Clime Australia Icome Fud APPLICATION FOR UNITS Dated 1 July 2015
How to Complete the Applicatio Form This is a Applicatio Form for uits i the Clime Australia Icome Fud (Fud) issued by Clime Asset Maagemet Pty Limited (ABN 72 098 420 770, AFSL No. 221146) (Clime) offered uder the iformatio memoradum for the Fud dated 1 July 2015 (the IM). This Applicatio Form must ot be distributed uless i or accompaied by, the IM. The IM cotais importat iformatio about ivestig i the Fud. It is importat you read i full the IM ad declaratios i this Applicatio Form before applyig. You may request a free prited copy of the IM ad the Applicatio Form by callig Clime o 1300 788 568 durig busiess hours. A perso who gives aother perso access to the Applicatio Form must at the same time ad by the same meas give the other perso access to the IM. Procedure 1. Complete the iformatio required i the Applicatio Form o pages I - IX. Please read Geeral Istructios commecig o this page. 2. Idetificatio ad verificatio documets are required uder Australia s Ati-Moey Lauderig ad Couter Terrorism Fiacig (AML/CTF) regulatios. To idetify the documets you eed to provide, see Ati-Moey Lauderig ad Couter-Terrorism Fiacig Istructios o page 4. 3. The Applicatio Form, your paymet as set out i Sectio D of the Applicatio Form ad certified copies of the documets required to verify your idetity should be set to: FudBPO Pty Limited GPO Box 4968 Sydey NS W 2001 If you eed assistace i completig the form, please cotact Clime Asset Maagemet o 1300 788 568. Geeral Istructios Please use CAPITAL LETTERS ad a black ball poit pe whe completig the forms. For joit ivestors we require the usual residetial address of each ivestor. You may oly elect oe postal address for all otices ad correspodece. Your usual residetial address caot be your fiacial adviser s address or a post office box. Compay applicatios should iclude a cotact ame ad ACN, ABN, or ARBN as applicable. For compay applicatios we require the full address of the registered office, plus pricipal place of busiess. Idividual applicats should be 18 years of age or over. You ca ivest o a mior s behalf by puttig their ame i the accout desigatio box. The uitholder will ot, however, be the mior. If you have a existig accout ad would like to add to the accout, please ote your existig accout umber. Tax File Number (TFN) You are ot obliged to provide your TFN, ABN or claim a exemptio. However, if you do ot do so we are required to deduct tax from distributios of icome made to you at the highest margial rate, plus Medicare Levy (if you are a Australia residet). Tax File Numbers for miors will ot be accepted. Applicatio Istructios The miimum applicatio amout is $200,000. Please cross your cheque ot egotiable ad make it payable to Clime Australia Icome Fud - Applicatio A/C. The cheque must be payable i Australia dollars. Cash is ot accepted. If paymet is made by EFT, the applicatio moey should be set to the bak accout as provided i Sectio D of the Applicatio Form. 1 CAIF Applicatio Form - July 2015
Accout Operatio Istructios Please idicate how you wish your accout to be operated. I the case of joit accouts, you may request joit sigatures or allow either sigatory to sig. For a compay or trustee, please idicate your operatio istructios by tickig the appropriate box. See Sectio G of the Applicatio Form. Examples of Correct Names & Accout Desigatios TYPE OF INVESTOR CORRECT NAMES INCORRECT NAMES SIGNATURE(S) REQUIRED Idividual / Joit Ivestors Use full ame of each applicat Compay Alex Joh Barde Laura Sue Barde Alex J Barde Laura S Barde Each Applicat Use full compay title Trusts / Miors Portal Pty Ltd Portal P/L Portal Co Portal Ic. Two directors; or Director & Secretary; or if there is oly oe director, by that director Use trustee(s)/idividual(s) ame(s) Use trust/mior ame as desigatio Superauatio Fud Name: Paul Rya Pruty A/C Desigatio: <Pruty Family Trust> <Joel Pruty> Name: Paul Pruty Family Trust Each Trustee If trustee is a compay, see above Use trustee(s)/idividual(s) ame(s) Use superauatio fud ame as desigatio Name: Amy Rachel Wood A/C Desigatio: <Amy Wood Super Fud> Name: AR Wood Super Fud Each Trustee If