ISA ADDITIONAL PERMITTED SUBSCRIPTION (APS)

*APIWP0100F* ISA ADDITIONAL PERMITTED SUBSCRIPTION (APS) Spouse inherited ISA application What is an Additional Permitted Subscription (APS)? When an ISA investor dies, his or her surviving spouse 1 is entitled to make an APS into an ISA, over and above the personal annual ISA allowance. The APS allowance available is dependent on the date of death: For deaths between 4 December 2014 and 5 April 2018, the allowance is limited to the value of the deceased s ISA as at the date of death; For deaths on or after 6 April 2018, the APS allowance is limited to the higher of 2 : (a) The value of the deceased s ISA as at the date of death (hereafter referred to as APS1); (b) The value of the deceased s ISA when it ceases to be a continuing account 3 (hereafter referred to as APS2). With this form you can: invest up to the APS allowance by moving inherited ISA funds from your late spouse s Old Mutual Wealth ISA into: your existing ISA with us, or a new ISA in your name (if you do not already have one with us). The funds will be moved into your ISA without actually selling them; this is known as an in specie transfer. This form will be required in addition to other documents needed when an ISA investor dies. We recommend that you seek advice from your financial adviser about completing this form, the APS options available to you, as well as our additional requirements in respect of the deceased s investment. PLEASE TICK ALL STATEMENTS BELOW THAT APPLY: As the deceased s surviving spouse, I inherited the ISA from the deceased The deceased s ISA was, and still is, held with Old Mutual Wealth I already have an ISA with Old Mutual Wealth, or intend to open one using this form HAVE YOU BEEN ABLE TO TICK ALL THREE STATEMENTS ABOVE? YES YOU CAN COMPLETE THIS APPLICATION For deaths between 4 December 2014 and 5 April 2018, HMRC rules only allow us to move the units that were in the deceased s ISA as at the date we were notified of the death, and which remain in the ISA when we act on the instruction (up to the APS allowance available). For deaths on or after 6 April 2018, HMRC rules allow us to move the units that are in the deceased s ISA when we act on the instruction (up to the APS allowance available). Send the completed form to: Old Mutual Wealth, Old Mutual House, Portland Terrace, Southampton, SO14 7AY NO THIS IS THE WRONG APPLICATION FOR YOU HMRC rules do not permit an in specie movement of the units, unless all of the criteria above are met. However, if you are the surviving spouse of an ISA investor, you can still use our ISA APS Cash Lump Sum application, which is available from your financial adviser or by calling our Customer Contact Centre on 0808 171 2626 NOTE This form cannot be used to invest cash lump sums, for which there is a separate application. If you already have an ISA with us, the funds must be added to your existing ISA; they cannot be held separately. If the deceased s ISA or the surviving spouse s ISA was invested using our Managed Portfolio Service (MPS) it will first need to be opted out. This application does not cater for automatic rebalancing, automatic withdrawals, or the income payment option, which can be arranged at a later date. The deceased s legal personal representative(s) (LPR) must also sign this form in section 8. Please be aware that once a subscription using the APS allowance has been made to Old Mutual Wealth, any future subscriptions from that APS allowance MUST also be made to Old Mutual Wealth. 1 References to spouse in this form also mean civil partner, as defined by the Civil Partnership Act 2004. 2 The value used will be subject to certain conditions being met please refer to the ISA Additional Permitted Subscription (APS) Options flyer for more information. 3 The deceased s ISA will cease to be a continuing account on the earlier of: completion of the administration of the deceased s estate; the third anniversary of the death; the closure of the account. Page 1 of 7

! IMPORTANT DOCUMENTS YOU NEED TO HAVE RECEIVED BEFORE PROCEEDING You need to have received several important documents about this product and the funds you choose, before you send us your application to invest in, or top up, an ISA. More information about these documents is in section 1. Please tick/complete this form, as applicable, using BLOCK CAPITALS and blue or black ink. u Complete the form carefully; errors or omissions by you or your financial adviser will not be corrected retrospectively 1 FINANCIAL ADVICE In most cases, we only accept business for investors who have received financial advice. This is because financial advisers can recommend investments that are most suitable for investors financial circumstances. Old Mutual Wealth cannot provide such