Clerical Medical Self-Invested Fund

Clerical Medical Self-Invested Fund Property purchase application form You need to complete this form if you want to acquire property as an investment within your Self-Invested Fund, or to transfer property which is already an asset of a pension scheme held by another provider or administrator to your Self-Invested Fund. Please complete this form as fully as possible and sign both parts (investment and insurance), but do not delay in returning it to us if some details are not known. Please return your completed form to: Clerical Medical Self-Invested Fund Department, PO Box 749, Ipswich IP1 9EZ. If accepted by us, this application will be a legally binding document and form part of the contract between you and Clerical Medical. Please read A guide to property purchases under the Self-Invested Fund (reference X2069) and Property Insurance notes (reference X2070) before completing this form. These documents are available on request. If you have any queries please contact your adviser. Please complete this form using CAPITAL LETTERS, with black ink and where appropriate. Did your adviser give advice in respect of this application? Advice given Advice not given 1. Details of investor(s) This section is for completion by all individual investors. Joint investors should nominate one individual to be our point of contact (and whose details should be the first to be entered in this section). We will be entitled to deal with that individual on all matters relating to the acquisition of the property and its subsequent management, including disclosure (where required) of individual investor cash balances. If there are more than eight investors, please use photocopies of this page and attach them to the form. Warning: sending personal information by email is not secure. Only include your email address if you agree to Clerical Medical or Suffolk Life sending you emails. First investor (This investor will be the point of contact.) In connection with this property do you wish Suffolk Life to liaise directly with you or with your adviser? Me My adviser Mr/Mrs/Miss/Ms or other title Age next birthday Full forename(s) Surname Permanent residential address Existing Clerical Medical policy number Home telephone number Mobile telephone number Work telephone number Nationality (if more than one nationality is held, please list them all) Country of residence (if other than UK) Occupation (if employed, or self-employed, please state your usual occupation) 1

1. Details of investor(s) (continued) Second investor Mr/Mrs/Miss/Ms or other title Age next birthday Full forename(s) Surname Permanent residential address Existing Clerical Medical policy number Home telephone number Mobile telephone number Work telephone number Nationality (if more than one nationality is held, please list them all) Country of residence (if other than UK) Occupation (if employed, or self-employed, please state your usual occupation) Third investor Mr/Mrs/Miss/Ms or other title Age next birthday Full forename(s) Surname Permanent residential address Existing Clerical Medical policy number Home telephone number Mobile telephone number Work telephone number Nationality (if more than one nationality is held, please list them all) Country of residence (if other than UK) Occupation (if employed, or self-employed, please state your usual occupation) Fourth investor Mr/Mrs/Miss/Ms or other title Age next birthday Full forename(s) Surname Permanent residential address 2

1. Details of investor(s) (continued) Existing Clerical Medical policy number Home telephone number Mobile telephone number Work telephone number Nationality (if more than one nationality is held, please list them all) Country of residence (if other than UK) Occupation (if employed, or self-employed, please state your usual occupation) Fifth investor Mr/Mrs/Miss/Ms or other title Age next birthday Full forename(s) Surname Permanent residential address Existing Clerical Medical policy number Home telephone number Mobile telephone number Work telephone number Nationality (if more than one nationality is held, please list them all) Country of residence (if other than UK) Occupation (if employed, or self-employed, please state your usual occupation) Sixth investor Mr/Mrs/Miss/Ms or other title Age next birthday Full forename(s) Surname Permanent residential address Existing Clerical Medical policy number Home telephone number Mobile telephone number Work telephone number Nationality (if more than one nationality is held, please list them all) Country of residence (if other than UK) Occupation (if employed, or self-employed, please state your usual occupation) 3

1. Details of investor(s) (continued) Seventh investor Mr/Mrs/Miss/Ms or other title Age next birthday Full forename(s) Surname Permanent residential address Existing Clerical Medical policy number Home telephone number Mobile telephone number Work telephone number Nationality (if more than one nationality is held, please list them all) Country of residence (if other than UK) Occupation (if employed, or self-employed, please state your usual occupation) Eighth investor Mr/Mrs/Miss/Ms or other title Age next birthday Full forename(s) Surname Permanent residential address Existing Clerical Medical policy number Home telephone number Mobile telephone number Work telephone number Nationality (if more than one nationality is held, please list them all) Country of residence (if other than UK) Occupation (if employed, or self-employed, please state your usual occupation) 4