trustee is a compay, see above Distributios & Redemptios Distributios will be reivested uless you elect to have them paid ito your bak accout specified i Sectio F. Please esure that you complete all details of the istitutio i full. We will also use these bak accout details to pay your redemptio proceeds. Request for Iformatio The aual report for the Fud (icludig audited Fud accouts) will be published o Clime s website (www.clime. com.au/services/clime-maaged-fuds/clime-australia-icome-fud/). It ca also be set to you, free of charge, by email (PDF file attachmet) or by post (prited copy). Clime ecourages you to elect i the applicatio form (Sectio H) to receive a copy by email or view o the website, as this saves o paper ad expeses for the Fud ad has evirometal beefits. Your electio ca be chaged at ay time by cotactig the Admiistrator, FudBPO. Sigatures Please esure you have siged i Sectio K of the Applicatio Form. You should esure that you have read the attached Product Disclosure Statemet (which icorporates the Additioal Iformatio Booklet) i full before sigig the applicatio. Joit applicatios must be siged by all persos. If the applicatio is beig siged uder Power of Attorey please eclose a certified copy of the Power of Attorey ad appropriate photo idetificatio of the attorey. 2 CAIF Applicatio Form July 2015
Lodgig the Applicatio Form Please mail the completed Applicatio Form, alog with your paymet ad documets that verify your idetity to: FudBPO Pty Limited GPO Box 4968 Sydey NSW 2001 Please esure paymet is made i full. Please ote that uits i the Fud will oly be issued o receipt of a properly completed Applicatio Form, issued together with the curret IM, idetificatio documets ad cleared fuds. If you have ay queries please call your fiacial adviser or cotact Clime o: PO Box Q1286, Quee Victoria Buildig NSW 1230 P 1300 788 568 F +61 (0)2 8917 2155 E ifo@clime.com.au W www.clime.com.au 3 CAIF Applicatio Form July 2015
Ati-Moey Lauderig & Couter-Terrorism Fiacig Istructios Idetificatio Requiremets Uder Australia Ati-Moey Lauderig ad Couter Terrorism Fiacig (AML/CTF) Legislatio, certai due diligece must be coducted o ay prospective ivestor before uits i the Fud may be issued to that ivestor. The due diligece icludes verifyig a prospective ivestor s idetity. Applicatios that do ot provide the required iformatio caot be processed. AML/CTF compliace will also iclude ogoig customer due diligece which may require the Trust Maager (Clime) to collect further iformatio. Requiremets for Idividuals / Sole Traders If you are a idividual ivestor or sole trader, you will eed to give us certified copies of oe documet from colum [1] OR oe documet from each of colum [2] AND [3]: Please ote that for Trusts, Parterships, Associatios ad Co-Operative Applicats, if you are required to complete the idividual sectio of the applicatio the you must also provide the documets required for a idividual applicat. Reliable ad Idepedet Documetatio Do ot sed origials; certified copies oly Colum [1] Primary Photographic Australia Drivers Liceces Valid Australia Passport# State or Territory Proof of Age Card Foreig Passport* Natioal ID Card issued by a foreig govermet cotaiig a photograph ad sigature* Foreig Driver s Licece with photograph ad date of birth* OR Colum [2] Primary No - Photographic Birth Certificate Commowealth Citizeship Certificate Pesio Card Health Care Card issued by Cetrelik Foreig Citizeship Certificate or Birth Certificate* AND Colum [3] Secodary Idetificatio Commowealth, State ad Territory fiacial beefits otice (less tha 12 moths old) Tax Ivoice (less tha 12 moths old) Local utilities provider otice (less tha 3 moths old) # A passport that expired withi the two years prior to submittig the applicatio form will be accepted. * Documets that are writte i a laguage that is ot Eglish must be accompaied by a Eglish traslatio prepared by a accredited traslator. WHO MAY CERTIFY YOUR DOCUMENTS AS BEING A TRUE AND CORRECT COPY OF THE ORIGINAL Judge Lawyer Notary Public Magistrate Police Officer A Registrar or Deputy Registrar of a court Justice of Peace Fiace Compay Officer* Full-time employee of the bak* A member of the