advice. However, in exceptional circumstances we can accept applications on an execution only (without advice) basis, provided we ensure you have been given appropriate information and you complete some additional paperwork, see 1.2. Tick 1.1 or 1.2 as applicable 1.1 I have received financial advice in respect of this application On what basis was the advice given? (your financial adviser will help you answer this) Restricted Independent IMPORTANT DOCUMENTS YOU NEED TO HAVE RECEIVED BEFORE APPLYING Your financial adviser will have provided you with the following: A Key Features Document and Terms & Conditions for the Individual Savings Account (ISA) Information about the funds being transferred to your ISA: a Key Investor Information Document (KIID) or a Key Information Document (KID) for each fund the rebates applicable to your fund choice A Cost and Charges Statement, contained in the illustration or projection for your investment. In section 9, the declaration you sign will include your confirmation that you have received and read these documents. 1.2 I have NOT received financial advice in respect of this application Please contact us on 0808 171 2626 or by email at ask@omwealth.com. We can then: assess whether we can accept your application on an execution only basis explain the restrictions when investing without financial advice, for example the fund choice available to you will be restricted to funds available for execution only investments u if any funds in the deceased s ISA are not available to you, we will sell them and send the cash proceeds to you. tell you which documents you need to have read before you send us your application provide you with the additional Execution Only Form you will need to sign and attach to your application. Tick here, if you have already contacted us, and your signed Execution Only Form is attached to this application. PDF11249/218-0331/March 2018 (APS) In Specie Application Page 2 of 7

2 PERSONAL DETAILS All three parts of this section must be completed. PART A YOUR INVESTMENT Type of investment New account u this only applies if you do not already have an ISA with us Top-up to account number: PART B YOUR DETAILS Your client reference number u if known Title Mr Mrs Miss Other (please specify) Surname Full forename(s) of birth National Insurance number Permanent UK residential Correspondence (if different from residential ) / / If you have never been issued with a National Insurance number, tick here Crown employees Contact telephone number (in case of query) Tick here if you are, or your late spouse was, a Crown employee working overseas (see Declaration point 1b in section 9) E-mail PART C DETAILS OF THE DECEASED Full name of birth National Insurance number Last permanent residential / / of death If the deceased had never been issued with a National Insurance number, tick here / / 2 0 of your marriage/civil partnership* with the deceased / / * as defined by the Civil Partnership Act 2004 The deceased s ISA account number(s): u if the deceased had more than one Old Mutual Wealth ISA, their values will be combined to form one APS allowance 3 FUND CHOICE The funds in the deceased s ISA will be transferred to your ISA, where possible*. For deaths before 6 April 2018: Units in the deceased s ISA, as at the date we receive notification of the death, will be moved into your name, provided their value does not exceed the APS allowance available to you. For deaths on or after 6 April 2018: Units in the deceased s ISA, as at the date we process your instruction, will be moved into your name, provided their value does not exceed the APS allowance available to you. If the value of the funds: has fallen, you can top up your ISA with a cash lump sum to maximise the APS allowance has increased, any excess above the APS allowance will be paid out in line with your instructions in section 4. * If any funds are not available for transfer, we will sell them and send you the cash proceeds, in line with your instructions in section 4. PDF11249/218-0331/March 2018 (APS) In Specie Application Page 3 of 7