2. Property information Please use this section to provide full details of the proposed property purchase. Address of the property ( the property ) Please give details below of exactly what all parts of the property are currently being used for. Description and use of the property (eg warehouse for book storage, solicitors offices, etc.) Does the property include living accommodation? Yes No If Yes, please give details below. Development works Do you intend to carry out any development works to the property following completion? Yes No If Yes, please give details below. Disputes Are you aware of any disputes of any kind in relation to the property or of any circumstances which might Yes lead to any such disputes? No If Yes, please give details below. Inspections Has the property been inspected pursuant to the asbestos regulations? Yes No If Yes, has an inspection report been prepared? Yes No If Yes, please supply a copy as soon as possible. Copy attached Copy to follow Copy not available Legal actions Are you aware of any action, actual or impending, which might be taken with respect to the property by Yes No the local authority or any other public authority? If Yes, please give details below. 5

2. Property information (continued) Adjoining properties Does the property directly adjoin any property already owned by you or a person connected with you? Yes No If Yes, please give details below. Contamination Have you any cause to think that the property may be contaminated in any way? Yes No If Yes, please give details below. Miscellaneous Do any unusual provisions apply? (e.g. options, rights, etc) Yes No If Yes, please give details below. Has the property been registered at the Land Registry? Yes No Don t know Type of ownership of the property Freehold Long leasehold Commonhold If Long leasehold please give details below. Ground rent per annum Outstanding term of lease years Proposed date of exchange of contracts (DD MM YYYY) Type of acquisition Property purchase Yes No Transfer of property from another pension scheme Yes No Site Plan Do you have a site plan readily available? Yes, attached Yes, to follow No. Suffolk Life will request a copy from your solicitor 3. Lease information This section is for details of the current occupant or proposed occupant. 3.1 Details of proposed lease Will the existing lease continue after completion? Yes No Will a new lease need to be drawn up after completion? Yes No 3.2 Details of tenant/proposed tenant Full name(s) Use to which the tenant puts, or intends to put, the premises As detailed in section 2 Other 6

3. Lease information (continued) If Other, please give details below. Address Telephone number Rent/proposed rent per annum Term remaining/proposed term years Is the tenant You, your business, or someone connected with you? Other? Is the property, or any part of the Yes, whole Yes, part No property, to remain vacant? If the property or any party or the property is to remain vacant, please give details below, including how long the property is expected to remain vacant. What is being stored at the property? Please be as specific as possible as this information is important for insurance purposes. (e.g. if a distribution unit, what is being held or if manufacturing what is being made and may be held in the property?) Are any processes being undertaken at the property? Yes No (e.g. woodworking, manufacturing use of heat etc.) If Yes, please give details below. Is the property multi-occupied? Yes No If Yes, please provide details, as above, in respect of each tenant on a separate sheet In respect of a multi-occupied property, please confirm whether there are any: Shared common parts? Yes No Shared common services? Yes No 7

4. Details of proposed acquisition 4.1 If property purchase Will the whole property be purchased by your Self-Invested Funds(s)? If yes, please give details below. Yes No Otherwise go to 4.1.2 What is the total purchase price? Is the purchase price subject to VAT? Yes No If yes, is the purchase price stated above VAT inclusive? Yes No 4.2 Purchase price of part share in the property to be purchased by the Self-Invested Fund(s) Is the purchase price subject to VAT? Yes No If yes, is the purchase price stated above VAT inclusive? Yes No Total current value of the whole property (if known) 4.3 If property transfer from another pension scheme Transfer value of the property Is the property currently elected for VAT? Yes No Is a full valuation report, no more than seven years old, available? Yes No If Yes, report is enclosed Yes to follow 5. Source of funds This section is for details of purchase, property development and transfers of property from other pension schemes. It tells us how you propose to finance the acquisition. The source of funds comprise lending, transfer values from other pension schemes and the existing value of your Self-Invested Fund. 5.1 Funds for the purchase/development These can be made up of the following: Transfers Existing Self-Invested Fund Subtotal Less current approximate Fund borrowings Current net Fund value It may be possible to borrow up to 50% of the net value of the total pension plan (at the time of borrowing) for which you have selected the self-invested option, less any existing borrowing. This 50% limit also includes borrowing for VAT purposes and to develop the property. Please note: It may be possible for you to recover the VAT. Please see Guide to Property Purchase under SIF (reference X2069). Is any part of the purchase/development to be financed by a loan? Yes No If Yes, please give details below. Otherwise go on to section 6. Source of Capital (In order to comply with money laundering regulations we require details as to the source of the transferred money. Clerical Medical reserves the right to request documentary evidence or further information relating to the source of funds if considered necessary.) Amount of loan required Towards property purchase To cover property development work Has any lender made an indicative offer? Yes No If Yes, please supply a copy. Please also complete the lender s details in section 5.3. 8