Istitute of Chartered Accoutats i Australia, CPA or NIA membership Medical Practitioer Pharmacist The eligible certifier must iclude the followig iformatio: Their full ame Address Telephoe Number The date of certifyig Capacity i which they are eligible to certify, ad A official stamp/seal if applicable Full-time employee of a post office Authorised represetative of a holder of a Australia Fiacial Services Licece* Australia Cosular Officer or Diplomatic Officer Teacher employed o a full-time basis at a school or tertiary educatio istitutio. The certified copy must iclude the statemet, I certify this is a true copy of the origial documet. For photographic documets, the certified copy must iclude the statemet, I certify this is a true copy of the origial documet ad the photograph is a true likeess. 4 CAIF Applicatio Form - July 2015
No - Idividual Ivestors Differet idetificatio ad verificatio requiremets apply to prospective ivestors who are ot idividuals, such as compaies, other bodies corporate, trusts; icludig superauatio trusts, parterships, associatios ad registered co-operatives. Australia Compaies Ay oe of the followig documets: a certified copy of the certificatio of registratio or licece or other records of the relevat commowealth, state or territory statutory regulator; a public documet issued by the relevat compay. Trusts & Trustees If the trust is a: Registered maaged ivestmet scheme, regulated trust, superauatio fud or govermet superauatio fud - a certified copy or relevat extract from the relevat regulator s website showig the full ame of the trust, ad that the trust is a registered scheme, regulated trust, superauatio fud or govermet superauatio fud. Other trust type: a certified copy or extract of the Trust Deed showig the ame of the trust; a letter from a solicitor or qualified accoutat that cofirms the ame of the trust; a otice issued by the ATO withi the last 12 moths (e.g. Notice of Assessmet). Idividual Trustee - verificatio of the Trustee s full ame, ad either date of birth OR residetial address is required by providig the idetificatio requiremets for a Idividual. Australia Compay Trustee - a certified copy of the certificatio of registratio. Australia Listed Compay or majority owed subsidiary of a Australia Listed Compay or a regulated compay - a certified copy of a public documet issued by the relevat compay. Importat Curret Australia Ati-Moey Lauderig requiremets, as well as prospective chages to legislatio, may i the future impose other due diligece procedures or require the collectio of further iformatio from ivestors. 5 CAIF Applicatio Form July 2015
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Uited States tax status form for ALL Ivestors Why this form? The Foreig Accout Tax Compliace Act (FATCA) is a Uited States (US) regulatory requiremet that aims to deter tax evasio by US taxpayers. The Australia ad US Govermets (through their tax offices) have a agreemet which meas we must ask you, ad you must aswer, these questios. Iformatio we gather is reported to the ATO ad i tur to US tax authorities. For more iformatio visit the ATO Website: https://www.ato.gov.au/geeral/new-legislatio/i-detail/other-topics/iteratioal/foreig-accout-tax-compliace-act/ If you are usure of ay of the aswers please cotact a legal, accoutig or immigratio professioal. 1. If you are a super fud If you ca tick this box, you do t eed to go past this questio other tha to sig this form at the ed: uless you have a GIIN. Help: If you ca tick this box, you do t eed to go past this questio other tha to sig this form at the ed. I am a super fud. 2. If you are trustee of a testametary trust If you ca tick this box, you do't eed to go past this questio other tha to sig this form at the ed. I am a trustee of a testametary trust. 