STELLAR AIM IHT ISA ISA ADVISED APPLICATION PACK BROCHURE
APPLICATION CHECKLIST NOTES ON APPLICATION Please contact Stellar on 020 3195 3500 if you have any questions relating to the completion of the Application Form. An application cannot be processed until all the required information is provided and the forms are completed. Have you fully completed all areas of the form? Have you fully completed an Identity Verification Certificate? Has the authorised adviser signed the Application Form in section 7a and the Identity Verification Certificate? Has the Applicant signed in section 6 and section 7b? Have the two pieces of identity verification been provided? Has a certified copy of Power of Attorney been provided? (if relevant) PAYMENT Payment should be made by means of a cheque drawn on an account in the name of the Applicant. Cheques should be made payable to Pilling & Co Stockbrokers Ltd. If this is not practicable and a cheque is drawn by a third party or a building society cheque or bankers draft, the Applicant s name, address and date of birth should be written on the back of the cheque or bankers draft and: (a) if a building society cheque or bankers draft is used, the building society or bank must also endorse on the cheque or draft the name and account number of the person whose account is being debited; or (b) if a cheque is drawn by a third party, the Applicant must ensure that either (1) an Adviser Certificate is provided; or (2) Original/Certified documentation is provided: one item from each of List A and List B (see page 12) is enclosed with the application form. If you are paying by bank transfer, please transfer the money to Pilling & Co Stockbrokers Ltd Account name: Pilling & Co Stockbrokers Ltd Client Free Money Bank: HSBC Manchester Sort code: 402080 Account number: 10091669 Reference: Investor surname Send your completed forms and enclosures to: Pilling & Co Stockbrokers Limited Henry Pilling House 29 Booth Street Manchester M2 4AF CONTENTS Application Form Transfer Forms Identity Verification Certificate
STELLAR AIM IHT ISA APPLICATION FORM Make your cheque payable to Pilling & Co Stockbrokers Ltd and send it, together with this completed and signed application form and your money laundering documentation, as soon as possible, to Pilling & Co Stockbrokers Ltd, Henry Pilling House, 29 Booth Street, Manchester M2 4AF 1. Subscription Please let us know how you would like to invest in the Stellar AIM IHT ISA by ticking the relevant (you may complete more than one) box. I wish to open a new Stocks and Shares ISA using my Tax year ISA allowance and invest I wish to make a transfer from my existing Cash ISA and/or Stocks and Shares ISA(s) and invest (Note A) I wish to transfer one or more previous tax year s Cash ISA and/or Stocks and Shares ISA(s) allowance which in total amounts to (Note A) The total investment must be at least 15,240 TOTAL Note A - Please complete the ISA Transfer Form(s) on page 7 2. Personal details (USE BLOCK CAPITALS) Title: (Mr/Mrs/Miss/Ms etc) Forename(s): Surname: Country of residence: Unique Tax Reference: (UTR) Date of birth: National Insurance No: Are you a US citizen or resident in the US for tax purposes? YES NO Home phone: Mobile phone: Email address: (required field for your online account) 2a. Power of Attorney (USE BLOCK CAPITALS) Please enclose a certified copy of Power of Attorney Title: (Mr/Mrs/Miss/Ms etc) Forename(s): Surname: Country of residence: Date of birth: Home phone: Mobile phone: Email address: STELLAR AIM IHT ISA APPLICATION PACK 03
3. Bank details Details of the bank account that you would like any funds to be credited to following withdrawal: Bank Name: Bank Account Name: Account Number: Bank Sort Code: Building society reference: 4. Life assurance policy (Please note that this life assurance policy will not be held within Stellar AIM IHT ISA) I would like to take out this policy YES NO If you have answered yes, please answer the following questions. It is very important that these questions are answered truthfully and accurately. If you are unsure as to whether any information is relevant then you should disclose it. At the time of any claim the insurer may decline the claim if it finds that all the relevant information was not disclosed. Applicant please tick ( ) yes or no. Are you over 80 years of age? YES NO Are you currently receiving or have received over the last five years treatment for any illness, symptoms or injuries and or taking any medication that has been prescribed? YES NO Have you been advised to undergo any medical treatment, or are you waiting to undergo any medical treatment? YES NO Has a proposal for life, disability or private medical insurance ever been declined, postponed, withdrawn or accepted on special terms? YES NO Do you reside outside the European Union for longer than three months in a calendar year or do you travel frequently outside the European Union? YES NO If you have answered yes to any of the above questions then you should provide further details on a short supplementary health questionnaire. (a) This questionnaire can be obtained by visiting www.stellar-am.com and downloading the Stellar Insurance Health Questionnaire. Hard copies can also be obtained by contacting us either by telephone 020 3195 3500 or by emailing info@stellar-am.com. Please tick the box to confirm a completed health questionnaire is attached (b) Whilst insurance cover is being obtained it is our policy to invest monies in accordance with the investment strategy contained in the Document. Should you prefer confirmation that insurance has been obtained prior to investment, please tick this box (c) I would like a copy of the draft trust document Please note that in any event your account will be opened and held in cash. 04 STELLAR AIM IHT ISA APPLICATION PACK
