Your point of contact in connection with the Product(s) is your independent financial adviser, except where stated otherwise.

Transcription

1 BARCLAS WEALTH Woolwich Plan Managers Limited Application Form for a direct investment, current year Stocks & Shares ISA, and ISA transfer Investment Plan Application Form our legal agreement with Woolwich Plan Managers Limited ( us, we, ours ) for the investment plan(s) detailed in Section 2 (the Product(s) ) will be made up of the following: (a) this application form ( Application Form ); (b) the brochure(s) for the Product(s), prepared by us (the Brochure(s) ); (c) the terms and conditions contained in the Brochure(s) (the Terms ); (d) the schedule contained in the Brochure (the Schedule ); and (e) any information made available to you on applicable charges, commissions and tariffs; together they are defined as the agreement (the Agreement ). our Agreement with us describes the basis on which we will provide you with the Product(s). ou can ask us at any time for a copy of the documents setting out the Agreement. our point of contact in connection with the Product(s) is your independent financial adviser, except where stated otherwise. The law favours written agreements, so it is important you read the documents setting out the Agreement carefully, to ensure they contain everything you want, and nothing you are not prepared to agree. ou should ensure you have been provided with all the documents setting out the Agreement and keep a copy of these in a safe place for future reference. If you have any queries or concerns please contact us. Adviser section - Please complete in full (For Adviser use only where advice has been given) Full Company Address Company name Company FSA no Adviser name Adviser FSA no Telephone To be processed at full commission (tick box) Or, if not, commission given up Money laundering certificate (or equivalent) attached % Are you an Appointed Representative es No If es, please state your network

2 To apply for the Product(s): (1) Please complete this Application Form clearly, in BLOCK CAPITALS using a black ballpoint pen, ensuring that all applicable signature blocks are duly signed and dated. (2) All sections are compulsory unless otherwise indicated by an asterix. (3) Once this Application Form has been completed, please return it to us at the following address: Woolwich Plan Managers Limited, PO Box 9283, Brentwood, Essex CM14 9AQ. IMPORTANT INFORMATION TO NOTE our Application Form may be rejected if you fail to comply with any of the following: (1) ou must receive advice if you are applying for a Product which aims to repay your initial capital but is considered a complex product, or you are applying for a Structured Capital at Risk Product, i.e. where you may lose some or all of your capital at maturity. To confirm that you have received advice please ensure that your Financial Adviser has completed the Adviser Section on the front page of this Application Form. (2) ou must complete Section 4 of this Application Form if you have not received advice and are applying for a Product that aims to repay your initial capital at maturity. (3) ou must submit an accurate and complete Application Form. Section 1 Personal details We must comply with anti-money laundering legislation; therefore, in some cases, we may ask you to provide documents to support your application evidencing your identity. A. 1st Applicant Title Mr Mrs Miss Ms Dr Other title Male Female First name(s) Surname Permanent residential address B. 2nd Applicant (for joint applications only) 2 Title Mr Mrs Miss Ms Dr Other title Male Female First name(s) Surname Permanent residential address Correspondence address Tick if as above, otherwise: Correspondence address Tick if as above, otherwise: Date of birth D D / M M / Nationality Date of birth D D / M M / Nationality Country of permanent residence Country of permanent residence Int code Area code Telephone Int code Area code Telephone Telephone Telephone Do you have a National Insurance (N.I.) number? 1 Do you have a National Insurance (N.I.) number? 1 If yes, please give details es No If yes, please give details es No 1 If you have been issued with an N.I. number, you should be able to find it on a payslip, P45 Form, P60 Form, a letter from HM Revenue & Customs or the Department of Work and Pensions, or a pension order book. For ISA investors only: If you have not been issued with an N.I. number you must provide us with a temporary N.I. number or a document stating the reason you are not eligible to obtain an N.I. number. Failure to do so will result in your Application Form being rejected. 2 This Section 1B is relevant for investments to be made jointly. It should not be completed if you wish to invest in a Product inside a Stocks & Shares ISA, since the ISA Regulations provide that investments inside an ISA may only be held individually, and not jointly.