4 BANK DETAILS FOR EXCESS PAYMENT u if applicable If the value of the funds being moved exceeds the APS allowance, or if the funds are not available for transfer, we will pay the excess cash proceeds direct into your bank account. Please give details of your bank account below. Name of bank/ building society Branch Sort code Bank account number - - Building society reference number (if applicable) Name of bank account holder(s) 5 PAYMENTS TO YOUR FINANCIAL ADVISER u to be completed with your financial adviser if required Only complete this section if you wish Old Mutual Wealth to deduct fees for your financial adviser from your account. Percentage fees must be entered in multiples of 0.05%. NOTE If you wish to cancel an existing fee instruction using this form, enter 0 or 0% in the boxes for the fee in question. It will be cancelled for the whole account, not just the investment in this application. Any Servicing Fee or Switch Fee you authorise here will apply to the entire account and will override any existing Servicing or Switch Fee instruction on your account. Initial Fee An initial fee is not available for this type of application. Fund Switch Fee Switch Fee required up to: OR: % from each switch The amount you authorise using this form is the maximum fund Switch Fee payable to your financial adviser. The actual fee payable for each switch must be stipulated up to this limit, at the time the switch instruction is given. Servicing Fee Servicing Fee required: OR: % each year Add VAT on top of the Servicing Fee? Yes Tick the frequency required Monthly Quarterly Half-yearly Yearly If you leave the frequency blank, we will assume monthly. The fee is an annual amount which will be divided by the payment frequency selected and paid to your adviser accordingly. If VAT applies to this fee, your financial adviser can either include VAT within this fee or add it on top. If you tick yes VAT will be added to the amount shown above. Where a percentage fee amount is agreed, the fee paid to your financial adviser may go up or down depending on the value of your account on the date the fee is deducted. We will only pay an ongoing adviser fee to your authorised financial adviser. If you are receiving discretionary fund management services from a third party, your adviser may pay all or a proportion of the fee to the third party as payment for these services, and where relevant, to cover any associated VAT. 6 OLD MUTUAL WEALTH SERVICE CHARGE & ADVISER SERVICING FEE DEDUCTIONS u where applicable You can choose which funds are sold to meet the Service Charge and adviser servicing fee, as applicable; the option selected will apply to both of these payments. Select one of the following options: Largest fund OR All funds OR The following fund(s) NOTE If you do not specify a preference, and in the absence of any existing instructions, we will deduct the payments from the largest fund in your account. More information about charges and fees is in the document Making the cost of investment clear. PDF11249/218-0331/March 2018 (APS) In Specie Application Page 4 of 7

7 POWER OF ATTORNEY Complete this section only if an attorney is signing the application on behalf of the applicant. u if there is more than one attorney, please attach the same information for each one by using a copy of this page We will need: the attorney s details below the original power of attorney, or a copy certified as a true copy of the original in ink on each page by a solicitor or the donor (the person giving the power) the attorney s identity verified. Surname Full forename(s) Full postal (if correspondence is to be sent to this, please enter it in section 2, part B) of birth / / Under HMRC regulations, we can only accept an ISA application made under a Power of Attorney if we have confirmation that at least one of the following circumstances applies. Please tick to indicate why the investor is unable to apply him/herself: Physical disability, illness or old age Mental disorder or incapacity The investor is a member of the armed forces on active service in a war zone. I have read the Personal Data Statement in the Terms and Conditions and consent to my personal data being used in accordance with that statement. Attorney s signature (You must sign both here and in section 9 writing the words as attorney after your signature) / / 2 0 8 LEGAL PERSONAL REPRESENTATIVE DECLARATION AND SIGNATURE The following declaration is made by each of the deceased s legal personal representatives (LPRs) signing below. u if the applicant is also a legal personal representative, he or she must sign in this section as well as section 9 a) I declare that the applicant named in section 2 part B of this form: is the surviving spouse of the deceased named in section 2 part C inherited the ISA from the deceased and that the funds held in the deceased s ISA can therefore be moved into an ISA in the applicant s name. b) I confirm that if the value of the funds being moved exceeds the APS allowance, or if a fund is not available for transfer, the excess cash proceeds can be paid to the applicant s bank account detailed in section 4. c) I further declare that: i. the details in this form are true and correct. ii. I will be responsible for any losses and/or expenses, which are the result of any untrue, misleading or inaccurate information given in this form or with respect to the benefits from the policy/account/bond. iii. I confirm that there is no Bankruptcy Order against the