5. About the adviser To be completed by the adviser. Adviser (USE BLOCK CAPITALS) Company: Title: (Mr/Mrs/Miss/Ms etc) Forename(s): Surname: Telephone: Administrator (USE BLOCK CAPITALS) Company: Title: (Mr/Mrs/Miss/Ms etc) Forename(s): Surname: Telephone: Email: Email: FCA number: Are you part of a network/service provider? YES NO please give us network/service provider name Please provide the bank account details for Stellar to pay your adviser charges by BACS Account Name: Email address for adviser charging statements YES NO Bank Sort Code: Email: Account Number: Stellar reserves the right to withhold adviser/intermediary charges if we are not fully satisfied that you are authorised under the Financial Services and Markets Act 2000 or exempt from authorisation 6. Adviser charges THIS IS AN ADVISED YES Initial adviser charge: (Fixed amount) or % one off Ongoing adviser charge: or % per annum This is taken from your Stellar AIM IHT ISA investment and paid to your adviser before your funds are invested. The amount or percentage stated (whichever is relevant) is an annual amount accrued on a daily basis. If you choose to pay on a percentage basis, this will be calculated on the value of your portfolio. We will pay your adviser six monthly and may sell holdings from your portfolio to facilitate this charge. I agree to these charges YES Applicant s signature: Adviser s signature: STELLAR AIM IHT ISA APPLICATION PACK 05
7a. Declaration (a) By the Adviser/Intermediary. By signing this form, I agree that: (i) I am authorised and regulated by the Financial Conduct Authority (or the equivalent body in an EU member state) to advise on and transact in investments in the UK or the EU; (ii) I consent to Stellar and Pilling placing reliance on me in respect of performing suitability and appropriateness tests on behalf of the client and carrying out verification checks in line with the Money Laundering Regulations 2007 and JMLSG Guidance, as amended; (iii) I have discussed the investment in Stellar AIM IHT ISA with the Investor, including both the risks and benefits associated with such investment and am satisfied as to its suitability/appropriateness (as applicable) for the Investor s investment objectives; (iv) I will ensure that the investment continues to be suitable/appropriate (as applicable) for the investor s investment objectives throughout the investment period so long as I remain as an appointed adviser to the Investor; (v) I have complied with the requirements of the Money Laundering Regulations currently in force and have duly completed the attached Identity Verification Certificate after carrying out the identification and verification checks to establish the identity of the investor; (vi) I have read and understood the Stellar Terms of Business for Intermediaries; (vii) I agree to be bound by these Terms of Business; and (viii) As an Appointed Representative, I warrant and represent that my principal also accepts the Terms of Business for Intermediaries. Your Name: Stamp of Authorised Adviser: Signature: Date: D D M M Y Y Y Y 7b. Declaration (b) By the Applicant. By signing this form, I HEREBY DECLARE THAT: (i) (ii) (iii) (iv) (v) (vi) All subscriptions made, and to be made, belong to me; I am 18 years of age or over; I have not subscribed, and will not subscribe, more than the overall subscription limit in total to a cash ISA and a stocks and shares ISA in the same tax year; I have not subscribed, and will not subscribe, to another stocks and shares ISA in the same tax year that I subscribe to this stocks and shares ISA; I am resident and ordinarily 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 I am married to, or in a civil partnership with, a person who performs such duties. I will inform Pilling if I cease to be so resident and ordinarily resident or to perform such duties or be married to, or in a civil partnership with, a person who performs such duties; To the best of my belief the detail in this form is correct, and I will inform Pilling immediately of any change that may affect this information; (vii) I agree to all of the provisions of the Investment Management Agreement and the Service Management Agreement (including the terms and conditions, fees and any other attachments), which I have fully understood and I understand that by signing and completing this Application Form I shall be deemed to have entered into and shall be bound by the Investment Management Agreement and the Service Management Agreement; (viii) I have read and understood the terms and the Risk Factors set out in the Document entitled Stellar AIM IHT ISA dated 5 January 2015; (ix) I understand that you will rely on our confirmation that I have read the Document and that you will, accordingly, rely