3. If you are a US idividual Whether ivestig for yourself or as a trustee, if you are a idividual that is a US citize, or a residet of the US for tax purposes, please give details. Help: TIN: THIS IS NOT YOUR TFN Name TIN It s short for US Taxpayer Idetificatio Number, oe of a umber of IDs issued by US authorities Name TIN Name TIN Not eough room? Write their details clearly ad attach them. It could for example be a US Social Security Number, a US Idividual Taxpayer Idetificatio Number or a US Employer Idetificatio Number. US citize or residet of the US for tax purposes: ayoe bor i the US who has t reouced their US citizeship a US citize icludig persos a dual or multiple citizeships US lawful permaet residets e.g. gree card holders 4. If you are US compay or trust Oly cosider this questio if you have t bee able to complete questio #2 above. If you are a US compay or trust, please give details: or if your status is exempt payee, write exempt payee TIN Help: a compay created i the US, established uder the laws of the US or which is a US taxpayer a trust subject to the laws of the US ad cotrolled by oe or more persos that are citizes or residets of the US 7 CAIF Applicatio Form July 2015
Uited States tax status form for ALL Ivestors 5. If you are a Fiacial Istitutio Oly cosider this questio if you have t bee able to complete questio #2 0r #3 above. If you are: a Fiacial Istitutio Australia Regulated Trust, or a trust whose trustee is a Fiacial Istitutio, please give details GIIN If you do't have a GIIN, tell us you FACTA status: Deemed compliat Foreig Fiacial Istitutio Excepted Foreig Fiacial Istitutio Registered deemed compliat Foreig Fiacial Istitutio No-participatig Foreig Fiacial Istitutio Exempt Beeficial Ower No-participatig Foreig Fiacial Istitutio GIIN applied for but ot yet issued No reportig IGA Foreig Fiacial Istitutio Other: please detail Help GIIN: Global Itermediary Idetificatio Number, a uique ID umber issued by US tax authorities to o-us fiacial istitutios whe they register for FATCA. Fiacial Istitutio a depository istitutio you accept deposits i the ordiary course of a bakig or similar busiess e.g. a bak a custodia istitutio a substatial portio of your busiess (20 %+of gross icome) is held i fiacial assets for the accout of others e.g. a custodia a ivestmet etity this icludes etities that trade i fiacial assets or that are ivestig, admiisterig, maagig fuds, moey, or certai fiacial assets o behalf of other persos e.g. ivestmet compaies. Note: if you are a professioal trustee, you will usually fall withi this category certai prescribed etities eg types of isurace compaies that have cash value products or auities. More iformatio ca be foud at: www.irs.gov/busiesses/ Corporatios/Iformatio-for-Foreig-Fiacial-Istitutios Australia Regulated Trust ASIC registered maagemet ivestmet schemes other trusts which are registered with the ATO or ASIC but excludig self-maaged superauatio fuds, APRA regulated superauatio fuds, Australia Govermet or Semi-Govermet Superauatio Fuds ad pooled super trusts (together Super Etities), uless such Super etities have a GIIN. 6. If you are a public compay I am a public compay. Help: Public compaies have the status of Active No- Fiacial Etity thaks for lettig us kow. 8 CAIF Applicatio Form July 2015
Uited States tax status form for ALL Ivestors 7. Are you still tryig to tell us somethig? Oly cosider this questio if you have t bee able to complete ay questio above. Commoly, it is proprietary (or Pty) compaies, whether ivestig themselves or as a trustee, that make it to this last questio. We eed to kow whether or ot you are a Passive No-Fiacial Etity: do t be put off! It s ot too complicated Help A Passive No-Fiacial Etity is broadly where someoe ivolved with you is caught by the US tax system. A US citize or residet of the US for tax purposes is defied above. To work this out, cosider whether ay of the people listed below are a US citize or residet of the US for tax purposes: ayoe that beeficially ows 25% or more of your issued capital? ayoe that exercises cotrol over you? by way of determiig decisios about the fiacial ad operatig policy if you are a trust, ay beeficiary or settlor? If you ticked ay box, please give details: Name Address TIN Name Address TIN Name Address TIN Name Address TIN Not eough room? Write their details clearly ad attach them. OR oe of the people listed above are a US citize or residet of the US for tax purpose Ivestor 1 Ivestor 2 Sigature Sigature 9 CAIF Applicatio Form July 2015
