Stocks and Shares ISA and ISA Transfer Application Form

Octopus Portfolio Manager Stocks and Shares ISA and ISA Transfer Application Form How to complete this application form ➊ Please read the current Octopus Inheritance Tax Service brochure. ➋ Write in BLOCK CAPITALS and use BLACK ink. ➌ Make sure you answer all questions marked with an asterisk (*). ➍ Leave blank any boxes that don t apply to you. ➎ Don t forget to include your cheque/banker s draft. ➏ Send your completed form (with payment) to: Octopus Investments Limited PO Box 10847 Chelmsford CM99 2BU

This form allows individuals to open an Octopus Portfolio Manager Stocks and Shares ISA, and to transfer ISAs from other providers. It cannot be used to transfer an Investment Bond or SIPP. The form has 10 sections: 1. About the investor 2. About the investment 3. Transferring from another provider 4. About the adviser (to be completed by the adviser) 5. Account charges 6. Tax Residency Status 7. Adviser/intermediary declaration 8. Applicant declaration 9. Authorisation to transfer from another provider 10. Direct Debit mandate Section 1 About the investor How to complete the form Please read the current Octopus Portfolio Manager Brochure, Fees and Charges document, Investment Profile Fact Sheet. Please make sure you answer all the required questions marked with an *. Tick the boxes that apply, like this: Leave boxes blank where they don t apply to you. * Title (Mr/Mrs/Miss/Ms/Other) * First name(s) * Last name * Existing Octopus investor? Yes No * If you are adding to an existing OPM ISA please provide the portfolio number here * Date of birth DD MM YYYY D D M M Y Y Y Y * Country(ies) of citizenship * Country of birth * Telephone numbers Country code Telephone number Home: Work: Mobile: * Primary address line 1 * Address line 2 * Town/City * County * Country * Postcode * National Insurance number Tick here if you don t have a National Insurance Number * Email address Information from Octopus Octopus may occasionally send you information that we believe to be of interest to you e.g. newsletters. If you would not like to receive such information, please tick the box. Page 2 of 20 Octopus OPM Stocks & Shares ISA and ISA Transfer Application Form Questions? 0800 316 2295

Section 2 About the investment(s) * Are you investing a lump sum? No Yes Amount * Cheque/banker s draft, or bank transfer? (Tick one box only) Cheque/banker s draft Please enclose a cheque from a personal account, made payable to Octopus Portfolio Manager Client Account. We do not accept cheques from business accounts, third parties (including your spouse) or post-dated cheques. Banker s drafts or building society cheques must specifically mention the investor s name. The amount of your lump-sum payment cannot exceed the maximum ISA allowance for that tax year. Bank transfer Please transfer your investment to the following account after first sending in your completed application form and identification, making sure that you reference the payment with your name: Sort code: 40-03-28 Bank: HSBC Account No. 42509148 Branch: Holborn Payments need to come from your personal account (we do not accept payments from business accounts) Please transfer funds from another Octopus Portfolio, account number on a one-off basis, I am aware this may incur tax charges before funds are invested in my ISA. Are you making regular monthly contributions? No Yes amount per month (min 100) Complete the Direct Debit mandate in Section 10 Which investment profile would you like to invest in? (e.g. Investment Profile 4: Conservative Capital Growth) Do you want to transfer funds from your Octopus Portfolio Manager Investment Account to invest in an ISA subscription each year? (starting in the next tax year and for each subsequent tax year thereafter) No Yes Applicant Full ISA subscription Other Amount We ll tell you when your subscription transfers will be made and they ll then continue until you tell us to stop them. Octopus Portfolio Manager Investment Account number * Do you want to take out a fixed amount from your portfolio as a regular withdrawal? No go to Section 3 Yes regular withdrawals can only be paid into a bank account, make sure you ve entered your account details below. How much do you want to withdraw? Starting from D D M M Y Y Y Y How often would you like to make withdrawals? Monthly Quarterly Semi-annually Annually * Please give us details of the bank account you would like future proceeds to be paid into Sort code Account holder name Account number Bank address Bank or building society name Postcode Building society roll number (if applicable) Section 3 Transferring from another provider Do you want to transfer any existing investments with another provider into your Octopus Portfolio Manager Investment Account? No go to Section 4 Yes How many transfers? Estimated total amount Please provide details of your transfers in Section 9 Authorisation to transfer from another provider. Octopus OPM Stocks & Shares ISA and ISA Transfer Application Form Questions? 0800 316 2295 Page 3 of 20