3 Section 2 Investment details Please provide details of the Product(s) you wish to invest into below using the information in the Investment Options table within the Schedule to the Brochure(s). Please ensure you accurately insert the Product Code(s) as we will use these to place your order(s). It is possible to invest in a product via a direct investment, current year Stocks & Shares ISA and by ISA Transfer at the same time. New Investments (Please ensure we have received your Application Form before 5pm on the last day of the Offer Period shown in the Schedule to the relevant Brochure(s)). Please refer to the final page A. Direct investment (outside an ISA) of the Brochure(s). Product Name Edition/Issue Option Direct Investment Product Code Amount () i) ii) iii) I would like to subscribe the following amount as a total direct investment (sum of A i, ii and iii) B. Stocks & Shares ISA investment for Current Tax ear Under current ISA regulations you can only subscribe to one Stocks & Shares ISA in any single tax year, and investments inside an ISA may only be held individually and not jointly. Note: Only Investment Plans with a term of 5 years or more are permitted for ISA investment. MANDATOR Please state the tax year of your ISA Investment e.g. 2011/12; 2012/13 etc Please refer to the final page of the Brochure(s). Product Name Edition/Issue Option ISA Product Code Amount () i) ii) I would like to subscribe the following total amount as a current year Stocks & Shares ISA Total investment (sum-total of A and B) ISA Transfer Please ensure we have received your Application Form before 5pm on the the Closing Date for ISA Transfers shown in the Schedule to the relevant Brochure(s). In addition, you must complete the ISA transfer instruction(s) to your existing ISA manager(s) in Section 5. (Only applicable to Investment Plans with an investment term of 5 years or more) Please refer to the final page of the Brochure(s). Product Name Edition/Issue Option ISA Transfer Product Code % of total transfer amount to be invested i) % ii) % iii) % If you wish to make a direct investment (outside an ISA) or transfer your ISA into more than three Products please photocopy this page and submit it with this Application Form. 100%

4 Section 3 Income payment details* *Only applicable where the Product you are applying for may pay an income during the term. Please provide your bank/building society account details below. This will allow us to directly credit your account with any income due (where applicable) for the Product(s). Please inform us immediately of any change to your bank account details. If the bank account listed below is a non Barclays Bank Account please enclose with this Application Form a copy of a recent bank statement, no more than three months old, proving that the account is in your name. We need to do this to record your bank details accurately and to ensure we do not make payments to third parties. Name of bank or building society Name of account holder Branch sort code Bank or building society account number Section 4 Appropriateness* *Only applicable where you have not received advice from a Financial Adviser. (Please note you may not invest in Our Emerging Markets Optimiser Plans or a SCARP Product without receiving advice.) es No 1. Do you understand that there may be minimum or maximum possible returns payable under the Investment(s) and what they are? 2. Do you understand the conditions under which you will receive returns from the investment(s) and when they will be paid? 3. Do you understand that if the stock market moves against you, then the investment's value when it matures will not be more than you invested and could be less? 4. Do you understand that if you choose to sell your investment(s) before the maturity date, you cannot do so until its next valuation (which may be up to three weeks after you give your instruction to sell)? 5. Do you understand that structured investment products are designed to be held for a fixed period and, if you decide to sell your investment(s) before maturity, you are likely to get back less than the amount you invested due to charges, adverse movements in the relevant stock market, interest rates, and other factors? 6. The issuer of the Product(s) is the firm that must pay you the investment proceeds when the Product(s) matures. Are you clearly aware of the identity of the Issuer of the Product(s)? 7. Are you aware that if, due to insolvency or extreme financial distress, the Issuer is unable to pay what is due to you when the Product(s) matures or on any earlier redemption, you may lose some or all of your investment? 8. Have you read and understood the Terms of the Product(s)? Section 5 - ISA transfer instructions Note: ISA transfers are not available to joint account applicants and only Products with a term of 5 years or more are permitted for ISA transfers. ou must complete a separate tear-off slip for each ISA manager you are transferring from. Please complete both sides of the tear-off slip(s) opposite if you wish to transfer your ISA(s) from your existing ISA manager(s). We will then send the tear-off slip to your existing ISA manager(s) to action your transfer - DO NOT DETACH the slips from the Application Form. Applications to transfer existing ISAs (either in full or in part) must be received by Woolwich Plan Managers Limited before 5pm on the Closing Date for ISA Transfers shown in the Schedule to the relevant Brochure(s). If you wish to transfer your current tax year ISA only a full transfer will be permitted. Partial transfers are permitted for ISAs from previous years. The aggregate total of all ISA transfers (from A and B) must exceed the minimum ISA investment amount stated in the Schedule of the Brochure. If you wish to transfer your ISA holdings from more than two ISA managers please detach a tear-off slip from another Application Form and submit it together with this Application Form.