on its terms as the basis of the relationship between us; and (x) I agree to adviser charges as set out in section 6. I authorise Pilling: (i) to hold my cash subscriptions, ISA investments, interest, dividends and any other rights or proceeds from those investments and any other cash; (ii) to make any claims for me to relief from tax in respect of ISA investments; (iii) on my written request and within a time frame stipulated by me (not less than 30 days) to transfer (full or part), or pay to me, ISA investments, interest, dividends, rights or other proceeds from such investments or any cash; (iv) to hold my plan investments in CREST, where possible, in the name of St Anns Square Nominees Limited; and (v) to manage the investments in my Stellar AIM IHT ISA in accordance with the Investment Management Agreement Name of Applicant: Date: D D M M Y Y Y Y Signature of Applicant: If this Application Form is completed and signed by a person authorised to sign on behalf of the applicant. Such as a power of attorney, then by signing this Application Form on behalf of the individual named in Section 2, I make a declaration (on behalf of such individual) on the terms set out above. Please note that ISA Regulations only permit signatures from an authorised person by reason of mental disorder or incapacity, or physical incapacity. Please provide a certified copy authorising you to act on behalf of the Applicant. 06 STELLAR AIM IHT ISA APPLICATION PACK
STELLAR AIM IHT ISA TRANSFER FORM Please use this form to transfer existing ISAs into your Stellar AIM IHT ISA. You must also fill out the main application form on pages 3-6. 1. Personal details (USE BLOCK CAPITALS) Title: (Mr/Mrs/Miss/Ms etc) Forename(s): Surname: Date of birth: D D M M Y Y Y Y National Insurance No: 2. Transfers Please transfer my stocks and shares ISA, or cash ISA This ISA is for the current tax year and/or a previous tax year I would like to transfer in full in part (see below) Partial ISA transfer Please transfer % of my total ISA holding, or Please transfer specific tax year Please add other years Please transfer the above ISAs immediately in their current form (in specie) to Pilling & Co Stockbrokers Ltd Please liquidate the above ISAs immediately and transfer the cash to Pilling & Co Stockbrokers Ltd Estimated value of transfer 2. Transfer Details Existing ISA Manager Name: Account Number: Transfer instruction I hereby instruct my current ISA manager to transfer the ISA(s) referred to above to Pilling & Co Stockbrokers Ltd. I authorise my existing ISA manager to provide Pilling & Co Stockbrokers Ltd with any information, written or non-written concerning the ISA and to accept any instructions from them. Signed: Date: D D M M Y Y Y Y STELLAR AIM IHT ISA APPLICATION PACK 07
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STELLAR AIM IHT ISA TRANSFER FORM Please use this form to transfer existing ISAs into your Stellar AIM IHT ISA. You must also fill out the main application form on pages 3-6. 1. Personal details (USE BLOCK CAPITALS) Title: (Mr/Mrs/Miss/Ms etc) Forename(s): Surname: Date of birth: D D M M Y Y Y Y National Insurance No: 2. Transfers Please transfer my stocks and shares ISA, or cash ISA This ISA is for the current tax year and/or a previous tax year I would like to transfer in full in part (see below) Partial ISA transfer Please transfer % of my total ISA holding, or Please transfer specific tax year Please add other years Please transfer the above ISAs immediately in their current form (in specie) to Pilling & Co Stockbrokers Ltd Please liquidate the above ISAs immediately and transfer the cash to Pilling & Co Stockbrokers Ltd Estimated value of transfer 2. Transfer Details Existing ISA Manager Name: Account Number: Transfer instruction I hereby instruct my current ISA manager to transfer the ISA(s) referred to above to Pilling & Co Stockbrokers Ltd. I authorise my existing ISA manager to provide Pilling & Co Stockbrokers Ltd with any information, written or non-written concerning the ISA and to accept any instructions from them. Signed: Date: D D M M Y Y Y Y STELLAR AIM IHT ISA APPLICATION PACK 09
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STELLAR AIM IHT ISA IDENTITY VERIFICATION CERTIFICATE To be completed by a regulated UK intermediary when introducing business Individual Investor An identity verification certificate must be completed for all Applicants. Title: (Mr/Mrs/Miss/Ms etc) Forename(s): Surname: Contact Tel No: Date of birth: D D M M Y Y Y Y If the Applicant has changed address in the last three years please provide the previous address. Previous address: Please indicate with a tick ( ) whether the application was made on a face to face basis or non face to face basis I/We have verified the identity of the applicant and have: (a) seen the original documents and provided certified copies; (b) checked that any requiring a signature were pre-signed; (c) confirmed that any associated photograph of the applicant bore a good likeness to the applicant; and (d) included the relevant reference information or certified documentary evidence on/with this certificate. Full name of Regulated Firm: Name of Regulator: FCA Reference Number: Signed * : Stamp of Adviser Name: Position: Date: D D M M Y Y Y Y * Note that this certificate must be signed by the person who has seen the original documentary evidence. STELLAR AIM IHT ISA APPLICATION PACK 11