deceased or claimant(s) nor is the deceased or claimant(s) an undischarged bankrupt, nor is the deceased or claimant(s) deemed to be insolvent within the meaning of the Insolvency Act. iv. if I have omitted any information required, I understand that Old Mutual Wealth will not act until all the required information has been received. v. I agree that the payment/transfer of this claim shall constitute a full discharge of the liability of Old Mutual Wealth and I undertake to indemnify Old Mutual Wealth in full against any claims or demands made by any other person(s), party(ies) as a result of the payment/transfer. Signature: Print name: Signature: Print name: u if there are more than two LPRs, please photocopy this page, complete and attach the details to this form. / / 2 0 / / 2 0 PDF11249/218-0331/March 2018 (APS) In Specie Application Page 5 of 7

9 APPLICANT S DECLARATION AND SIGNATURE Please read this section carefully it is important that you read and understand the Terms and Conditions as well as this declaration. You should ask questions if there is anything you do not understand before you sign and date below. APS Eligibility Declaration This section must be completed to confirm the investor named on this application is eligible to make an Additional Permitted Subscription to an ISA in respect of the deceased named on this application. 1. a) I wish to subscribe from my APS allowance in respect of the deceased to a Stocks & Shares ISA by in specie transfer of existing ISA investments that have remained with Old Mutual Wealth s nominee since the date of death. b) I declare that: all subscriptions made, and to be made, belong to me; I am 18 years of age or over; I was married to or in a civil partnership* with the deceased at their date of death and have evidence to support this declaration that can be produced on request I am the surviving spouse of the deceased I was living with the deceased within the meaning of section 1011 of the income tax act 2007 at the date of the deceased s death (we were not separated under an order of a court or a deed of separation and were not separated in circumstances where the separation was likely to become permanent) the subscription is made under the provisions of regulation 5DDA of the ISA regulations (Additional Permitted Subscription) the subscription is being made within 180 days of beneficial ownership passing to me as the surviving spouse. I am resident in the United Kingdom for tax purposes or, if not so resident, either perform duties which, by virtue of section 28 of Income Tax (Earnings & Pensions) Act 2003 (Crown employees serving overseas), are treated as being performed in the United Kingdom, or the deceased performed such duties. I will inform Old Mutual Wealth Limited if I cease to be so resident, or to perform such duties. c) I understand that once a subscription to an APS allowance has been made, any future subscriptions under that APS allowance MUST be made to this ISA manager and be accompanied by an APS Eligibility Declaration. 2. I authorise Old Mutual Wealth Limited a) to hold my cash subscription and ISA investments, interest distributions, dividends and any other rights or proceeds in respect of those investments and any other cash; and b) to make any claims to relief from tax in respect of ISA investments on my behalf; and c) to sell units or shares in investments within my account to meet any charges or fees for my financial adviser, in accordance with the Terms and Conditions; and d) to give effect to my instructions in accordance with the Terms and Conditions. 3. I understand that I will not receive contract notes relating to transactions involving the purchase or sale of investments which are carried out on a periodic basis in the manner agreed to in any future instruction from me. Details of these transactions will be shown in the periodic statement which will be sent to me. In particular, such transactions include: - regular investments payable by direct debit; - phased investments; - automatic rebalances; - automatic withdrawals; - dividend and rebate reinvestments; and - sales of units to meet Old Mutual Wealth Limited charges and fees for my financial adviser (if applicable). 4. I have been given the opportunity to read and keep the following, and to have any questions concerning them answered to my satisfaction: a) Terms and Conditions, to which I agree b) Key Features Document c) Costs and Charges Statement, included in an illustration or projection regarding my investment d) all available Key Investor Information Documents, Key Information Documents and information about rebates, in respect of my chosen funds. 5. I consent to my personal data being used in accordance with the Personal Data Statement in the Terms and Conditions. 