5 ISA transfer instruction to your current ISA manager* (1) *Only applicable where you are instructing an ISA transfer. Title Mr Mrs Miss Ms Dr ISA Manager Other title Male Female ISA account number First name(s) Surname Permanent residential address ISA sort code Address of your current ISA manager Please check with your existing provider to see if there are any penalties for or restrictions on such transfers. It is particularly important that we are aware of any notice period applicable to your existing ISA as this may affect the time it takes to complete your transfer. Please note your existing Cash ISA provider may require the return of an account passbook before transferring your investment and this should be arranged as soon as possible to avoid delays. All transfers we receive will be classified as Stocks & Shares ISAs. If you transfer from a Cash ISA you will not be able to transfer back to a Cash ISA at a later date. P.T.O ISA transfer instruction to your current ISA manager* (2) *Only applicable where you are instructing an ISA transfer. Title Mr Mrs Miss Ms Dr Other title Male Female First name(s) Surname Permanent residential address ISA Manager ISA account number ISA sort code Address of your current ISA manager Please check with your existing provider to see if there are any penalties for or restrictions on such transfers. It is particularly important that we are aware of any notice period applicable to your existing ISA as this may affect the time it takes to complete your transfer. Please note your existing Cash ISA provider may require the return of an account passbook before transferring your investment and this should be arranged as soon as possible to avoid delays. All transfers we receive will be classified as Stocks & Shares ISAs. If you transfer from a Cash ISA you will not be able to transfer back to a Cash ISA at a later date. P.T.O

6 Please complete A and /or B, and C as required. (1) Tax ear e.g. 2011/12; 2012/13 A. Do you wish to transfer your current year ISA? If es, please state the approximate amount being transferred 100 % B. Previous ISAs to be transferred? Please tick to indicate whether you wish to transfer all or part of your previous year ISA investments. (i) Full If yes, approximate amount being transferred 100 % OR (ii) Partial*** If es, please state percentage and/or approximate amount being transferred % C. Approximate total amount to be transferred (A + B) *** Please check with your existing ISA manager that partial transfers are allowed. ou may use the box below to give further instructions to your existing ISA manager with regard to what specific amount or tax years should be transferred and/or what investments should be realised to meet the transfer. Additional information for ISA manager I request that you sell the appropriate investments held in my account, as detailed above, and send a cheque(s) for the proceeds to: Woolwich Plan Managers Limited, PO Box 9283, Brentwood, Essex CM14 9AQ Only action my request to transfer if proceeds will be sent within 3 weeks of the ISA transfers close date (as detailed in the transfer letter attached). Cheques should be made payable to Barclays Investment Plans. Signature Date D D / M M / Please complete A and /or B, and C as required. (2) Tax ear e.g. 2011/12; 2012/13 A. Do you wish to transfer your current year ISA? If es, please state the approximate amount being transferred 100 % B. Previous ISAs to be transferred? Please tick to indicate whether you wish to transfer all or part of your previous year ISA investments. (i) Full If yes, approximate amount being transferred 100 % OR (ii) Partial*** If es, please state percentage and/or approximate amount being transferred % C. Approximate total amount to be transferred (A + B) *** Please check with your existing ISA manager that partial transfers are allowed. ou may use the box below to give further instructions to your existing ISA manager with regard to what specific amount or tax years should be transferred and/or what investments should be realised to meet the transfer. Additional information for ISA manager I request that you sell the appropriate investments held in my account, as detailed above, and send a cheque(s) for the proceeds to: Woolwich Plan Managers Limited, PO Box 9283, Brentwood, Essex CM14 9AQ Only action my request to transfer if proceeds will be sent within 3 weeks of the ISA transfers close date (as detailed in the transfer letter attached). Cheques should be made payable to Barclays Investment Plans. Signature Date D D / M M /