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Applicatio for Uits Clime Australia Icome Fud Attach cheque here Uits i the Clime Australia Icome Fud are oly issued o receipt of: this applicatio form; verificatio of the applicat s idetity, AND paymet i full. This is a Applicatio Form for uits i the Clime Australia Icome Fud (Fud) issued by Clime Asset Maagemet Pty Limited (ABN 72 098 420 770, AFSL No. 221146) (Clime) offered uder the iformatio memoradum for the Fud dated 1 July 2015 (the IM). This Applicatio Form must ot be distributed uless i or accompaied by, the IM. The IM cotais importat iformatio about ivestig i the Fud. It is importat you read i full the IM ad declaratios i this Applicatio Form before applyig. You may request a free prited copy of the IM ad the Applicatio Form by callig Clime o 1300 788 568 durig busiess hours. A perso who gives aother perso access to the Applicatio Form must at the same time ad by the same meas give the other perso access to the IM. SECTION A Do you have a existig ivestmet i a Clime fud? Please tick oe box ONLY. Yes: My / Our Ivestor Number is Name Phoe Number Go to Sectio D No: This is a ew ivestmet (go to Sectio B) SECTION B - Ivestor Details What type of etity is applyig? Please tick oe box ONLY. Idividual, joit or sole trader complete B1 Partership complete B1 & B2 Compay complete B1 (Directors) & B2 Trust / Super Fud with Idividual/s as Trustee complete B1 (Trustees) & B3 Trust / Super Fud with Corporate Trustee complete B1 (Directors), B2 (Corporatio) & B3 (Trust or Super Fud) Other Note: I the case of Partership, Compay or Trust/Super Fud ivestors, if all parters, directors or trustees respectively do ot sig the Applicatio Form, a Power of Attorey or appropriate documetatio showig the sigatories have authority to make the ivestmet is to be provided with the Applicatio Form. I CAIF Applicatio Form July 2015
B1 INDIVIDUAL INVESTOR DETAILS (icludig idividuals actig as Trustee ad Corporate Directors) INVESTOR 1 (Your ame MUST match exactly to the ame o your idetificatio documets) Title Give ame(s) i full Surame Date of Birth / / Occupatio Australia Tax File Number or Tax Referece Number i coutry of residece Australia Busiess Number (ABN) or Foreig Compay ID Number Residetial Address Suburb State Postcode Coutry Please provide certified copies of your idetificatio documets, see page 4 (please tick whe attached) INVESTOR 2 (Your ame MUST match exactly to the ame o your idetificatio documets) Title Give ame(s) i full Surame Date of Birth / / Occupatio Australia Tax File Number or Tax Referece Number i coutry of residece Australia Busiess Number (ABN) or Foreig Compay ID Number Residetial Address Suburb State Postcode Coutry Please provide certified copies of your idetificatio documets, see page 4 (please tick whe attached) II CAIF Applicatio Form July 2015
B2 CORPORATION, CORPORATE TRUSTEES & PARTNERSHIP DETAILS Name Name of Cotact Perso Registered Office Address: Pricipal Place of Busiess: Type of Compay: Public Private Coutry of Registratio Australia Busiess Number (ABN) or Foreig Compay ID Number Australia Tax File Number or Tax Referece Number i coutry of residece For a private compay (1) How may directors are there? Directors Full Names (IN CAPITALS) (1) (2) (3) (4) (5) (6) If there are more tha 6 directors, please provide all their ames o a separate page ad iclude it with your applicatio form Tick if you have provided ames ad details of additioal directors. III CAIF Applicatio Form July 2015
(2) Provide the followig details for all idividuals who beeficially ow 25% or more of the compay s issue capital. Same as Ivestor 1 (See B1 or B2 for details) Same as Ivestor 2 (See B1 or B2 for details) Additioal Idividuals Name Residetial Address Name Residetial Address Name Residetial Address B3 TRUSTS or SUPER FUND DETAILS Name of Trust or Fud Coutry of Establishmet Australia Busiess Number (ABN) or Foreig Compay ID Number Australia Tax File Number or Tax Referece Number i coutry of residece A certified copy of the Trust Deed is attached to this applicatio (please tick if applicable) NOTE: As Clime the Trust Maager oly recogises the Trustee(s) as the ivestor ad ot the beeficiary, the Trustee(s) details must be give above. However Clime the Trust Maager is also required to record the beeficiary details. BENEFICIARY 1 Same as Ivestor 1 (See B1 or B2 for details) Name Residetial Address Australia Busiess Number (ABN) or Foreig Compay ID Number Australia Tax File Number or Tax Referece Number i coutry of residece IV CAIF Applicatio Form July 2015