Section 4 About the adviser (to be completed by the adviser) * Company * Title (Mr/Mrs/Miss/Ms/Other) * First name(s) * Last name * Telephone * Address * Country * Postcode * Email address * FCA number * Are you part of a network/service provider? No Yes please give us the network/service provider name Advisers are also required to sign the declaration in Section 7. Section 5 Account charges * Initial adviser charge For each payment type ticked, choose either fixed amount or percentage Lump sum Fixed amount Transfers Fixed amount Regular contributions Fixed amount OR Percentage % OR Percentage % OR Percentage % If no option is selected from the above no initial adviser charge will be applied. Any initial adviser charge agreed with your adviser will be taken from your lump-sum payment before your funds are invested. The amount of your lump-sum payment cannot exceed the maximum ISA allowance for that tax year to facilitate initial charges. * Ongoing adviser charge (Tick one box only) Fixed amount per year OR Percentage % Octopus Annual Management Charge If no option is selected from the above no ongoing adviser charge will be applied. This is an annual amount, accrued each day. If you choose to pay on a percentage basis, this will be calculated on the value of your portfolio. We will pay your adviser quarterly by selling assets from your portfolio. Profile Octopus Annual Management Charge 1 0.15% + VAT (0.18%) 2 0.40% + VAT (0.48%) 3 10 0.65% + VAT (0.78%) This is an annual amount, accrued each day, based on the value of your portfolio. Octopus will take this charge quarterly by selling assets from your portfolio. Special instructions Page 4 of 20 Octopus OPM Stocks & Shares ISA and ISA Transfer Application Form Questions? 0800 316 2295

Section 6 Tax residency status * 6.1 Are you tax resident, or do you complete tax returns, in any country other than the UK? No please go straight to Section 7. If your country of birth of country of citizenship is outside of the UK, please send us a certified copy of a valid UK ID, such as a UK driving licence or passport, or a certified letter from HMRC, to confirm your UK tax residency status. Yes please complete the table below. * 6.2 Please list the country(ies), other than the UK, in which you are resident for tax purposes. Please provide the Taxpayer Identification Number (TIN) or functional equivalent for each country(ies), or tick the relevant box if the country does not provide a TIN. Country(ies) Taxpayer Identification Number (TIN) TIN not available Section 7 Adviser/intermediary declaration To be completed by the adviser named in Section 4. * Advisor/intermediary signature By submitting this form, I agree that: I have read and understood the Octopus Terms of Business for Intermediaries. I agree to be bound by these Terms of Business. As an Appointed Representative, I warrant and represent that my principal also accepts the Terms of Business for Intermediaries. I have made a personal recommendation to the applicant that satisfies the requirements of COBS 9 suitability. * Date signed DD MM YYYY D D M M Y Y Y Y Section 8 Applicant declaration To be completed by the investor named in Section 1, or registered Attorney(s) These declarations apply to both new subscriptions into an ISA in the current tax year and ISA transfers from other plan managers. By signing this form I HEREBY DECLARE THAT I: 1. Have read and understood the current Octopus Portfolio Manager Brochure, Fees and Charges document and Investment Profile Fact Sheet(s), and understand the risks associated with Octopus Portfolio Manager. 2. Have read and understood the Octopus Portfolio Manager Terms and Conditions and agree to be bound by them. 3. I have read and understood the Octopus policies regarding best execution, conflicts of interest and gift and benefits, all available at octopusinvestments.com. 4. Have considered whether I/we need financial and tax advice. 5. Understand that if I am/we are investing monthly contributions, these will continue until I/we cancel them by writing to you. 6. Consent to Octopus facilitating the fees and charges to my/our adviser as set out in Section 5. Octopus OPM Stocks & Shares ISA and ISA Transfer Application Form Questions? 0800 316 2295 Page 5 of 20

