Host capital uk student accommodation Fund

Host Capital UK Student Accommodation Fund Host capital uk student accommodation Fund Class A Accumulation Class A Income Class B Income ISA Class Class C Accumulation (EUR) Class C Accumulation (USD) Host capital uk student accommodation Feeder TRUST Class A Net Accumulation Feeder Trust Investment Application Form Important: Please note that the ACD may defer redemptions, from time to time, in order to regulate liquidity in the Fund. For full details of the risks associated with this investment please refer to the Host Capital UK Student Accommodation Fund ( The Fund ) Prospectus and The Host Capital UK Student Accommodation Fund Income and Growth Feeder Trust ( The Trust ) Prospectus. Requirements for INdIVIduAL/JOINT Applications: This Application Form, completed and signed In/Jnt Identity Verification Certificate (1 x certified BLACK AND WHITE copy or original document per applicant) ID for evidence of address of Applicant (1 x certified BLACK AND WHITE copy or original document per applicant) SIPP/SSAS/OSB/P Requirements for SIPP/SSAS /Off Shore Bond /Platform Applications: This Application Form, completed and signed Identity Verification Certificate (1 x certified BLACK AND WHITE copy or original document per applicant) ID for evidence of address of Applicant (1 x certified BLACK AND WHITE copy or original document per applicant) Surety Letter Sections to complete: 1,3,4,5,6,7,11,13 Sections to complete: 1,3,4,5,9,11,12,13 Requirements for CORPORATE Applications: This Application Form, completed and signed Certified copy of Certificate of Incorporation Certified copy of Articles of Association 3 years Audited Accounts Identity Verification Certificate (1 x certified BLACK AND WHITE copy or original document per named individual) ID for evidence of address of each named individual (e.g. Shareholders/ Directors) (1 x certified BLACK AND WHITE copy or original document per named individual) Sections to complete: 1,3,4,5,10,11,12,13 CORP Requirements for ISA Applications: This Application Form, completed and signed Identity Verification Certificate (1 x certified BLACK AND WHITE copy or original document per applicant) ID for evidence of address of Applicant (1 x certified BLACK AND WHITE copy or original document per applicant) Surety Letter ISA Class - available to ISA plan managers only. Sections to complete: 1,3,4,5,8,11,13 ISA Important Information All appropriate sections of the application form must be completed in BLOCK CAPITALS. Please use page 4 for any additional information relating to the investment. Please fax or email a scanned copy to the Host Capital Limited and mail the original of this form to the address shown below: Address: Host Capital Limited, Investor Services Team, 14 St George Street, London, W1S 1FE Tel: +44 (0)800 024 2400 Fax: +44 (0)1481 734546 Email: investorservices@kleinwortbenson.com 1

1. Subscription & Payment: I/We wish to invest the amount(s) below, as indicated. Host Capital UK Student Accommodation Fund (GBP unless otherwise stated) CLASS SEDOL ISIN MIN SUBSCRIPTION MIN Regular Savings Plan LUMP SUM INVESTMENT AMOUNT (Please enter amount in the space provided below) Regular SavER PLAN MONTHLY INVESTMENT AMOUNT* (Please enter amount in the space provided below) 1. Class A Accumulation B8XFCM3 GB00B8XFCM30 3,000 250 2. Class A Income B8XFCN4 GB00B8XFCN47 3,000 250 3. Class B Income *** B8XFCP6 GB00B8XFCP60 3,000 250 4. ISA Class ** B8XFCQ7 GB00B8XFCQ77 3,000 250 5. Class C ACCUMULATION (EUR) *** B8XFCR8 GB00B8XFCR84 3,000 250 6. Class C ACCUMULATION (USD) *** B8XFCS9 GB00B8XFCS91 $3,000 $250 Host Capital UK Student Accommodation Feeder Trust The Feeder Trust is only available to platforms and institutional investors such as non-tax exempt bodies corporate 7. Class A Net Accumulation B8XFCJ0 GB00B8XFCJ01 3,000 *NOTE: For GBP Regular Saver Plan applicants, please complete the Direct Debit Mandate attached to this Application Form. For USD and EUR Regular Saver Plan applicants, the Direct Debit Mandate is not applicable. Payments must be made via bank transfer and received prior to the due settlement Please provide one of the following with the application form: Original Bank Statement (no more than three months old), Cheque (marked as void), Paying in Slip. The above documents need to relate directly to the account that is funding the Savings Plan. **NOTE: ISA Class - Only investments via an ISA plan manager are accepted. Host Capital Ltd does not act as a plan manager. ***NOTE: Initial charge of up to 5% may be charged. 2

2. Settlement Instructions CURRENCY CHEQUE PAYABLE TO: ELECTRONIC TRANSFER GBP Host Capital Limited Acc. Name Host Capital Limited GBP Current Account Bank Royal Bank of Scotland Sort Code 16-00-15 Acc Number 23181080 IBAN: GB34RBOS16001523181080 BIC: RBOSGB2L EURO Host Capital Limited Acc. Name Host Capital Limited EUR Current Account Bank Royal Bank of Scotland Sort code 15-20-25 Account Key TRINECOA - EURA IBAN GB45RBOS16107010091704 BIC RBOSGB2L USD Host Capital Limited Acc. Name Host Capital Limited USD Current Account Bank Royal Bank of Scotland Sort Code 15-20 - 25 Number IBAN BIC HUECATAL-USDC GB02RBOS16630000628836 RBOSGB2L NB - Cleared Funds must be received prior to the dealing cut-off* so please allow for processing time. *CUT OFF TIMES Completed application forms must be received by Host Capital Ltd by 12:00 noon in order to be included in that day s dealing. 3