5. Source of funds (continued) 5.2 If property transfer from another pension scheme Is an outstanding loan attached to the property? If Yes, please give details below. Yes No Otherwise go on to section 6 Amount outstanding If Yes, have you spoken with the lender? Yes No Are you expecting to transfer the property subject to this loan? Yes No Please also complete the existing or proposed lender s details in section 5.3. 5.3 Details of lender Name of lender Contact name Address Telephone number Fax number 6. Professionals This section is for details of your preferred solicitor and valuer. We will normally be happy to appoint these professionals to act on our behalf in the property purchase or transfer for your Self-Invested Fund. 6.1 Solicitor To purchase or transfer the property and, where necessary, to draw up the lease. Name of firm Contact name Address Telephone number Fax number 6.2 Valuer To advise on the purchase/the terms of any new lease. Please note: Must be qualified and registered with the Royal Institute of Chartered Surveyors (RICS). Name of firm Contact name Address Telephone number Fax number 9

7. Seller This section is for details of the seller (if a property purchase) or the transferor and their solicitor. 7.1 Details of seller Please indicate below whose details are being given Seller in respect of a property purchase Is the seller connected with you? Yes No If Yes, please give details of the connection below Transferor in respect of a property transfer from another pension scheme Name of seller/transferor Address Telephone number 7.2 Seller s/transferor s solicitor Name Address Telephone number 8. Declaration, details of ownership and signature(s) Please read the declaration before entering details of ownership. All investors involved in the purchase must sign the form. 8.1 Investor declaration I/we confirm that I/we have received a copy of the property insurance notes and acknowledge that these form part of the agreement. I/we authorise Suffolk Life to instruct the above mentioned solicitor, valuer and where appropriate, lending source or such other solicitor, valuer or lender as may be decided. I/we understand that Suffolk Life will proceed to acquire the property and acknowledge that title to the property may be held in the name of a nominee. I/we authorise Suffolk Life, during the time my/our Self-Invested Fund(s) is/are invested in the property to instruct a solicitor, surveyor, or lender as may be decided, when required and that their fees will be payable from my/our Self-Invested Fund(s). I/we understand that before acquiring the property, Suffolk Life will arrange an environmental audit from their chosen provider and that during the time my/our Self-Invested Fund (s) is/are invested in the property, Suffolk Life may also arrange an environmental audit if advised as necessary by a suitably qualified professional and take such action as it sees fit to mitigate an environmental contamination risk which may include the purchase of insurance and that any costs and charges will be payable from my/our Self-Invested Fund(s). I/we confirm that either: 10 I have no connection with the seller and that neither I nor anyone connected with me has owned the property within the last three years, or I have disclosed full details of any connection in section 7.1. I/we acknowledge that unless legal responsibility rests with a third party, Suffolk Life will arrange for the land and buildings to be insured and that Suffolk Life will retain any commission it is paid in respect of the property insurance policy. I/we agree to be solely responsible for my share of all costs, fees and charges associated with the ongoing administration of the property (including, where applicable, an environmental audit) and these will be payable from my/our Self-Invested Fund(s).