Section 8 Applicant declaration Declaration A Lump Sum and Regular Contribution Please sign below if you are investing a lump sum in an ISA in the current tax year. i. All subscriptions made, and to be made, belong to me. ii. I am 18 years of age or over. iii. I have not subscribed and will not subscribe to another Stocks and Shares ISA in the same year that I subscribe to this ISA. I have not subscribed, and will not subscribe, more than the appropriate overall subscription limit in Cash ISA and a Stocks and Shares ISA in the same tax year. iv. I am resident in the UK for tax purposes, or if not so resident perform duties which, by virtue of Section 28 of the Income Tax (Earnings & Pensions) Act 2003 (Crown employees serving overseas) are treated as being performed in the UK, or I am married to, or in a civil partnership with, a person who performs such duties. I will inform Octopus Investments Limited if I cease to be so resident or to perform such duties or be married to, or in a civil partnership with, a person who performs such duties. v. I hereby authorise Octopus Investments Limited to be my ISA Manager and directly or through its appointed Nominee to hold my cash subscription, ISA investments, interest, distributions and any other rights or proceeds in respect of those investments and any other cash, to make on my behalf any claims to relief from tax in respect of ISA investments and on my written request to transfer or pay to me, as the case may be, ISA investments, interest, distributions, rights or other proceeds in respect of such investments or any cash. vi. Where I invest using a Direct Debit, an ISA will be opened for the current tax year and each successive tax year until I notify you in writing. The amount I wish to contribute is outlined in Section 2 and will be either the amount outlined or the maximum permissible subscription for that year until further notice. vii. Where I invest using funds withdrawn from another Octopus Portfolio Manager account I am aware that the withdrawal may incur tax charges before the funds are invested in my ISA. * Applicant name * Applicant/Attorney signature * Date signed DD MM YYYY D D M M Y Y Y Y Declaration B ISA Transfer Please sign here if you are investing through an ISA Transfer. * Applicant name i. Hold my cash subscription, ISA investments, interest, dividends and any other rights or proceeds in respect of those investments and any other cash, ii. Make on my behalf any claims to relief from tax in respect of ISA investments, and iii. On my written request, transfer or pay to me, as the case may be, ISA investments, interest, dividends, rights or other proceeds in respect of such investments or any cash. iv. I understand that Octopus Investments accepts no responsibility for any loss incurred as a result of any delay between my submission and Octopus Investments receipt of the application form. v. I understand that this application is subject to acceptance by the ISA Manager. vi. I understand that, where I am transferring a Cash ISA, it will be transferred into a Stocks and Shares ISA. vii. You are not contractually bound until the ISA investment is made. * Applicant signature * Date signed DD MM YYYY D D M M Y Y Y Y Page 6 of 20 Octopus OPM Stocks & Shares ISA and ISA Transfer Application Form Questions? 0800 316 2295

When you have completed the form, tick the following to confirm: You ve answered all the questions that apply to you. You ve completed Section 6 Tax Residency Status. If you are transferring from another provider, you have completed Section 9 Authorisation to transfer from another provider. If you are making regular payments, you have completed Section 10 Direct Debit mandate. You have enclosed the necessary verification of identity documentation which must be certified by a regulated individual (e.g. financial adviser, solicitor or accountant): an Identity Verification Certificate or one each of the following; a certified copy of identification (your passport or driving licence) plus; a certified copy of proof of address (driving licence, bank statement or recent utility bill (not mobile phone)) If you are paying by cheque, you have enclosed a cheque from a personal account, made payable to Octopus Portfolio Manager Client Account. We do not accept cheques from business accounts, third parties (including your spouse) or post-dated cheques. Banker s drafts or building society cheques must specifically mention the investor s name. Or, if you are paying via CHAPS/BACS, please transfer your investment to the following account after first sending in your completed application form and identification, making sure that you reference the payment with your name: Sort code: 40-03-28 Bank: HSBC Account No. 42509148 Branch: Holborn Payments need to come from your personal account (we do not accept payments from business accounts). If you would like to set up a Family Group or become part of an existing Family Group, you have filled in and enclosed a separate Family Group Form. You have added any special instructions that may apply within Section 5 Account Charges. What happens next? ➊ ➋ We will send you an acknowledgement that we have received your application, and your funds will be invested as quickly as possible. Once your funds have been invested we will send you regular valuation statements. You can also check your account online through our secure website. Octopus OPM Stocks & Shares ISA and ISA Transfer Application Form Questions? 0800 316 2295 Page 7 of 20

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Octopus Portfolio Manager Section 8 Authorisation to transfer from another provider How to complete this application form ➊ Please complete all sections as directed. ➋ Once completed please send to: Octopus Investments Limited PO Box 10847 Chelmsford CM99 2BU