3. Bank Account Details for Income Payments (Where appropriate) Account Name(s): Account Number: Sort/Swift code: IBAN Number: Bank Name: Bank Address: In/Jnt SIPP/SSAS/OSB/P CORP ISA Country: PLEASE NOTE that income payments will only be sent to this bank account and that any changes to these must be notified immediately in writing (not by fax) to the administrator at the address provided on the first page. No third party payments will be allowed. All income payments to non GBP accounts or GBP accounts based overseas will be paid by cheque. 4. Contract Notes Please provide email addresses below for any recipients due to receive contract notes via email: In/Jnt SIPP/SSAS/OSB/P CORP ISA Email Address 1: Email Address 2: Email Address 3: By ticking this box, I/we confirm that a hard copy of the contract note through the postal system is not required. In/Jnt SIPP/SSAS/OSB/P CORP ISA 5. Additional Information Please use this section to add further details pertaining to the application/investment which may assist i.e correspondence address 4

In/Jnt 6. Financial Adviser Details To be completed by the financial adviser Financial Adviser: Company Name: Company Address: WARNING: YOUR CLIENT S CAPITAL IS AT RISK, THEY COULD LOSE SOME OR ALL OF THEIR INVESTMENT Telephone Number: Fax Number: Email: Regulator: Regulatory Reference Number: Declaration by Financial Adviser I confirm that: I am an authorised firm or the appointed representative of such a firm. I have read the Host Capital UK Student Accommodation Fund/Feeder Trust Prospectus and accompanying literature and understand that this fund is aimed at eligible investors and that it is a long term investment which offers limited liquidity and may require a deferral of redemptions dependant on the size of the redemption. I have communicated the Fund s features and restrictions to the Applicant(s) detailed in this Application form. I have advised the named Applicant(s) on the suitability of this investment and deemed it to be fully suitable, and confirm that I have explained the risks in detail, specifically that their capital is at risk and the risks inherent to real estate investments; longevity risk, valuation risk, liquidity risk, transaction risk, concentration risk, servicing risk, sourcing risk, counterparty risk, taxation risk and management risk. I have read the terms of this Application Form and advised the Applicant(s) about its terms. I also confirm that the information supplied by the Applicant(s) in this Application Form and in the documents accompanying it, is accurate and has been verified by me. I understand that you are only willing to accept this Application Form in reliance on my declaration, and the other information in and accompanying this Application Form. I have read and understood the Host Capital Terms of Business for Authorised Intermediaries. Please also tick to confirm the following, if applicable: I am a UK Financial Adviser and have completed my obligations under the FCA s rules (as in force from time to time) in relation to the subject matter of this form and the documents and transaction referred to in it. Financial Adviser s Signature: Company/Adviser s stamp 5

7a. Investor Details. To be completed by individual/joint applicants: In/Jnt 1st Applicant Title: Mr Mrs Miss Ms Other First Name(s): Surname: Address: Telephone Number: Date of Birth: / / Nationality: Occupation: Email: Place of Birth: ID Number: Employer: Nature of Business: (if self employed): 2nd Applicant Title: Mr Mrs Miss Ms Other First Name(s): Surname: Address: Telephone Number: Date of Birth: / / Nationality: Occupation: Email: Place of Birth: ID Number: Employer: Nature of Business: (if self employed): 6

3rd Applicant Title: Mr Mrs Miss Ms Other First Name(s): Surname: Address: Telephone Number: Date of Birth: / / Nationality: Occupation: Email: Place of Birth: ID Number: Employer: Nature of Business: (if self employed): 4th Applicant Title: Mr Mrs Miss Ms Other First Name(s): Surname: Address: Telephone Number: Date of Birth: / / Nationality: Occupation: Email: Place of Birth: ID Number: Employer: Nature of Business: (if self employed): 7

In/Jnt 7b. Declaration Individual/ Joint Applicants to complete Before signing this Application Form, you should CAREFULLY READ the Fund Prospectus. Please also make sure you keep a copy of these documents for your records. If you do not understand any point please ask your Financial Adviser for further information. WARNING: YOUR CAPITAL IS AT RISK, YOU COULD LOSE SOME OR ALL OF YOUR INVESTMENT By signing this Application Form, you are agreeing to be bound by it and its terms and conditions as described at the end of this form This Application Form will equally apply for any orders you place later on to purchase additional shares in the Fund. -Please see the Fund Prospectus for more information on this. Please tick here if you have not received advice from a Financial Adviser to make your proposed investment in the fund Please tick here to confirm that: You qualify to invest in the Host Capital UK Student Accommodation Fund. All the information you have provided in relation to this investment into the Host Capital UK Student Accommodation Fund is accurate The investments you are making belong to you and you are not investing on behalf of anyone else. You have received and have kept a copy of the Fund Prospectus. You consent to the Fund carrying out electronic verification of identity checks and that you will provide any further information regarding this investment to Host Capital Limited on request where it reasonably needs this to comply with its regulatory obligations. You have read, understood and retained the Key Investor Information Document (KIID) in conjunction with Supplementary Information Document (SID) Please note that we may undertake a search with Experian for the purpose of verifying your identity. To do so, Experian may check the details we hold about you and which you have supplied against any particulars on any database (public or otherwise) to which Experian may have access. Experian may also use your details in the future to assist other companies for verification purposes. A record of the search will be retained. We may make your name and address available to companies within the Host Capital group and associated companies to enable information about other investment services and products to be sent to you. If you do not want to receive this information please tick this box. Please tick here to confirm that you are not a US Citizen or Green Card Holder. Please tick here to confirm that you have attached: Identity Verification Certificate (1 x certified BLACK AND WHITE copy or original document per applicant). ID for evidence of address of Applicant (1 x certified BLACK AND WHITE copy or original document per applicant). For Regular Savers, one of the requirements listed on page 2. (Please see page 21 for details) Individual Applicants sign below: 1st Applicant: 2nd Applicant: 3rd Applicant: 4th Applicant: NOTE Any changes to the investment will require the signatures of all applicants. 8

8a. Investor Details. To be completed by ISA plan managers: ISA NOTE: ISA Class - Only investments via an ISA plan manager are accepted. Host Capital Ltd does not act as a plan manager. Intermediary name: Account No Registered address: Investment in the name of: Main contact name: Email: Telephone number: Regulatory Ref Number (if applicable): Please detail below all beneficial owners, underlying principals, Directors and authorised signatories (or equivalent). KYC information will be required on the controller of the ISA and should be attached to this form. 1st Authorised Signatory Name: Address: 2nd Authorised Signatory Name: Address: 9