8. Declaration, details of ownership and signature(s) (continued) I agree to be solely responsible for my share of all liabilities, losses, damages and costs which Suffolk Life may incur in holding the property and I agree to reimburse Suffolk Life if they are responsible to pay any such liabilities, losses, damages and costs. I/we acknowledge that Suffolk Life does not monitor the property on an ongoing basis. I/we acknowledge that any responsibility for doing so falls upon me/us and that I/we will reimburse Suffolk Life to the extent of my share of any liabilities, losses, damages and costs which it may incur, for example, as a result of the property becoming or remaining taxable property. I acknowledge that where another investor in the property is unable to meet their share of the costs, fees and charges with the ongoing administration of the property or any liabilities, losses, damages and costs which Suffolk Life may incur in holding the property, responsibility falls upon me and any other investors equally and I will reimburse Suffolk Life to the extent of my share of the shortfall. If I/we instruct you to sell a property, or otherwise dispose of it, I/we acknowledge that a valuation of the property will be required at the time. Where there is more than one investor, we confirm that following completion of the property acquisition, we will sign up to a group investment agreement in a form supplied by Suffolk Life or in such other form as agreed between us and Suffolk Life. We acknowledge that Suffolk Life s form of group investment agreement is available upon request. Data Privacy Notice Your personal information will be held by Scottish Widows Ltd which is part of the Lloyds Banking Group. More information on the Group can be found at www.lloydsbankinggroup.com This privacy notice contains key information about how we will use and share your personal information and the rights you have in relation to this. If you want to know more please access our full privacy notice at www.scottishwidows.co.uk/legalprivacy or ask us for a copy. We will use your personal information: to provide products and services, manage your relationship with us and comply with any laws or regulations we are subject to (for example the laws that prevent financial crime or the regulatory requirements governing the products we offer). for other purposes including improving our services, exercising our rights in relation to agreements and contracts and identifying products and services that may be of interest. To support us with the above we analyse information we know about you and how you use our products and services, including some automated decision making. You can find out more about how we do this, and in what circumstances you can ask us to stop, in our full privacy notice. Your personal information will be shared within Lloyds Banking Group and other companies that provide services to you or us, so that we and any other companies in our Group can look after your relationship with us. By sharing this information it enables us to better understand our customer s needs, run accounts and policies, and provide products and services efficiently. This processing may include activities which take place outside of the European Economic Area. If this is the case we will ensure appropriate safeguards are in place to protect your personal information. You can find out more about how we share your personal information with credit reference agencies below and can access more information about how else we share your information in our full privacy notice. We will collect personal information about you from a number of sources including: information given to us on application forms, when you talk to us in branch, over the phone or through the device you use and when new services are requested. from analysis of how you operate our products and services, including the frequency, nature, location, origin and recipients of any payments. from or through other organisations (for example card associations, credit reference agencies, insurance companies, retailers, comparison websites, social media and fraud prevention agencies). in certain circumstances we may also use information about health or criminal convictions but we will only do this where allowed by law or if you give us your consent. You can find out more about where we collect personal information about you from in our full privacy notice. We may be required by law, or as a consequence of any contractual relationship we have, to collect certain personal information. Failure to provide this information may prevent or delay us fulfilling these obligations or performing services. The law gives you a number of rights in relation to your personal information including: the right to access the personal information we have about you. This includes information from application forms, statements, correspondence and call recordings. the right to get us to correct personal information that is wrong or incomplete. in certain circumstances, the right to ask us to stop using or delete your personal information. from 25 May 2018 you will have the right to receive any personal information we have collected from you in an easily re-usable format when it s processed on certain grounds, such as consent or for contractual reasons. You can also ask us to pass this information on to another organisation. 11

