MLC Wrap Self Managed Super Additional and regular investments Navigator Australia Limited ABN 45 006 302 98 AFSL 236 466 ( the Operator ) March 2011 Please tick where appropriate: make an additional investment (Sections 1, 2, 3, 4, 5, 6, 8, 10, 11 and 12. Section is optional.) change my current additional investment allocation for future deposits (Sections 1, 2, 4, 5, 10, 11 and 12.) set up a regular investment (direct debit only) (Sections 1, 2, 5, 8, 10, 11 and 12. Section 4 optional.) change my regular investment details (Sections 1, 2, 9, 10, 11 and 12. Section 4 optional.) Please complete these instructions in BLACK INK using BLOCK letters. MLC Wrap Self Managed Super GPO Box 256 Melbourne Victoria 3001 Phone 1300 428 482 Fax: (03) 9869 1595 1. Fund details Full name of fund Fund code 2. Investor details MLC Wrap Investments account name MLC Wrap Investments account number Member name Member ID (eg 00001) Account type: Super P ension 3. Investment amount My contribution $,,. 4. Investment allocation Invest as per my additional investment allocation OR Reinvest earnings Amount ($ or %) (yes or no) Investment(s) APIR/ASX Code (Minimum $500 per share) (Managed investments only) Total $ Note:,. % If there is an existing automatic re-weighting facility on your MLC Wrap Investments account and the above allocation is not in line with your target allocation, the automatic re-weighting facility will be cancelled. Some managed investments are classified as illiquid investments and may take longer to redeem from than other managed investments. If you invest in these illiquid investments you may not be able to switch within 30 days. Refer to the relevant PDS and the Investment Allocation Authority for further information. If your Investment Allocation includes managed investments which are no longer available or if the investment minimum isn t met, this component of your additional investment will remain in your cash holding account until you nominate an alternative investment. A managed investment may no longer be available for further investment because it has been closed by the investment manager or taken off the Investment Allocation Authority. 1
5. Contribution type (super accounts only) Personal Contribution concessional Personal Contribution non-concessional Eligible Spouse Contribution Rollover Employer Contribution employer name Other 6. Payment details enter the Biller Code: 14613 and your MLC Wrap Reference Number. Refer to mlc.com.au for details Direct Debit complete the Direct Debit Request on page 4 Cheque EFT cheque payable to MLC Wrap Self Managed Super using the EFT details we ve provided you or contact Client Services on 1300 428 482 for details Registered to Bpay Pty Ltd ABN 69 09 13 518. Set up a Progressive Investment Facility Using the progressive investment facility will cancel any existing automatic re-weighting facility on your MLC Wrap Investments account. Preferred date for first instalment is Number of instalments Amount $,,. (this amount must be the monthly or quarterly instalment amount) Frequency Monthly Quarterly 8. Set up a regular investment (direct debit only) My regular investment is made up of: My regular contribution $,,. Preferred date for first instalment is Please complete the Direct Debit Request on page 4. Frequency Monthly Quarterly Half yearly Yearly 9. Change regular investment details I would like to: change my regular investment to $, from suspend my regular investment from recommence my regular investment from cancel my regular investment from change my regular investment allocation (complete section 4) Frequency Monthly Quarterly Half yearly Yearly 2
10. Adviser Service Fees i) Additional investment. % OR $, ( available for one off contributions only) ii) Regular investment. % Note: The remuneration specified here will apply for all regular investments made until we are instructed otherwise. iii) Adviser share transaction fee $ ( maximum of $110 per share trade) OR. % ( maximum of 1.10% per trade value) 11. Trustee declaration I/We: have received the relevant Product Disclosure Statement or Financial Services Guide for each investment I have selected, as well as any additional disclosure documents for the underlying investments, acknowledge and accept that where I ve invested into an illiquid investment product, or an investment product I hold has become illiquid, the Operator may take longer than 30 days in which to switch out of my investment option, acknowledge that I have access to NAB s privacy policy available on mlc.com.au and any NAB company may collect, use, disclose and handle my personal information in a manner set out in that policy, understand it s my responsibility to be fully informed about any investment I consider for inclusion in my portfolio at all times, acknowledge I ve read the Direct Debit Service Agreement available on mlc.com.au for any direct debits I ve requested. Signature of Trustee 1 / Authorised person Signature of Trustee 2 / Authorised person Date Date 12. Financial adviser details Adviser name Adviser code Office Dealer group Contact name Contact number Adviser stamp 3
MLC Wrap Self Managed Super Direct Debit Request Navigator Australia Limited ABN 45 006 302 98 AFSL 236466 ( the Operator ) March 2011 Investor details Title Family name Given name Second given name MLC Wrap Investments account number MLC Wrap Investments account name Member ID (eg 00001) I/We (Surname or company name) (Given names or ABN) request the Operator, until further notice, to debit my/our account at the financial institution identified below, any amounts which the Operator, (User ID no. 31115, 3114), may debit or charge me/us through the direct debit request system. This request will remain in force in accordance with the terms described in the direct debit service agreement provided to me/us. Details of account to be debited Name of financial Institution Account name BSB number Account number Initial Direct Debit Preferred date of debit Amount of initial direct debit payment $,,. Regular Investment Facility Preferred date of debit 4
Authorisation I/We declare we have read the direct debit service agreement details available online and agree to be bound by them: a) For joint bank accounts, both to sign together. b) For company accounts, please execute this form under seal (if required) by two directors or a director and secretary on behalf of the company. A) Individual or joint account holders sign here. B) Companies or Trustee companies sign here. If the account is in joint names, both account holders must sign. If signing under company seal, we confirm it was affixed in our presence. Signature of Trustee 1 Director Signature of Trustee 2 Director / Sole Director and Secretary (Delete as applicable) Date Date Company Seal (if required under your company s constitution) 5 80169M0211