ISA 8b. Declaration ISA Applicants to complete Before signing this Application Form, you should CAREFULLY READ the Fund Prospectus. Please also make sure you keep a copy of these documents for your records. If you do not understand any point please ask your Financial Adviser for further information. WARNING: YOUR CLIENT S CAPITAL IS AT RISK, THEY COULD LOSE SOME OR ALL OF THEIR INVESTMENT By signing this Application Form, you are agreeing to be bound by it and its terms and conditions as described at the end of this form This Application Form will equally apply for any orders you place later on to purchase additional shares in the Fund. -Please see the Fund Prospectus for more information on this. Please tick here if you have not received advice from a Financial Adviser to make your proposed investment in the fund. Please tick here to confirm that: The ISA plan qualifies to invest in the Host Capital UK Student Accommodation Fund. All the information you have provided in relation to this investment into the Host Capital UK Student Accommodation Fund is accurate. You have received and have kept a copy of the Fund Prospectus. You consent to the Fund carrying out electronic verification of identity checks and that you will provide any further information regarding this investment to Host Capital Limited on request where it reasonably needs this to comply with its regulatory obligations. You have read, understood and retained the Key Investor Information Document (KIID) in conjunction with Supplementary Information Document (SID). Please note that we may undertake a search with Experian for the purpose of verifying your identity. To do so, Experian may check the details we hold about you and which you have supplied against any particulars on any database (public or otherwise) to which Experian may have access. Experian may also use your details in the future to assist other companies for verification purposes. A record of the search will be retained. We may make your name and address available to companies within the Host Capital group and associated companies to enable information about other investment services and products to be sent to you. If you do not want to receive this information please tick this box. Please tick here to confirm that you have attached: Identity Verification Certificate (1 x certified BLACK AND WHITE copy or original document per applicant). ID for evidence of address of Applicant (1 x certified BLACK AND WHITE copy or original document per applicant). Surety Letter* (Please see page 21 for details) Authorised Signatories Sign Below: 1st Authorised Signatory: 2nd Authorised Signatory: NOTE Any changes to the investment will require the signatures of all applicants. *NOTE Please note that a Standard Form Surety Letter is required stating that you operate in line with relevant UK Legislation and have satisfied all applicable CDD on any Beneficial owners 10

9a. Investor Details SIPP / SSAS / Offshore Bond / Wrap Platform applicants to complete SIPP/SSAS/OSB/P NOTE Platforms not able to cope with income streaming should invest into the Feeder Trust Intermediary name: Account No (SIPP / SSAS / Offshore Bond) Registered address: Investment in the name of: Main contact name: Email: Telephone number: Regulatory Ref Number (if applicable): Please detail below all beneficial owners, underlying principals, Directors and authorised signatories (or equivalent). If the investment is to be on behalf of an SIPP or SSAS, KYC information will be required on the controller of the SIPP / SSAS 1st Authorised Signatory Name: Address: 2nd Authorised Signatory Name: Address: 11

9b. Declaration SIPP / SSAS / Offshore Bond / Wrap Platform applicants to complete Before signing this Application Form, you should CAREFULLY READ the Fund /Feeder Trust Prospectus. Please also make sure you keep a copy of these documents for your records. If you do not understand any point please ask your Financial Adviser for further information. SIPP/SSAS/OSB/P WARNING: YOUR CLIENT S CAPITAL IS AT RISK, THEY COULD LOSE SOME OR ALL OF THEIR INVESTMENT By signing this Application Form, you are agreeing to be bound by it and its terms and conditions as described at the end of this form This Application Form will equally apply for any orders you place later on to purchase additional shares in the Fund. -Please see the Fund Prospectus for more information on this. Please tick here if you have not received advice from a Financial Adviser to make your proposed investment in the fund Please tick here to confirm that: The SIPP/SSAS/Offshore Bond/Wrap Platform qualifies to invest in the Host Capital UK Student Accommodation Fund/ Feeder trust All the information you have provided in relation to this investment into the Host Capital UK Student Accommodation Fund/ Feeder Trust is accurate You have received and have kept a copy of the Fund/ Feeder Trust Prospectus. You consent to the Fund/ Feeder Trust carrying out electronic verification of identity checks and that you will provide any further information regarding this investment to Host Capital Limited on request where it reasonably needs this to comply with its regulatory obligations. You have read, understood and retained the Key Investor Information Document (KIID) in conjunction with Supplementary Information Document (SID). If you invest into the Host Capital UK Student Accommodation Fund, you may not acquire shares in the Fund unless you make the Declaration by Bodies Corporate and Nominees acquiring shares in the Fund on page 16. I/we have filled in and signed the Declaration by Bodies Corporate and Nominees acquiring shares in the Fund on page 16. Please note that we may undertake a search with Experian for the purpose of verifying your identity. To do so, Experian may check the details we hold about you and which you have supplied against any particulars on any database (public or otherwise) to which Experian may have access. Experian may also use your details in the future to assist other companies for verification purposes. A record of the search will be retained. We may make your name and address available to companies within the Host Capital group and associated companies to enable information about other investment services and products to be sent to you. If you do not want to receive this information please tick this box. Please tick here to confirm that you have attached: Identity Verification Certificate (1 x certified BLACK AND WHITE copy or original document per applicant) ID for evidence of address of Applicant (1 x certified BLACK AND WHITE copy or original document per applicant) Surety Letter* (Please see page 21 for details) Authorised Signatories Sign Below: 1st Authorised Signatory: 2nd Authorised Signatory: NOTE Any changes to the investment will require the signatures of all applicants. *NOTE Please note that a Standard Form Surety Letter is required stating that you operate in line with relevant UK Legislation and have satisfied all applicable CDD on any Beneficial owners 12