7 Section 6 Payment details* *Only to be completed where you are applying for a new investment Payment from a Barclays Bank PLC current account Account holder name Branch sort code 2 0 Account number Branch address Amount (from Section 2) Or, payment by cheque Name of person(s) providing funds Manco 12 (must be completed) I enclose a cheque for (from Section 2, made payable to Barclays Investment Plans ) Manco 12 Section 7 Personal declaration The Agreement is our standard client agreement for the Product(s) upon which we intend to rely. For your own benefit and protection you should read all the documents setting out the Agreement before signing this Application Form, which documents include the Brochure(s), including the Terms, and this Application Form. If you do not understand any point, please ask for further information; By signing this Application Form, you agree, confirm and declare the following: (A) Information you have provided to us for the purposes of establishing the arrangements contemplated by the Agreement (including as to your status, residence and domicile for tax purposes) is true, complete and correct to the best of your knowledge and belief. ou will notify us promptly if there is any material change to this information and will provide any further information that we reasonably request in order for us to perform the Agreement or comply with all applicable law or regulation. Failure to do so may adversely affect the quality of the service that we are able to provide; (B) Local regulations prevent certain products and services from being made available in certain jurisdictions; we will not be able to supply the Product(s) where local regulations prohibit us from doing so. ou are not resident in Australia, Canada, Japan, Malaysia or the US, and will immediately notify us if you become resident, whether permanently or temporarily, in any of these countries; please note that we may need to terminate this Product if you become so resident; (C) If you wish to invest inside a Stocks & Shares ISA: (a) (b) (c) ou authorise us to act as ISA manager and, in particular, to: (i) Hold in your ISA: your cash subscription and ISA investments, interest, dividends and any other rights or proceeds in respect of those investments and any other cash; (ii) Make on your behalf any claims to relief from tax in respect of your ISA, and provide HM Revenue & Customs ( HMRC ) with any particulars of your ISA as HMRC may request; (iii) On your written request, transfer to another ISA manager, or pay you, the contents of your ISA; and (iv) Act as principal or agent in selling investments to, or buying investments from your ISA; All subscriptions/transfers made, and to be made, belong to you. ou will inform us promptly if any amount paid into your ISA does not belong to you; ou have not subscribed, and will not subscribe, more than the prevailing maximum overall subscription limit in total to a Stocks & Shares ISA and a cash ISA in the same tax year; (D) ou are 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 the Income Tax (Earnings and Pensions) Act 2003 (Crown employees serving overseas), are treated as being performed in the United Kingdom, or you are married to, or in a civil partnership with, a person who performs such duties. ou will inform us if you 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; (E) Relevant only if this Application Form is being signed by an Authorised Representative acting on behalf of the investor in the ISA: The investor is not able to complete this Application Form by reason of mental disorder or incapacity or physical disability, illness or old age and the signatory to this Application Form is the legally appointed representative of the investor in the ISA, by authority granted by (tick as appropriate): Guardianship Appointment under Court Order Power of Attorney Enduring/lasting Power of Attorney The original document (or a certified copy of the original) granting such authority must be provided by you with this Application Form. For further advice on documentation, please contact Woolwich Plan Managers Limited on Marketing preferences From time to time, we and other members of the Barclays Group would like to keep you up-to-date about products and services which we think you will find useful. Please tick the following box if you do not wish to be contacted: Signature: 1st Applicant 4,5 Signature: 2nd Applicant 6 Date D D / M M / Date D D / M M / 4 As detailed in Section 1A. 5 If this Application Form is being signed by an Authorised Representative acting on behalf of the investor in the ISA, evidence of your legal entitlement to sign will need to be provided, together with your name and evidence documenting your authority. 6 As detailed in Section 1B.

8 This item can be provided in Braille, large print or audio by calling * (via TextDirect if appropriate). *Lines are open 8am to 8pm UK time Monday to Friday and 9am to 5pm UK time Saturday and UK bank holidays. Calls to 0800 numbers are free if made from a UK landline. Other call costs may vary please check with your telecoms provider. Calls may be recorded so that we can monitor the quality of our service and for security purposes. To receive details of those fraud prevention agencies from whom we obtain and with whom we record information about you, contact the Barclays Information Line on If calling from outside the UK, please call +44 (0) Lines are open 7:00 am to 11:00 pm (GMT). Calls may be recorded so that we can monitor the quality of our service and for security purposes. Under Data Protection legislation you have a right of access to certain personal records. Should you wish to exercise this right, please write to your account-holding centre. A fee will be charged for this service. Woolwich Plan Managers Limited is authorised and regulated by The Financial Services Authority. FSA Number: Woolwich Plan Managers Limited is registered in England, Registered Number Registered Office: 1 Churchill Place, London E14 5HP. Correspondence address: PO Box 9283, Brentwood, Essex CM14 9AQ. Item Ref: IBIM0133. February 2012