Section 8 Authorisation to transfer from another provider You can use this form to transfer existing ISAs into your Octopus Portfolio Manager ISA. * I have a Stocks and Shares ISA OR Cash ISA * This ISA is for The current tax year I wish to transfer my current year s ISA subscriptions. A previous tax year I wish to transfer my previous year s ISA subscriptions. * Please transfer my ISA In full OR In part - please complete the below section * Estimated value of ISA ISA Investments to be transferred in part Please check with your existing ISA Manager that they can accommodate partial transfers. Please transfer % of my total ISA holding, OR Please transfer specific tax years as detailed below (example 2007/2008) 1. / 2. / 3. / 4. / * Name Details of ISA Manager Address Address * Account number of the ISA to be transferred * Sort code (if your ISA is held by a bank) * Telephone number * Title (Mr/Mrs/Miss/Ms/Other) Personal Details Country Postcode * First name(s) * Last name * Postcode * National Insurance Number * Transfer instruction Transfer Instruction Transfer instruction I hereby instruct my current ISA Manager to transfer the ISA(s) referred to in this section, to Octopus Investments Limited (my new Manager) by liquidating the assets and forwarding the proceeds to Octopus Investments Limited. This request is subject to Octopus Investments acceptance of my transfer application. I authorise my existing ISA Manager to provide Octopus Investments Limited with any information, written or nonwritten, concerning the ISA and to accept any instructions from them. * Applicant signature * Date signed DD MM YYYY D D M M Y Y Y Y Page 10 of 20 Octopus OPM Stocks & Shares ISA and ISA Transfer Application Form Questions? 0800 316 2295

Section 8 Authorisation to transfer from another provider You can use this form to transfer existing ISAs into your Octopus Portfolio Manager ISA. * I have a Stocks and Shares ISA OR Cash ISA * This ISA is for The current tax year I wish to transfer my current year s ISA subscriptions. A previous tax year I wish to transfer my previous year s ISA subscriptions. * Please transfer my ISA In full OR In part - please complete the below section * Estimated value of ISA ISA Investments to be transferred in part Please check with your existing ISA Manager that they can accommodate partial transfers. Please transfer % of my total ISA holding, OR Please transfer specific tax years as detailed below (example 2007/2008) 1. / 2. / 3. / 4. / * Name * Account number of the ISA to be transferred * Sort code (if your ISA is held by a bank) * Telephone number * Title (Mr/Mrs/Miss/Ms/Other) Details of ISA Manager Personal Details Address Address Country Postcode * First name(s) * Last name * Postcode * National Insurance Number * Transfer instruction Transfer Instruction Transfer instruction I hereby instruct my current ISA Manager to transfer the ISA(s) referred to in this section, to Octopus Investments Limited (my new Manager) by liquidating the assets and forwarding the proceeds to Octopus Investments Limited. This request is subject to Octopus Investments acceptance of my transfer application. I authorise my existing ISA Manager to provide Octopus Investments Limited with any information, written or nonwritten, concerning the ISA and to accept any instructions from them. * Applicant signature * Date signed DD MM YYYY D D M M Y Y Y Y Page 12 of 20 Octopus OPM Stocks & Shares ISA and ISA Transfer Application Form Questions? 0800 316 2295

Section 8 Authorisation to transfer from another provider You can use this form to transfer existing ISAs into your Octopus Portfolio Manager ISA. * I have a Stocks and Shares ISA OR Cash ISA * This ISA is for The current tax year I wish to transfer my current year s ISA subscriptions. A previous tax year I wish to transfer my previous year s ISA subscriptions. * Please transfer my ISA In full OR In part - please complete the below section * Estimated value of ISA ISA Investments to be transferred in part Please check with your existing ISA Manager that they can accommodate partial transfers. Please transfer % of my total ISA holding, OR Please transfer specific tax years as detailed below (example 2007/2008) 1. / 2. / 3. / 4. / * Name * Account number of the ISA to be transferred * Sort code (if your ISA is held by a bank) * Telephone number * Title (Mr/Mrs/Miss/Ms/Other) Details of ISA Manager Personal Details Address Address Country Postcode * First name(s) * Last name * Postcode * National Insurance Number * Transfer instruction Transfer Instruction Transfer instruction I hereby instruct my current ISA Manager to transfer the ISA(s) referred to in this section, to Octopus Investments Limited (my new Manager) by liquidating the assets and forwarding the proceeds to Octopus Investments Limited. This request is subject to Octopus Investments acceptance of my transfer application. I authorise my existing ISA Manager to provide Octopus Investments Limited with any information, written or nonwritten, concerning the ISA and to accept any instructions from them. * Applicant signature * Date signed DD MM YYYY D D M M Y Y Y Y Page 14 of 20 Octopus OPM Stocks & Shares ISA and ISA Transfer Application Form Questions? 0800 316 2295