10a. Investor Details. To be completed by CORPORATE applicant CORP Corporate name: Registered address: Main contact name: Email: Telephone number: Date of incorporation: Registration number: Place of incorporation: Nature of Business: Please detail below all beneficial owners, (N.B - A Beneficial Owner is a body that owns more than 25% of the shares) underlying principals, Directors and authorised signatories (or equivalent). Please state in what capacity they operate 1st Authorised Signatory: Name: Address: Position: 2nd Authorised Signatory: Name: Address: Position: 13

10b. Declaration CORPORATE Applicants to complete Before signing this Application Form, you should CAREFULLY READ the Fund/Feeder Trust Prospectus. Please also make sure you keep a copy of these documents for your records. If you do not understand any point please ask your Financial Adviser for further information. CORP WARNING: YOUR CAPITAL IS AT RISK, YOU COULD LOSE SOME OR ALL OF YOUR INVESTMENT By signing this Application Form, you are agreeing to be bound by it and its terms and conditions below This Application Form will equally apply for any orders you place later on to purchase additional shares in the Fund. -Please see the Fund Prospectus for more information on this. Please tick here if you have not received advice from a Financial Adviser to make your proposed investment in the fund Please tick here to confirm that: You qualify to invest in the Host Capital UK Student Accommodation Fund/Feeder Trust. All the information you have provided in relation to this investment into the Host Capital UK Student Accommodation Fund/ Feeder Trust is accurate. The investments you are making belong to the company detailed above and you are not investing on behalf of anyone else. You have received and have kept a copy of the Fund/Feeder Trust Prospectus. You consent to the Fund/ Feeder Trust carrying out electronic verification of identity checks and that you will provide any further information regarding this investment to Host Capital Limited on request where it reasonably needs this to comply with its regulatory obligations. You have read, understood and retained the Key Investor Information Document (KIID) in conjunction with Supplementary Information Document (SID). If you invest into the Host Capital UK Student Accommodation Fund, you may not acquire shares in the Fund unless you make the Declaration by Bodies Corporate and Nominees acquiring shares in the Fund on page 16. I/we have filled in and signed the Declaration by Bodies Corporate and Nominees acquiring shares in the Fund on page 16. Please note that we may undertake a search with Experian for the purpose of verifying your identity. To do so, Experian may check the details we hold about you and which you have supplied against any particulars on any database (public or otherwise) to which Experian may have access. Experian may also use your details in the future to assist other companies for verification purposes. A record of the search will be retained. We may make your name and address available to companies within the Host Capital group and associated companies to enable information about other investment services and products to be sent to you. If you do not want to receive this information please tick this box. Please tick here to confirm that none of the company shareholders are US Citizens or Green Card Holders Please tick here to confirm that you have attached: Certified copy of Certificate of Incorporation Certified copy of Articles of Association 3 years audited accounts Identity Verification Certificate (1 x certified BLACK AND WHITE copy or original document per named individual) ID for evidence of address of each named individual (e.g. Shareholders/ Directors) (1 x certified BLACK AND WHITE copy or original document per named individual) Authorised Signatories sign below: 1st Authorised Signatory: 2nd Authorised Signatory: 14

11. Declaration of Eligibility for Gross Distributions In/Jnt SIPP/SSAS/OSB/P CORP ISA To receive gross distributions, you must satisfy the terms for gross investors, as set out in the prospectus. Such investors typically include, amongst others, UK tax resident companies; UK authorised investment funds; ISA plan managers; administrators of registered pension schemes and charities. If you are unsure as to whether you are entitled to receive gross distributions you should consult your tax advisor. Please complete and sign the following declaration to confirm that you are entitled to receive gross distributions. If the following is not completed, you will only be eligible to receive net income distributions. I/We confirm that the applicant can receive distributions gross and/or is within the charge to corporation tax. I/We undertake to inform the manager as soon as this declaration no longer applies. Please note: Host Capital UK Student Accommodation Fund reserves the right to withhold tax, reclaim tax paid and pass on any charges which it might incur if it believes that the information supplied in this declaration does not meet with the HM Revenue & Customs requirements for corporate holdings. Charity number if applicable: Exempt Pension Fund Manager: UK Corporate Body: Yes Yes No No The shareholder(s) hereby indemnifies, the Fund, Host Capital UK Student Accommodation Fund and/or its OEIC Administrator in respect of any tax, claim, penalty, action, demand, liability, cost, expense, damage or loss incurred by any of them in connection with the information provided (or omitted to be provided) by the Shareholder(s) in this declaration. NOTE: Investors classed as Not Ordinarily Resident (NOR) in the UK are not entitled to receive Gross Distributions. NOR s will however be entitled to claim back TAX via the usual methods with HMRC. Applicants/Authorised signatories sign here: Signatory 1: Signatory 2: Signatory 3: Signatory 4: 15

12. Declaration by Bodies Corporate and Nominees Acquiring Shares in the Fund SIPP/SSAS/OSB/P CORP No Body Corporate may acquire Shares (whether as beneficial owner or otherwise) unless it certifies either that it holds (Please tick either sections A, B or C): Section A All the Shares as beneficial owner; Please proceed to section D. Section B Some or all of the Shares on behalf of one or more other Bodies Corporate, in which case it must further certify that all of the following have been complied with (to comply, all boxes need to be ticked): Section C its own interest (if any) is less than 10% of the net asset value ( NAV ) of the Company; the interest of each Body Corporate for which it holds Shares is less than 10% of the NAV of the Company; and each of the other Bodies Corporate has given the undertakings described in section D and E All the Shares on behalf of one or more persons none of whom are Bodies Corporate. Section D Undertaking regarding size of holding required from any corporate owner Any Body Corporate that acquires Shares as beneficial owner (whether the Shares are registered in its name or the name of a nominee or other person) must give the following undertakings (to comply, both boxes need to be ticked): not to acquire 10% or more (directly or indirectly) of the NAV of the Company; and on becoming aware that it has acquired 10% or more (directly or indirectly) of the NAV of the Company, to reduce its proportionate holding to less than 10%. Section E - Undertaking required from every corporate nominee (to comply, both boxes needs to be ticked) Any Body Corporate that acquires Shares and holds them otherwise than as beneficial owner must undertake to disclose to the ACD the names and extent of the Shareholding of each Body Corporate on whose behalf it is holding Shares. If a Body Corporate is close to reaching the 10% investment limit but wishes to remain invested in the Company, it should contact the ACD with a view to switching its Shares in the Company for units in the appropriate sub-fund of the Feeder Fund. Authorised Signatories sign below: 1st Authorised Signatory: 2nd Authorised Signatory: 16