8. Declaration, details of ownership and signature(s) (continued) You can find out more about these rights and how you can exercise them in our full privacy notice. We may also collect personal information about other individuals who you have a financial link with. This may include people who you have joint accounts or policies with such as your partner/spouse, dependents, beneficiaries or people you have commercial links to, for example other directors or officers of your company. We will collect this information to assess any applications, provide the services requested and to carry out credit reference and fraud prevention checks. You can find out more about how we process personal information about individuals with whom you have a financial link in our full privacy notice. In order to process your application we may supply your personal information to credit reference agencies (CRAs) including how you use our products and services and they will give us information about you, such as about your financial history. We do this to assess credit worthiness and product suitability, check your identity, manage your account, trace and recover debts and prevent criminal activity. We may also continue to exchange information about you with CRAs on an ongoing basis, including about your settled accounts and any debts not fully repaid on time, information on funds going into the account, the balance on the account and, if you borrow, details of your repayments or whether you repay in full and on time. CRAs will share your information with other organisations, for example other organisations you ask to provide you with products and services. Your data will also be linked to the data of any joint applicants or other financial associates as explained above. You can find out more about the identities of the CRAs, and the ways in which they use and share personal information, in our full privacy notice. The personal information we have collected from you and anyone you have a financial link with may be shared with fraud prevention agencies who will use it to prevent fraud and money laundering and to verify your identity. If fraud is detected, you could be refused certain services, finance or employment. Further details of how your information will be used by us and these fraud prevention agencies, and your data protection rights, can be found in our full privacy notice. If you apply to us for insurance, we may pass your details to the relevant insurer and their agents. If a claim is made, any personal information given to us, or to the insurer, may be put onto a register of claims and shared with other insurers to prevent fraudulent claims. It is important that you understand how the personal information you give us will be used. Therefore, we strongly advise that you read our full privacy notice, which you can find at www.scottishwidows.co.uk/legalprivacy or you can ask us for a copy. If you have any questions or require more information about how we use your personal information please contact us using https://www.scottishwidows.co.uk/secure/forms/contact_us/individual_customers/policy-enquiries You can also call us on 0345 300 2244. If you feel we have not answered your question Lloyds Banking Group has a Group Data Privacy Officer, who you can contact on 0345 300 2244 and tell us you want to speak to our Data Privacy Officer. Money Laundering Regulations Under current regulations we are required to verify the identity of our customers. In order to meet this requirement and for the prevention and detection of fraud, we will access information from a credit reference agency* to confirm your identity. They will authenticate your name, address and date of birth, which involves checking the details you supply against those held on any databases that the company carrying out the checks on our behalf (or any similar company) has access to. This includes information from the Electoral Register. We will use scoring methods to authenticate your identity. Our search will not be used by lenders or insurers when assessing lending or insurance risks. We may also pass information to financial and other organisations involved in money laundering and fraud prevention to protect ourselves and our customers from theft and fraud. If you give us false or inaccurate information and we suspect fraud, we will record this and share this information with other organisations. If you provide us with information about another person, we will treat this as confirmation that they have appointed you to act for them to consent to the processing of their personal data. This means that you have informed them of our identity and the purpose for which their personal data will be processed, namely to verify their name, address and date of birth. Where Clerical Medical or Suffolk Life receives notification affecting the legal ownership of the plan, or the appointment of an attorney under a Power of Attorney or other circumstances where there are new parties associated with the contract, the same process as set out above will apply. Please note that if we cannot confirm your name, address and date of birth by using a credit reference agency we may contact you to ask you to supply certain documents to verify this information. If you ask, we will tell you which credit reference agency we have used so you can get a copy of your details from them. *Please note we only use this agency to verify identity to fulfil anti-money laundering regulations and not to check credit worthiness. 12

8. Declaration, details of ownership and signature(s) (continued) 8.2 Details of ownership and signature(s) The proposed percentage shares in the property should reflect the respective contributions towards the purchase price by each investor. Please complete the following for each investor in the order in which they have been entered in section 1. Investor 1 Marketing Choices We would like to keep you up to date on products and offers that may be of interest to you. Please select how you would like to hear from us below. These choices won t affect any necessary information we need to send you such as statements and, don t worry, you can change your mind and update your preferences at any time. SCOTTISH WIDOWS WEBSITES You may see relevant messages when you log in to our online services. If you choose no, you may still see messages, but they will not be tailored to you. Yes No EMAIL Yes No POST Yes No DEVICE NOTIFICATIONS As we develop mobile applications you ll receive relevant notifications to your mobile device Yes No TEXT MESSAGES Yes No PHONE Yes No By saying yes, you are giving consent for Scottish Widows to use your personal information to send you relevant offers and information about our products. Scottish Widows includes the following legal entities: Scottish Widows Ltd, Scottish Widows Unit Trust Managers Limited, Scottish Widows Administration Services Limited and HBOS Investment Fund Managers Limited. Occasionally we will send you selected offers from other companies within Lloyds Banking Group that may be relevant to you. Signature of first investor Date (DD MM YYYY) Full name of signatory (CAPITAL LETTERS) Percentage share % Investor 2 Marketing Choices We would like to keep you up to date on products and offers that may be of interest to you. Please select how you would like to hear from us below. These choices won t affect any necessary information we need to send you such as statements and, don t worry, you can change your mind and update your preferences at any time. SCOTTISH WIDOWS WEBSITES You may see relevant messages when you log in to our online services. If you choose no, you may still see messages, but they will not be tailored to you. Yes No EMAIL Yes No POST Yes No DEVICE NOTIFICATIONS As we develop mobile applications you ll receive relevant notifications to your mobile device Yes No TEXT MESSAGES Yes No PHONE Yes No By saying yes, you are giving consent for Scottish Widows to use your personal information to send you relevant offers and information about our products. Scottish Widows includes the following legal entities: Scottish Widows Ltd, Scottish Widows Unit Trust Managers Limited, Scottish Widows Administration Services Limited and HBOS Investment Fund Managers Limited. Occasionally we will send you selected offers from other companies within Lloyds Banking Group that may be relevant to you. Signature of second investor Date (DD MM YYYY) Full name of signatory (CAPITAL LETTERS) Percentage share % 13