BENEFICIARY 2 Same as Ivestor 2 (See B1 or B2 for details) Name Residetial Address Australia Busiess Number (ABN) or Foreig Compay ID Number Australia Tax File Number or Tax Referece Number i coutry of residece If there are more tha 2 beeficiaries, please provide full details for each o a separate page ad iclude it with your applicatio form. Tick if you have provided ames ad details of additioal beeficiaries. SECTION C - Accout Cotact Details Joit ivestors with differet residetial addresses must elect oe postal address i this sectio. Accout Desigatio (optioal) Mai Cotact Residetial Address Suburb State Postcode Coutry Email Address Home Phoe Work Phoe Fax Mobile V CAIF Applicatio Form July 2015
SECTION D - Ivestmet Details I/we apply to ivest $ i Clime Australia Icome Fud Wholesale Uits. Please tick the box to advise how your paymet will be made: Cheque Please make cheque payable to: Clime Australia Icome Fud Applicatio A/C Direct Deposit (EFT) Bak: Natioal Australia Bak (NAB) BSB: 082 001 Accout Number: 24 633 5038 Accout Name: Clime Australia Icome Fud Applicatio A/C Referece: [Applicat(s) Name] For EFT paymets, proof of paymet should be faxed to: Fud BPO o +61 2 9251 3525. Please Note: For both cheque ad EFT paymets, fuds must be trasferred from a bak accout i the ame of the registered uitholder(s). No third party paymets will be permitted. SECTION E - Distributio Electio You ca elect to have distributios reivested, or paid ito your accout. Please ote that if o electio is made, your distributios will be reivested. Yes, please reivest my distributios as additioal Uits No, please pay my distributios directly ito my accout i Sectio F below SECTION F - Bak Accout Details All ivestors must complete this sectio with a Australia bakig istitutio, for distributios ad redemptios. Bak Name/Istitutio Brach Name ad Address BSB Accout Number Accout Name Please ote: This accout must be i the ame of the registered uit holder(s) VI CAIF Applicatio Form July 2015
SECTION G - Operatig Authority Whe givig istructios to us about your ivestmet please idicate who has authority to operate your accout: INDIVIDUAL/JOINT ACCOUNTS (if o box is ticked we will assume all to sig) ay oe to sig both to sig COMPANY, TRUST AND OTHER ACCOUNTS (if o box is ticked, all future writte istructios must be siged by two directors/trustees, director ad secretary, or the sole director) ay oe to sig ay two to sig all to sig other SECTION H - Request for Aual Report (optioal) The accouts for the Fud are available to ivestors o our website www.clime.com.au/services/climemaaged-fuds/clime-australia-icome-fud/ each year. Leave both boxes blak if you wish to receive a copy by post. Clime requests that you tick oe of the boxes as it is costly for the Fud to prit ad mail out the Aual accouts. If you chage your mid, cotact the admiistrator. Receive as a Email Attachmet (you must provide your email address i Sectio C) View the report o the website SECTION I - Privacy Clime may wish to cotact you about future ivestmet opportuities that may be of iterest. Please tick the box if you do NOT wish to be cotacted for this purpose. I/We do ot wish to receive iformatio from Clime regardig future ivestmet opportuities. SECTION J - Providig Idetificatio - New Ivestors Oly I/We cofirm I/we have attached certified copies of the required proof of idetificatio with this applicatio form for each ivestor/applicat. VII CAIF Applicatio Form July 2015