13. FATCA Provisions In/Jnt Individual Self-Certification Tax Regulations1 require us to collect information about each investor s tax residency. In certain circumstances (including if we do not receive a valid self-certification from you) we may be obliged to share information on your account with HMRC. If you have any questions about your tax residency, please contact your tax advisor. Should any information provided change in the future, please ensure you advise us of the changes promptly. Tax residency Please indicate all countries in which you are resident for tax purposes and the associated Tax Reference Numbers (e.g. National Insurance Number) in the table below. If you are a US citizen or resident, please include United States in this table along with your US Tax Identification Number. COUNTRY/COUNTRIES OF TAX RESIDENCY TAX REFERENCE NUMBER Place/Country of Birth: If you are not resident in any country for tax purposes, please tick this box Declaration I declare that the information provided on this form is to the best of my knowledge and belief, accurate and complete. I agree to notify Host Capital immediately in the event the information in the self-certification changes. Signed by (please print name): Permanent Address: Date of Birth: / / Signature: 17

13. FATCA Provisions continued SIPP/SSAS/OSB/P CORP ISA Entity Self-Certification Tax Regulations1 require us to collect certain information about each investor s tax residency and tax classifications. In certain circumstances (including if we do not receive a valid self-certification from you) we may be obliged to share information on your account with HMRC. Please complete all sections below as directed. If you have any questions about your organisation s classifications, please refer to the instructions overleaf for key definitions or contact your tax advisor. Should any information provided change in the future, please ensure that we are advised promptly. Section 1: Tax residency If your organisation has more than one country of tax residency, please complete one self-certification form for each country. 1.1 Please state the country in which your organisation is resident for tax purposes: 1.2 Please provide us with your organisation s Tax Reference Number: 1.3 If the organisation is not a Specified Person2 in the country stated in 1.1 above, please tick this box Section 2: Organisation s classification under applicable tax regulations1 Please tick one box only in section A, with reference to the tax residency stated in box 1.1. A. Classification 2.1 UK Financial Institution or a Partner Jurisdiction Financial Institution 4 2.2 Participating Foreign Financial Institution 4 2.3 Non-Participating Foreign Financial Institution 4 2.4 Financial Institution resident in the USA or in a US Territory 4 2.5 Deemed Compliant Foreign Financial Institution (besides those listed above) 4 2.6 Exempt Beneficial Owner 5 2.7 Active Non-Financial Entity 6 2.8 Passive Non-Financial Entity 8 A Passive Non-Financial Entity will be required to submit individual tax residence self-certifications for each of its Controlling Persons 9 If your organisation is a financial institution, please tick this box if it is an Investment Entity 10 An Investment Entity will be required to submit individual tax residence self-certifications for each of its Controlling Persons 9 Please provide your organisation s Global Intermediary Identification Number ( GIIN ): / / / Section 3: Declaration I declare that the information provided on this form is to the best of my knowledge and belief, accurate and complete. I agree to notify Host Capital immediately in the event the information in the self-certification changes. Signed by (please print name): On behalf of (organisation name): Position (in organistion): Signature: 18