8. Declaration, details of ownership and signature(s) (continued) Investor 3 Marketing Choices We would like to keep you up to date on products and offers that may be of interest to you. Please select how you would like to hear from us below. These choices won t affect any necessary information we need to send you such as statements and, don t worry, you can change your mind and update your preferences at any time. SCOTTISH WIDOWS WEBSITES You may see relevant messages when you log in to our online services. If you choose no, you may still see messages, but they will not be tailored to you. Yes No EMAIL Yes No POST Yes No DEVICE NOTIFICATIONS As we develop mobile applications you ll receive relevant notifications to your mobile device Yes No TEXT MESSAGES Yes No PHONE Yes No By saying yes, you are giving consent for Scottish Widows to use your personal information to send you relevant offers and information about our products. Scottish Widows includes the following legal entities: Scottish Widows Ltd, Scottish Widows Unit Trust Managers Limited, Scottish Widows Administration Services Limited and HBOS Investment Fund Managers Limited. Occasionally we will send you selected offers from other companies within Lloyds Banking Group that may be relevant to you. Signature of third investor Date (DD MM YYYY) Full name of signatory (CAPITAL LETTERS) Percentage share % Investor 4 Marketing Choices We would like to keep you up to date on products and offers that may be of interest to you. Please select how you would like to hear from us below. These choices won t affect any necessary information we need to send you such as statements and, don t worry, you can change your mind and update your preferences at any time. SCOTTISH WIDOWS WEBSITES You may see relevant messages when you log in to our online services. If you choose no, you may still see messages, but they will not be tailored to you. Yes No EMAIL Yes No POST Yes No DEVICE NOTIFICATIONS As we develop mobile applications you ll receive relevant notifications to your mobile device Yes No TEXT MESSAGES Yes No PHONE Yes No By saying yes, you are giving consent for Scottish Widows to use your personal information to send you relevant offers and information about our products. Scottish Widows includes the following legal entities: Scottish Widows Ltd, Scottish Widows Unit Trust Managers Limited, Scottish Widows Administration Services Limited and HBOS Investment Fund Managers Limited. Occasionally we will send you selected offers from other companies within Lloyds Banking Group that may be relevant to you. Signature of fourth investor Date (DD MM YYYY) Full name of signatory (CAPITAL LETTERS) Percentage share % 14

