for which coverage is requested. 2. Most recent Fiscal Year Audited Financial Statement and CPA letter of Recommendation to Management for any non-investment Company for which coverage is requested. The undersigned persons declare that to the best of their knowledge the statements set forth above and in any attachments to this APPLICATION are true and correct, and that every reasonable effort has been made to obtain sufficient information to facilitate the proper and accurate completion of this APPLICATION. The undersigned agree that if any significant change in the condition of the Applicant is discovered between the date of this APPLICATION and the effective date of the bond which would render this APPLICATION inaccurate or incomplete, notice of such change will be reported in writing to the COMPANY immediately and, if necessary, any outstanding quotation may be modified or withdrawn. The undersigned persons understand and further agree that the completion and signing of this APPLICATION neither binds the COMPANY to sell nor the Applicant to purchase the insurance. Please note: ONLY CHUBB APPOINTED AGENTS AND LICENSED BROKERS ARE AUTHORIZED TO SOLICIT APPLICA- TIONS FOR COVERAGE. AGENTS AND BROKERS ARE NOT AUTHORIZED TO BIND COVERAGE. NO COVERAGE SHALL BE PROVIDED UNLESS THE COMPANY ACCEPTS THE APPLICATION AND BINDS THE COVERAGE. False Information: Any person who, knowingly and with intent to defraud any insurance company or other person, files an APPLICA- TION for insurance containing any false information, or conceals for the purpose of misleading, information concerning any material fact thereto, commits a fraudulent insurance act, which is a crime. Proposed First Named Insured BY Signature of Chief Executive Officer (or other Senior Officer if the Chief Executive Officer is also the Chairman, Board of Directors/Trustees) BY Signature of Chairman, Board of Directors/Trustees Date Date A bond cannot be issued unless the APPLICATION is properly signed and dated by the Chief Executive Officer (or other senior officer if the Chief Executive Officer is also the Chairman, Board of Directors/Trustees) and the Chairman, Board of Directors/Trustees. NOTE: This APPLICATION and all attachments shall be treated in strictest confidence. Page 4 of 5
SCHEDULE OF PROPOSED NAMED INSURED NAME OF PROPOSED INSURED DATE CREATED OR ACQUIRED NATURE OF BUSINESS NAME OF CUSTODIAN NAME OF TRANSFER AGENT TOTAL ASSETS (in MILLIONS) Please attach a prospectus for each investment company listed above and an annual report and financial statement for all other Proposed Named Insureds. This information is attached to and forms a part of the Application. (IF NECESSARY, PLEASE ATTACH SUPPLEMENTAL SCHEDULE FOLLOWING THIS FORMAT.) ICAP Bond App. - CCIC (8-92) Form 17-03-0069 (Ed. 8-92) Page 5 of 5