FATCA Provisions Notes 1 Tax Regulations The term Tax Regulations refers to regulations created to enable automatic exchange of information and include FATCA3, various Agreements to Improve International Tax Compliance entered into between the UK and its Crown Dependencies and its Overseas Territories and the OECD Common Reporting Standard for Automatic Exchange of Financial Account Information. 2 Specified Person The term Specified Person is defined by reference to local laws in the country where an entity is established. In the UK, a Specified United Kingdom Person means a person or entity who is resident in the United Kingdom for tax purposes, other than: (i) a corporation the stock of which is regularly traded on one or more established securities markets; (ii) any corporation that is a Related Entity 11 of a corporation described in clause (i); (iii) a Depository Institution; (iv) a broker or dealer in securities, commodities, or derivative financial instruments (including notional principal contracts, futures, forwards, and options) that is registered as such under the laws of the United Kingdom; (v) a Governmental Entity; (vi) an International Organisation (examples of which include The International Monetary Fund, The World Bank, The International Bank for Reconstruction and Development and The European Community for a full list please see the relevant guidance issued by HMRC, or the IRS); (vii) a Central Bank; or (viii) a pension scheme or other arrangement registered with HMRC under Part 4 ofthe Finance Act 2004. Similar definitions apply to entities in the US (defined in the FATCA Regulations) and Crown Dependencies and Overseas Territories (as defined in the relevant Agreement to Improve International Tax Compliance with the UK). Entities in other jurisdictions should instead apply the similar definition of Reportable Person under the OECD Common Reporting Standard for Automatic Exchange of Financial Account Information. 3 FATCA The Foreign Account Tax Compliance provisions (commonly known as FATCA) contained in the US Hire Act 2010. 4 Financial Institution The term Financial Institution means a Custodial Institution, a Depository Institution, an Investment Entity10, or a Specified Insurance Company as defined for the purposes of FATCA. The same definitions apply to the UK s Agreements to Improve International Tax Compliance. Please see the relevant Tax Regulations for the classification definitions that apply to Financial Institutions. 5 Exempt Beneficial Owner The term Exempt Beneficial Owner means (i) a Governmental Entity; (ii) an International Organisation (examples of which include The International Monetary Fund, The World Bank, The International Bank for Reconstruction and Development and The European Community for a full list please see the relevant guidance issued by HMRC, or the IRS); (iii) a Central Bank; or (iv) a UK registered pension scheme, or non-uk pension scheme falling within the definition of Exempt Beneficial Owner for the purpose of FATCA. 6 Active Non-Financial Entity (NFE) A NFE is any entity that is not a Financial Institution. An Active NFE is any NFE that meets one of the following criteria: (i) Less than 50 per cent of the NFE s gross income for the preceding calendar year or other appropriate reporting period is passive income (such as dividends, interest, royalties, annuities and rent) and less than 50 per cent of the assets held by the NFE during the preceding calendar year or other appropriate reporting period are assets that produce or are held for the production of passive income; (ii) The stock of the NFE is regularly traded on an established securities market or the NFE is a Related Entity11 of an entity, the stock of which is traded on an established securities market; Mansion ref 00690 APP FORM S1 (iii) The NFE is a government, a political subdivision of such government, or a public body performing a function of such government or a political subdivision thereof, or an entity wholly owned by one or more of the foregoing; (iv) Substantially all of the activities of the NFE consist of holding (in whole or in part) the outstanding stock of, or providing financing and services to, one or more subsidiaries that engage in trades or businesses other than the business of a Financial Institution. However the entity will not qualify as an Active NFE if it functions (or holds itself out to be) an investment fund, such as a Private Equity Fund, Venture Capital Fund, Leveraged Buyout Fund or any Investment Vehicle whose purpose is to acquire or fund companies and then hold interests in those companies as capital assets for investment purposes. In these circumstances the entity will be a passive NFE; (v) The NFE is not yet operating a business and has no prior operating history, but is investing capital into assets with the intent to operate a business other than that of a Financial Institution; provided that the NFE shall not qualify for this exception after the date that is 24 months after the date of the initial organisation of the NFE; (vi) The NFE was not a Financial Institution in the past five years, and is in the process of liquidating its assets, or is reorganising with the intent to continue or recommence operations in a business other than that of a Financial Institution; (vii) The NFE primarily engages in financing and hedging transactions with, or for Related Entities11 that are not Financial Institutions, and does not provide financing or hedging services to any entity that is not a Related Entity, provided that the group of any such Related Entities is primarily engaged in a business other than that of a Financial Institution; or (viii) The entity is a Non-Profit Organisation 7. 7 Non-Profit Organisation The term Non-Profit Organisation means an entity that meets ALL of the following criteria: (i) It is established and operated in its jurisdiction of residence exclusively for religious, charitable, scientific, artistic, cultural, athletic, or educational purposes; or it is established and operated in its jurisdiction of residence and it is a professional organisation, business league, chamber of commerce, labour organisation, agricultural or horticultural organisation, civic league or an organisation operated exclusively for the promotion of social welfare; (ii) It is exempt from income tax in its country of residence; (iii) It has no shareholders or members who have a proprietary or beneficial interest in its income or assets; (iv) The applicable laws of the entity s country of residence or the entity s formation documents do not permit any income or assets of the entity to be distributed to, or applied for the benefit of, a private person or non-charitable entity other than pursuant to the conduct of the entity s charitable activities, or as payment of reasonable compensation for services rendered, or as payment representing the fair market value of property which the entity has purchased; and (v) The applicable laws of the entity s country of residence or the entity s formation documents require that, upon the entity s liquidation or dissolution, all of its assets be distributed to a governmental entity or other non-profit organisation, or escheat to the government of the entity s country of residence or any political subdivision thereof. 8 Passive Non-Financial Entity (NFE) A Passive NFE is any NFE that is not an Active NFE 6. 9 Controlling Persons The term Controlling Persons means the natural persons who exercise control over an entity. In the case of a trust, such term means the settlor, the trustees, the protector (if any), the beneficiaries or class of beneficiaries, and any other natural person exercising ultimate effective control over the trust, and in the case of a legal arrangement other than a trust, such term means persons in equivalent or similar positions. The term Controlling Persons must be interpreted in a manner consistent with the Financial Action Task Force Recommendations. 10 Investment Entity The term Investment Entity means any entity: (a) that primarily conducts as a business one or more of the following activities or operations for or on behalf of a customer: i. trading in money market instruments (cheques, bills, certificates of deposit, derivatives, etc.); foreign exchange; exchange, interest rate and index instruments; transferable securities; or commodity futures trading; ii. individual and collective portfolio management; or iii. otherwise investing, administering, or managing Financial Assets or money on behalf of other persons; or (b) the gross income of which is primarily attributable to investing, reinvesting, or trading in Financial Assets, if the entity is managed by another entity that is a Depository Institution, a Custodial Institution, a Specified Insurance Company, or an Investment Entity described in (a) above. An entity is treated as primarily conducting as a business one or more of the activities described in (a), or an entity s gross income is primarily attributable to investing, reinvesting, or trading in Financial Assets for purposes of (b), if the entity s gross income attributable to the relevant activities equals or exceeds 50 per cent of the entity s gross income during the shorter of: (i) the three-year period ending on 31 December of the year preceding the year in which the determination is made; or (ii) the period during which the Entity has been in existence. The term Investment Entity does not include an entity that is an Active NFE because it meets any of the criteria in (iv) to (vii) in the definition of Active NFE 6 above. 11 Related Entity An entity is a Related Entity of another entity if either entity controls the other entity, or two entities are under common control. For this purpose control includes direct or indirect ownership of more than 50 per cent of the vote and value in an entity. 19