SECTION K - Declaratios & Sigatures PLEASE READ THE INFORMATION MEMORANDUM IN FULL BEFORE SIGNING THIS APPLICATION FORM. By completig the applicatio form you: 1. Declare that you have read ad uderstood the Iformatio Memoradum (IM) ad you are a wholesale cliet as the Corporatio Act defies this 12. Declare that sole sigatories sigig o behalf of a compay are sigig as sole director or as a sole director/secretary of the compay. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Agree to the collectio, use ad disclosure of your persoal iformatio provided i the applicatio form. Declare that you have received the IM persoally, or a pritout of it, accompaied by or attached to the applicatio form before sigig the form. Declare that all iformatio provided i the applicatio ad/or ay other iformatio provided i support of the applicatio is true ad correct. Agree to give further iformatio or persoal details to the Admiistrator ad/or Clime if it reasoably believes that it is required to meet its obligatios uder Ati-Moey Lauderig ad Couter-Terrorism (AML/ CTF) or taxatio legislatio. Represet ad coveat that the fuds you are ivestig are ot the proceeds of crime, moey lauderig, or coected with the fiacig of terrorism. Agree that the Issuer may i its absolute discretio determie ot to issue uits to you ad may cacel or may redeem ay uits issued to you if Clime believes such actio to be ecessary or desirable i the light of its obligatios uder the AML/CTF Act or ay related legislatio. Declare if you have received the IM from the iteret or other electroic meas, that it was either received persoally or that a pritout accompaied the applicatio form before makig a applicatio for uits i the Clime Australia Icome Fud. Ackowledge that oe of Clime, the admiistrator or the custodia or ay member of their respective groups or ay of their directors or associates or ay other etity guaratees the performace of the Fud or the repaymet of capital ivested i the Fud, or icome from the Fud. Declare that if the applicatio is siged uder power of attorey, you have o kowledge of the revocatio of that power of attorey. Declare that you have the power to make a ivestmet i accordace with the applicatio. 13. 14. 15. 16. 17. 18. 19. Ackowledge that a ivestmet i the Fud is subject to risks icludig possible delays i repaymet ad possible loss of capital ivested Agree to be boud by the provisios of the Costitutio goverig the Clime Australia Icome Fud referred to i the IM as ameded from time to time. Agree to be boud by the terms of the IM as ameded or reissued from time to time. Ackowledge that the IM does ot costitute a offer i ay jurisdictio i which, or to ay perso of whom it would be ulawful to make the offer. Declare that if ivestig as a trustee o behalf of a superauatio fud or trust you are actig i accordace with your desigated powers ad authority uder the trust deed. I the case of a superauatio fud, you also cofirm that the fud is a complyig superauatio fud uder the Superauatio Idustry (Supervisio) Act. Ackowledge that all iformatio relatig to this applicatio for ivestmet or ay subsequet iformatio relatig to this ivestmet may be disclosed to ay service provider to the Fud ad to your adviser. You uderstad this will ot iclude disclosure of your TFN, ABN or ay iformatio i relatio to it to your adviser. If you use ay facsimile or email facility you: (a) release, discharge ad agree to idemify Clime ad its agets, icludig the admiistrator ad custodia, ad their respective officers from ad agaist all losses, liabilities, actios, proceedigs, accouts, claims ad demad arisig from istructios received uder the facility. (b) agree that a paymet made i accordace with the coditios of ay such facility shall be i complete satisfactio of all obligatios to you for a paymet, ot withstadig it was requested, made or received without your kowledge or authority. VIII CAIF Applicatio Form July 2015
Sigature of Ivestor 1 Name of Ivestor 1 Date Tick Role (Compaies oly) Sole Director Director Secretary Sigature of Ivestor 2 Name of Ivestor 2 Date Tick Role (Compaies oly) Sole Director Director Secretary POST APPLICATION, ID DOCUMENTS (& CHEQUE) TO FUNDBPO PTY LTD: GPO BOX 4968 SYDNEY NSW 2001 IX CAIF Applicatio Form July 2015
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Clime Asset Maagemet Pty Ltd ABN 72 098 420 770 AFSL Number 221146 Level 7, 1 Market Street Sydey NSW 2000 Australia PO Box Q1286 Quee Victoria Buildig NSW 1230 Australia www.clime.com.au 1300 788 568 +61 2 8917 2155 ifo@clime.com.au 1 July 2015