8. Declaration, details of ownership and signature(s) (continued) Investor 5 Marketing Choices We would like to keep you up to date on products and offers that may be of interest to you. Please select how you would like to hear from us below. These choices won t affect any necessary information we need to send you such as statements and, don t worry, you can change your mind and update your preferences at any time. SCOTTISH WIDOWS WEBSITES You may see relevant messages when you log in to our online services. If you choose no, you may still see messages, but they will not be tailored to you. Yes No EMAIL Yes No POST Yes No DEVICE NOTIFICATIONS As we develop mobile applications you ll receive relevant notifications to your mobile device Yes No TEXT MESSAGES Yes No PHONE Yes No By saying yes, you are giving consent for Scottish Widows to use your personal information to send you relevant offers and information about our products. Scottish Widows includes the following legal entities: Scottish Widows Ltd, Scottish Widows Unit Trust Managers Limited, Scottish Widows Administration Services Limited and HBOS Investment Fund Managers Limited. Occasionally we will send you selected offers from other companies within Lloyds Banking Group that may be relevant to you. Signature of fifth investor Date (DD MM YYYY) Full name of signatory (CAPITAL LETTERS) Percentage share % Investor 6 Marketing Choices We would like to keep you up to date on products and offers that may be of interest to you. Please select how you would like to hear from us below. These choices won t affect any necessary information we need to send you such as statements and, don t worry, you can change your mind and update your preferences at any time. SCOTTISH WIDOWS WEBSITES You may see relevant messages when you log in to our online services. If you choose no, you may still see messages, but they will not be tailored to you. Yes No EMAIL Yes No POST Yes No DEVICE NOTIFICATIONS As we develop mobile applications you ll receive relevant notifications to your mobile device Yes No TEXT MESSAGES Yes No PHONE Yes No By saying yes, you are giving consent for Scottish Widows to use your personal information to send you relevant offers and information about our products. Scottish Widows includes the following legal entities: Scottish Widows Ltd, Scottish Widows Unit Trust Managers Limited, Scottish Widows Administration Services Limited and HBOS Investment Fund Managers Limited. Occasionally we will send you selected offers from other companies within Lloyds Banking Group that may be relevant to you. Signature of sixth investor Date (DD MM YYYY) Full name of signatory (CAPITAL LETTERS) Percentage share % 15

8. Declaration, details of ownership and signature(s) (continued) Investor 7 Marketing Choices We would like to keep you up to date on products and offers that may be of interest to you. Please select how you would like to hear from us below. These choices won t affect any necessary information we need to send you such as statements and, don t worry, you can change your mind and update your preferences at any time. SCOTTISH WIDOWS WEBSITES You may see relevant messages when you log in to our online services. If you choose no, you may still see messages, but they will not be tailored to you. Yes No EMAIL Yes No POST Yes No DEVICE NOTIFICATIONS As we develop mobile applications you ll receive relevant notifications to your mobile device Yes No TEXT MESSAGES Yes No PHONE Yes No By saying yes, you are giving consent for Scottish Widows to use your personal information to send you relevant offers and information about our products. Scottish Widows includes the following legal entities: Scottish Widows Ltd, Scottish Widows Unit Trust Managers Limited, Scottish Widows Administration Services Limited and HBOS Investment Fund Managers Limited. Occasionally we will send you selected offers from other companies within Lloyds Banking Group that may be relevant to you. Signature of seventh investor Date (DD MM YYYY) Full name of signatory (CAPITAL LETTERS) Percentage share % Investor 8 Marketing Choices We would like to keep you up to date on products and offers that may be of interest to you. Please select how you would like to hear from us below. These choices won t affect any necessary information we need to send you such as statements and, don t worry, you can change your mind and update your preferences at any time. SCOTTISH WIDOWS WEBSITES You may see relevant messages when you log in to our online services. If you choose no, you may still see messages, but they will not be tailored to you. Yes No EMAIL Yes No POST Yes No DEVICE NOTIFICATIONS As we develop mobile applications you ll receive relevant notifications to your mobile device Yes No TEXT MESSAGES Yes No PHONE Yes No By saying yes, you are giving consent for Scottish Widows to use your personal information to send you relevant offers and information about our products. Scottish Widows includes the following legal entities: Scottish Widows Ltd, Scottish Widows Unit Trust Managers Limited, Scottish Widows Administration Services Limited and HBOS Investment Fund Managers Limited. Occasionally we will send you selected offers from other companies within Lloyds Banking Group that may be relevant to you. Signature of eighth investor Date (DD MM YYYY) Full name of signatory (CAPITAL LETTERS) Percentage share % Total of all percentage shares 100% The percentage shares will be finalised after completion and confirmed in a group investment agreement which we will supply, and which all joint investors will need to sign. www.clericalmedical.co.uk Clerical Medical is a trading name of Scottish Widows Limited. Scottish Widows Limited is registered in England and Wales No. 3196171. Registered office in the United Kingdom at 25 Gresham Street, London EC2V 7HN. Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Financial Services Register number 181655. G1274/0318