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Suitable Documents for Identification Private Individual You are required to select a document per individual from each of the following lists, one to confirm the individual s name and one to confirm their address Please forward certified copies of each document Documents can be certified by a regulated professional person e.g. IFA, Lawyer, Solicitor, Accountant Each copy must be certified as being a true copy of the original and the certifier must apply their company stamp, sign and print their name and date the copy If you are unable to obtain certified copies, please forward the original documents to us for our certification and return Please note - Colour copies of Passports are not acceptable EVIDENCE OF NAME Current full signed passport Current UK / EEA photo-card driving licence (1) Current full UK non-photographic driving licence (old style) (1) National identity card (non-uk nationals) Identity card issued by the Electoral Office, Northern Ireland / EEA Members / Switzerland State pension or benefits book / notification letter (1) - (Must show full names) Firearms / shotgun certificate Sub-contractors certificate (2) HMRC tax notification (Tax Assessment/Statement of Account/ Notice of Coding) (3) (Must show full names) Residence permit issued to EU nationals by Home Office Local authority tax bill Local authority rent card / tenancy agreement EVIDENCE OF ADDRESS (5) Current UK / EEA photo-card driving licence (1) Current full UK non-photographic driving licence (old style) (1) Most recent mortgage statement Current local authority tax bill Electoral roll check (4) Local authority rent card or tenancy agreement Bank / building society / credit union statement (6) Current house or motor insurance certificate Utility bill/statement (not mobile phone) (6) State pension or benefits book / notification letter (1) Solicitor letter confirming completion of house purchase or land registration (4) Company / Trust / Entity Identification You are required to supply the below documents for the Company / Trust / Entity Please forward certified copies of each document Documents can be certified by a regulated professional person e.g. IFA, Lawyer, Solicitor, Accountant Each copy must be certified as being a true copy of the original and the certifier must apply their company stamp, sign and print their name and date the copy If you are unable to obtain certified copies, please forward the original documents to us for our certification and return REQUIRED DOCUMENTS Certificate of Incorporation List of all beneficial owners, underlying principals, Directors, authorised signatories (or equivalent), individuals and Shareholders holding a 25% or more interest in the Capital or Net assets (please supply an Individual Verification Certificate for each named individual) Latest annual accounts / financial statements Trust deed if applicable (showing name of the trust, parties to the trust and signature page; and In relation to a trust, an authorised signatory list including specimen signatures would also be required) List of Trustees if applicable (please supply an Individual Verification Certificate for each Trustee) KEY NOTES 1) These items may be used to evidence address or identity but not both. 2) For self-employed persons in the construction industry tax exemption certificate with photograph (C1S4 and C1S6). 3) Please note that a P45 or P60 issued by an employer are not acceptable for this purpose. 4) You must submit a certified copy of the search if you are relying on this as evidence. 5) The previous address should also be verified if the Applicant has been at the current address for less than 3 months. 6) Must be no more than 3 months old. We reserve the right to request further information. 21