Section 8 Authorisation to transfer from another provider You can use this form to transfer existing ISAs into your Octopus Portfolio Manager ISA. * I have a Stocks and Shares ISA OR Cash ISA * This ISA is for The current tax year I wish to transfer my current year s ISA subscriptions. A previous tax year I wish to transfer my previous year s ISA subscriptions. * Please transfer my ISA In full OR In part - please complete the below section * Estimated value of ISA ISA Investments to be transferred in part Please check with your existing ISA Manager that they can accommodate partial transfers. Please transfer % of my total ISA holding, OR Please transfer specific tax years as detailed below (example 2007/2008) 1. / 2. / 3. / 4. / * Name * Account number of the ISA to be transferred * Sort code (if your ISA is held by a bank) * Telephone number * Title (Mr/Mrs/Miss/Ms/Other) Details of ISA Manager Personal Details Address Address Country Postcode * First name(s) * Last name * Postcode * National Insurance Number * Transfer instruction Transfer Instruction Transfer instruction I hereby instruct my current ISA Manager to transfer the ISA(s) referred to in this section, to Octopus Investments Limited (my new Manager) by liquidating the assets and forwarding the proceeds to Octopus Investments Limited. This request is subject to Octopus Investments acceptance of my transfer application. I authorise my existing ISA Manager to provide Octopus Investments Limited with any information, written or nonwritten, concerning the ISA and to accept any instructions from them. * Applicant signature * Date signed DD MM YYYY D D M M Y Y Y Y Page 16 of 20 Octopus OPM Stocks & Shares ISA and ISA Transfer Application Form Questions? 0800 316 2295

Instruction to your bank or building society Section 8 Direct Debit mandate Please complete this section if you are making regular payments. Send this section to: Octopus Investments Limited, Operations Team, 33 Holborn, London EC1N 2HT To the Manager Bank or building society name Branch address Instruction to your bank or building society Please pay Octopus Investments Direct Debits from the account detailed in this Instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this Instruction may remain with Octopus Investments, and if so, details will be passed electronically to my bank/building society. Signature Name(s) of account holder(s) Account number Postcode Branch sort code Date signed DD MM YYYY D D M M Y Y Y Y Banks and building societies may not accept Direct Debit Instructions for some types of accounts. Originator s Identification Number 2 5 3 9 4 6 Reference number This guarantee should be detached and retained by the Payer. The Direct Debit Guarantee This Guarantee is offered by all banks an d building societies that accept instructions to pay Direct Debits. If there are any changes to the amount, date or frequency of your Direct Debit, Octopus Investments will notify you 10 working days in advance of your account being debited or as otherwise agreed. If you request Octopus Investments to collect a payment, confirmation of the amount and date will be given to you at the time of the request. If an error is made in the payment of your Direct Debit, by Octopus Investments or your bank or building society, you are entitled to a full and immediate refund of the amount paid from your bank or building society if you receive a refund you are not entitled to, you must pay it back when Octopus Investments asks you to. You can cancel a Direct Debit at any time, by writing to your bank or building society. Written confirmation may be required. Please also notify us. Octopus OPM Stocks & Shares ISA and ISA Transfer Application Form Questions? 0800 316 2295 Page 17 of 20

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Octopus Portfolio Manager Got a question? We don t offer financial or tax advice, which is why we always recommend talking to a qualified financial adviser before making any investment decisions. However, if you have any other questions about Octopus Portfolio Manager, please call us on 0800 316 2295. We re always happy to hear from you. 0800 316 2295 clientrelations@octopusinvestments.com octopusinvestments.com Octopus Investments, 33 Holborn, London EC1N 2HT M2-CAM06015-1711 Octopus Investments Limited is authorised and regulated by the Financial Conduct Authority