6. I declare that this application has been completed correctly and to the best of my knowledge and belief. 7. If I have agreed any fees in this application : a) I authorise Old Mutual Wealth to deduct those fees from my investment and pay them to my financial adviser. b) I understand that: i. the fees agreed will be met as follows (as applicable): Fund switch fee by deduction from the sale proceeds of the switch, before they are invested into my new choice of funds Servicing fee by selling units as instructed in section 6 ii. if I have ticked Yes to add VAT to any servicing fees, the amount of the agreed fee will be increased to include VAT at the rate prevailing when the fee is deducted iii. if I select a percentage amount servicing or switch fee, the fee paid to my financial adviser may go up or down depending on the value of my account on the date the fee is calculated iv. I will need to reauthorise any increases to fees that have been previously agreed. c) I confirm that: i. I have agreed any fees in this application with my financial adviser ii. my financial adviser has explained the effect that selling units to pay Adviser Charges from my investment will have on its future value iii. Old Mutual Wealth has brought to my attention the importance of reading and discussing fees with my financial adviser before signing below. d) I understand that: i. I can cancel an adviser servicing fee at least 10 working days before it is deducted, by contacting Old Mutual Wealth ii. I cannot cancel a fee once it has been deducted, instead I would need to contact my financial adviser to discuss whether a refund is payable * as defined in the Civil Partnership Act 2004 Applicant s signature / / 2 0 *APIWP0100F* PDF11249/218-0331/March 2018 (APS) In Specie Application Page 6 of 7

10 FINANCIAL ADVISER S DECLARATION u to be completed by your financial adviser 1. I understand that adviser fees will be paid subject to the limits outlined in Old Mutual Wealth s Remuneration Guide. 2. I confirm that: (a) I have verified the identity of all relevant parties referred to in this application (b) the information in this form was obtained by me in respect of the relevant parties (c) the evidence I have obtained to verify the identity of the relevant parties can be produced on demand and meets the standard of evidence set out within the guidance for the UK Financial Sector issued by the Joint Money Laundering Steering Group (JMLSG) (d) if any individual referred to in this application has changed within the last three months, I can provide evidence on demand (e) I have not verified the identity of the following parties referred to in this application because they are exempt from verification under Money Laundering Regulations (f) this section is signed below by the person who has seen the documentary evidence (which may include an electronic identity check). Financial adviser s signature 2 0 Print name Financial Services number Full name of regulated firm (or sole trader) Position Contact number Send the completed form to: Old Mutual Wealth Old Mutual House Portland Terrace Southampton SO14 7AY Tel: Customer Contact Centre 0808 171 2626 CHECKLIST Once you have signed the application, please check that you have completed all applicable sections and enclosed the following: (if applicable) Execution Only form (see section 1.2) www.oldmutualwealth.co.uk Please be aware that calls and electronic communications may be recorded for monitoring, regulatory and training purposes and records are available for at least five years. Old Mutual Wealth is the trading name of Old Mutual Wealth Limited which provides an Individual Savings Account (ISA) and Collective Investment Account (CIA) and Old Mutual Wealth Life & Pensions Limited which provides a Collective Retirement Account (CRA) and Collective Investment Bond (CIB). The WealthSelect Managed Portfolio Service is provided by Old Mutual Wealth Limited and Old Mutual Wealth Life & Pensions Limited. Old Mutual Wealth Limited and Old Mutual Wealth Life & Pensions Limited are registered in England and Wales under numbers 1680071 and 4163431 respectively. Registered Office at Old Mutual House, Portland Terrace, Southampton SO14 7EJ, United Kingdom. Old Mutual Wealth Limited is authorised and regulated by the Financial Conduct Authority. Old Mutual Wealth Life & Pensions Limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Their Financial Services register numbers are 165359 and 207977 respectively. VAT number 386 1301 59. When printed by Old Mutual this item is produced on a mixed grade material, which uses a combination of recycled wood or paper fibre from controlled sources and virgin fibre sourced from well managed, sustainable forests. PDF11249/218-0331/March 2018 (APS) In Specie Application Page 7 of 7