Terms & Conditions 1. General 1.1 These Terms and Conditions relate to the subscription of Shares in the Fund/Feeder Trust and the applicant(s) agree(s) to be bound by these Terms and Conditions and the Instrument of Incorporation of the Fund. 1.2 The Fund and the Administrator reserve the right to reject any application in whole or in part which is not completed in full and supported by the documentation requested and cleared monies, or for any other reasons at its sole discretion. Failure to attach all documentation requested will result in a delay in the transaction being processed. 1.3 The Fund and the Administrator reserve the right to request additional information and documentation, including but not limited to, translations and certifications relating to such additional requests from the applicant(s) and existing investors in compliance with the legislation and regulations in force from time to time. 2. Prevention of money Laundering 2.1 All applicants must attach to this Application Form all the relevant documentation requested. 2.2 All applicants understand that due to the changing nature of anti-money laundering laws and regulations and the possible extensions of applicable rules, the Administrator may update and amend its procedures from time to time to comply with such amendments. 2.3 In compliance with applicable anti-money laundering rules and regulations, the Administrator may require further identification of the applicant(s) or an existing investor before the application can be processed or the redemption proceeds can be paid out. 2.4 Subscription monies from a third party will not be accepted. Redemption proceeds cannot be paid to a third party. 3. Joint Applicants 3.1 If more than one person is named in a single Application Form, all applicants will be considered as joint applicants. As such, they authorise the Administrator to act and rely on the signed or purportedly signed instructions of any one of the applicants without liability with respect to any transfer, payment or other act made or done or omitted to be done in accordance with such instructions. 3.2 The different joint holders shall determine between them, by separate agreement, the rights of any joint account holder on the account. The Administrator may at any time request each joint account holder to inform it about this determination. Under no circumstances can the knowledge that the Administrator has about the distribution of assets between the account holders of a joint account be used against the Administrator in any way. 3.3 The applicants hereby confirm that upon the death of any of the undersigned, this individual signatory power will continue to be in force the Fund and the Administrator may rely and act without liability on any instruction including the transfer or redemption of the Shares signed by the survivor(s) unless the Administrator has been informed in writing of the contrary. 3.4 Unless otherwise advised in writing, all notices and communications shall be addressed and all payments directed to the first applicant specified in section 1 of the present Application Form (the First Applicant ). 4. Indemnity 4.1 The applicant(s) will indemnify upon first demand the Fund and the Administrator and any other delegates against any actions, proceedings, claims, losses, damages, costs and expenses which may be brought against, suffered or incurred by them arising either directly or indirectly out of or in connection with a breach by the applicant(s) of these Terms and Conditions or out of anything done or omitted by the Fund or the Administrator pursuant to any instructions given by fax or out of the Fund or Administrator relying on, accepting or failing to act on any instruction or declaration or information given by or on behalf of the applicant(s) unless due to the wilful default, fraud or gross negligence of the Fund or the Administrator. 4.2 The Registrar and Transfer Agent will indemnify the applicant for direct damages solely to the extent of its gross negligence, wilful misconduct or fraud. The Administrator will in no way indemnify indirect or consequential damages suffered by the applicant(s). 4.3 Where this Application Form is submitted by fax: 4.3.1 The applicant specifically authorises the Fund and the Administrator to act upon instructions received by fax. This fax authority will remain in force until notice in writing of its termination is received by the Administrator and shall apply to all dealings and transactions between the Administrator and the applicant in relation to the Fund, Mansion ref 00690 APP FORM S4 provided that it does not apply to notifications of change of name, address, death or transfers; in such circumstances original documentation must be sent to the Administrator. 4.3.2 The Fund and the Administrator are entitled in their absolute discretion to refuse to comply with any fax instruction which is, in their opinion, unclear or ambiguous. 4.3.3 The applicant agrees to send the original application form to the Administrator. For redemption forms submitted by fax, the Administrator will only pay out the redemption proceeds upon receipt of the original redemption form. 5. Confidentiality 5.1 The Administrator agrees to keep all information concerning the applicant(s) confidential unless required to disclose such to third parties by applicable law or by formal instruction of the applicant(s). 5.2 The applicant(s) accept and agree that the Administrator may be required to disclose personal details for the processing of cash payment instructions in accordance with applicable anti- money laundering rules and regulations. 5.3 The applicant(s) accept that personal details may be disclosed to external parties, such as the Fund s Distributors, as necessary for the provision of enhanced shareholders related services and that personal details (subject to the application of the local laws/and or regulations) be used outside the United Kingdom and may therefore be potentially subject to the scrutiny of regulatory and tax authorities outside the United Kingdom. 6. data Processing 6.1 The applicant(s) acknowledge and agree that the applicant(s) personal details will be held by the Administrator and may be subject to data processing. The applicant(s) will have access to his/her/their personal details and will be entitled to request relevant amendments to such details. The Administrator will keep the personal details for at least 5 years after the end of the relationship between the applicant(s) and the Administrator. 7. Subscription Orders 7.1 Upon receipt of the completed Application Form and the full subscription amount, the Administrator will issue for the Fund/Feeder Trust the Shares in the name of the applicant(s). 8. Instructions 8.1 All notices, reports, statements, documents and communications will be sent at the risk of the applicant(s) by ordinary mail or where otherwise specified by United Kingdom legislation or the Fund s constitutional documents, by registered mail to the address of the First Applicant unless otherwise specified by the applicant(s) in writing. 8.2 All notices, reports, statements, documents and communications sent to the address of the first applicant are deemed to have been effected to all the applicants on the date sent to the first applicant s address. 8.3 Instructions may be given by letter or facsimile and are at the risk of the applicant(s). The applicant(s) assume(s) all risks and in particular those arising from delays in delivery, errors in communication, or comprehension, including but not limited to, errors as to the information contained in the instruction. The applicant(s) holds harmless the Fund and the Administrator of all responsibility in this respect. 8.4 The applicant(s) specifically agree(s) that for instructions sent by fax he/they hold the Administrator fully indemnified from and against all liabilities, losses, costs, actions, proceedings, claims and demands which may be incurred by or brought or made against the Fund or the Administrator arising directly or indirectly from having acted upon such instructions. 8.5 In case the Application Form is sent by fax, the original must also be sent to the Administrator immediately thereafter by post. 8.6 A fax authority is not sufficient for notifications of change of name, notification of death, deed of pledges and appointment of an attorney or any other notification or instruction where original documentation is required to be sent by post to the Administrator. 8.7 The applicant(s) shall check the accuracy of the details contained in the contract noted and statements of accounts sent by the Administrator. Failure to report any inaccuracy within 30 business days of their dispatch will result in the confirmation details to be deemed accurate by the applicant(s). 9. Late Trading and market Timing 9.1 The Administrator shall not permit transactions which it knows to be or has reason to believe to be related to late trading or market timing practices as defined in FCA Rules and shall report those transactions to the FCA. 10. Cancellation Rights 10.1 Applicants who have received advice may have the right to cancel their application to buy Shares at any time during the 14 days after the date on which they receive a cancellation notice from the ACD. In the case of Investors who have received advice investing through the Regular Savings Plan, they may also have a right to cancel their application to buy Shares in respect of their initial subscription (but not for subsequent contributions under the plan) at any time during the 14 days after the date on which they receive a cancellation notice from the ACD. The ACD may extend cancellation rights to other investors but is under no obligation to do so. If an applicant decides to cancel the contract, and the value of the investment has fallen at the time the ACD receives the completed cancellation notice, they will not receive a full refund as an amount equal to any fall in value will be deducted from the sum originally invested. 11. Telephone Recording 11.1 The applicant(s) specifically accept(s) that telephonerecording procedures may be used and agree(s) that these records may be used in court or any legal proceeding, with the same value as written evidence. 12. Fraudulent use Of signature 12.1 Neither the Fund nor the Administrator shall be liable for the fraudulent use by a third party of the applicant s signature, whether this signature be authentic or forged ( Fraudulent Instruction ). 12.2 Except in the event of gross negligence on their part, the Fund and/or the Administrator shall not be liable for any damage, loss, expense or liability of any nature which the applicant(s) may suffer due to the reliance by the Fund and/or the Administrator on a Fraudulent Instruction which the Fund and/or Administrator believe in good faith to be genuine and to have been given or signed by the applicant(s). 13. Amendments to The Terms And Conditions 13.1 The Administrator reserves the right at any time to modify these Terms and Conditions. The Administrator shall inform the applicant (s) in writing of all amendments to these Terms and Conditions. Such modifications shall be deemed to be accepted by the applicant(s) if the applicant(s) does not raise any objection in writing to the proposed amendments, within two weeks from the date of the notification. 14. Severance 14.1 If any provision or clause of these Terms and Conditions is or becomes void or unenforceable in whole or in part for any reason such enforceability or invalidity shall not affect the validity of the remaining Terms and Conditions. Corresponding Terms and Conditions must replace the invalid terms and conditions. 15. Applicable Law 15.1 The laws of England and Wales shall govern the validity and construction of these Terms and Conditions and the parties agree to be bound by the exclusive jurisdiction of the courts of England and Wales. 16. Client Money. 16.1 Any client money (as defined by the FCA Handbook) received in relation to the issue of units that have not been passed onto the depositary by the close of business on the business day following the receipt will be segregated and treated in accordance with the FCA client money rules. This means that the money is held in an account separate from that which the Manager uses to hold its own money. The manager will not calculate or pay to the investor any interest that might arise on those monies. 16.2 By signing the Funds application form clients are agreeing to Host Capital Limited using the exemption under CASS 7.11.21.R, allowing Host Capital to hold client s assets in the Firms bank account until the following business day after receipt. 17. Final Provision 17.1 These Terms and Conditions form an integral part of the Application Form, which applicant(s) declare having accepted by signing this Application Form. 22