EVIDENCE OF NAME AND ADDRESS We require as a minimum at least one of the evidence of name boxes to be completed and for at least one of the evidence of address boxes to be completed for all individual investors. Evidence of Name Document Reference/account number Issuing Authority/ notice of coding Current full signed passport Place of birth Date of birth Date of expiry/issue Certified copy attached (please tick) (2) Resident permit issued to EU nationals by Home Office N/A N/A N/A Current UK/EU photo driving Licence (1) N/A N/A N/A Current full UK driving Licence (old Style) (1) N/A N/A N/A Firearms certificate State pension or benefits book/ notification letter (1) Sub-contractors certificate (3) HM Revenue & Customs tax notification (4) Evidence of Address Document Reference/account number Name of lender etc Address current (yes/no) Solicitors letter confirming completion of N/A N/A N/A home purchase or land registration (5) (6) Electoral roll check (5) N/A N/A N/A Most recent mortgage statement Current local authority tax bill Local authority rent card or tenancy agreement Bank/building society/credit union statement or passbook Utility bill (not mobile phone) Date of letter/ check/issue Certified copy attached (please tick) (2 Current UK/EU photo driving Licence (1) Current full UK driving Licence (old Style) (1) N/A N/A State pension or benefits book/ notification letter (1) Notes: (1) These items may be used to evidence address or identity but not both. (2) If this column is ticked, certified copies must be attached. When attaching certified copies of the evidence you do not need to also record the relevant details on this sheet. (3) For self-employed persons in the construction industry tax exemption certificate with photograph (C154 and C156). (4) Please delete as appropriate. This document must be issued by HM Revenue & Customs. A P45 or P60 issued by an employer is not acceptable for this purpose. (5) You must submit a certified copy of the search if you are relying on this as evidence of address. (6) The previous address should also be verified if the applicant has only been resident at the current address for less than three months. Other forms of evidence may be accepted. If in doubt please enquire. 12 STELLAR AIM IHT ISA APPLICATION PACK
DATA PROTECTION By signing this Application Form, the Applicant hereby confirm that he/she consents to the use of their personal information as follows. Except as stated in the section of the Investment Management Agreement titled Data Protection and below, the Sponsor and the Investment Manager will not make the personal information provided by the Applicant as part of the application to become an Investor available to any person or entity outside the Sponsor and the Investment Manager without the Applicant s consent. This personal information will be stored on the databases of the Sponsor and the Investment Manager. This personal information may be used by the Sponsor and the Investment Manager to send the Applicant details of new and existing products (including by e-mail) unless the Applicant notifies the Sponsor and the Investment Manager in writing that it may not be used in this way. The Sponsor and the Investment Manager are registered under the data protection laws of the United Kingdom. MONEY LAUNDERING REGULATIONS It is a condition that applications comply with the Money Laundering Regulations. The Investment Manager requires verification of identity from each Investor. Pending the provision of evidence satisfactory to the Investment Manager as to the identity of the Investor and/or any person on whose behalf the Investor appears to be acting, the Investment Manager may, in its absolute discretion, retain an Application Form lodged by an Investor and/or the cheque or other remittance relating thereto. Verification of identity is required, which may result in delay in dealing with an application and in rejection of the application. The Investment Manager reserves the right, in its absolute discretion, to reject any application in respect of which it considers that it has not received evidence of such identity satisfactory to it within a reasonable period. In the event of an application being rejected in any such circumstances, the Investment Manager reserves the right, in its absolute discretion, but shall have no obligation, to terminate any contract relating to or constituted by such Application Form (in which event the money payable or paid in respect of the application will be returned (without interest) to the account of the drawee bank from which such sums were originally debited). The submission of an Application Form will constitute an undertaking by the Investor to provide promptly to the Investment Manager such information as may be specified by it as being required for the purpose of the Money Laundering Regulations. STELLAR AIM IHT ISA APPLICATION PACK 13
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STELLAR ASSET MANAGEMENT LIMITED Kendal House 1 Conduit Street, London W1S 2XA t 020 3195 3500 e info@stellar-am.com www.stellar-am.com Authorised and Regulated by the Financial Conduct Authority