Absolute Return Government Bond Fund Application Form Institutional Investors 1
Please note that only Institutional Investors (as defined within Articles 174 & 175 of the Luxembourg law of 17 December 2010 on Undertaking for Collective Investment, as amended) should purchase I class shares. Please ensure you are an eligible institutional investor prior to completing this application form. Important information Before you sign this form, you must read an up-to-date version of the Key Investor Information Document (KIID) for each Sub-fund and Share Class of the UCITS in which you want to invest. Please contact us if you have not received up-to-date versions of these documents, by calling +352 24 52 4363. Please also note that, should you wish to make any future investments in any other Sub-Funds and/or Share Classes of the UCITS, you will be required to complete and sign an additional application form. If you want to apply for shares in sub-funds of (the Company ), please complete this application form and return the signed original to the Transfer Agency, The Bank of New York Mellon (Luxembourg) S.A., Attn: AIS Investor Services,, 2-4, Rue Eugène Ruppert, L-2453 Luxembourg. Telephone + (352) 24 52 4363 or Fax + (352) 24 52 4237. Please ensure that all required Anti-Money Laundering supplements (see Appendix 1) are attached with this application. Application forms will not be processed if the supplement is not completed in full. Each investor must complete a separate Anti-Money Laundering supplement and attach the appropriate documentation as required. Registered Shareholder Details Mr Mrs Miss Ms Other Registered Shareholder Name (in full) Date of birth Country of Incorporation Date of Incorporation (DDMMYY) Tax Residence Country Designation (if applicable) Permanent Registered Address Postcode Correspondence Address (if different) Postcode 2
Contact Name Telephone Number Fax Number Email Address Joint Shareholders Details 2 Full name Date of birth Address 3 Full name Date of birth Address 4 Full name Date of birth Address Politically Exposed Persons (PEPs*) Politically Exposed Persons: Are you currently a natural person(s) who is/are or has at anytime in the preceding year been entrusted with prominent public functions; or are you an immediate family member or person(s) known to be close associates of such persons? Please tick as appropriate. Yes: No: (*) Please refer to Section III (c) of Appendix 1 for further information. Source of Wealth: Source of Funds: Expected account activity: Beneficial Owner Declaration Please tick the following as appropriate: I am/we are investing on my/our own behalf and I am/we are the ultimate economic beneficiary(ies) of the Fund and any subsequent income invested. I am/we are investing on behalf of a third party who is the ultimate economic beneficiary of the Fund and any subsequent income invested. If investing on behalf of a third party, the third party has to be fully identified unless the applicant is a regulated professional of the financial sector located in a recognised equivalent FATF country. Where no box is ticked the first statement will be taken as default meaning that the applicant is the beneficial owner. 3
Please provide full name of Beneficial Owner(s) if different from Registered Shareholder(s). For all legal entities, please enter below the names of any persons that own or control more than 25% of the voting rights in the body or partnership, or are entitled to more than 25% of its capital or profits. Full Name Capacity (e.g. Trustee, Partner, Shareholder, Beneficiary etc) Permanent Registered Address Date of Birth I/We hereby certify that the above is a complete list of the beneficial owners and controllers as described above and that they are known to me/one or more of us or, in the case of a class of beneficiary, that the description is appropriate and accurate. To be signed by one or more of the Registered Shareholders detailed on previous page, in whose names the shares will be registered. Authorised signature(s): 1: 2: 3: 4: Investment details I/We want to invest in the following sub-fund pursuant to the terms and conditions of the Prospectus of the Company (together with any applicable Addenda, Supplements and Key Investor Information Document, collectively referred to as the Prospectus ). I/We confirm I/we have received this documentation Please complete the Cash Subscription Amount or Number of Shares for the Share Class required in the table overleaf. 4
Ignis Absolute Return Government Bond Fund Share Class Currency Initial Minimum Investment Cash Subscription Amount Number of shares ISIN I Accumulation GBP 1,000,000 LU0866993545 EUR Hedged 1,000,000 LU0866993628 CHF Hedged 1,000,000 LU0866993974 USD Hedged 1,000,000 LU0866994196 SEK Hedged 10,000,000 LU0866994279 SI Accumulation GBP 50,000,000 LU0866994352 EUR Hedged 50,000,000 LU0866994519 CHF Hedged 50,000,000 LU0866994600 USD Hedged 50,000,000 LU0866994782 SEK Hedged 500,000,000 LU0866994865 I Distribution GBP 1,000,000 LU0995119152 EUR Hedged 1,000,000 LU1061566979 SI Distribution GBP 50,000,000 LU0995119319 5
Payment/Subscription Method Payments must be made by electronic transfer. The minimum subscription must be met after deduction of all applicable bank charges. Please note the Shareholder will be liable for all banking charges. Transfer instructions should specify the applicant s name, account number and Share Class into which the subscription is being made. Please provide either a SWIFT payment reference number or a copy of your SWIFT payment instruction to the Transfer Agency at the time of transfer of subscription payments (if payment made via SWIFT). Please note that the details of both the Intermediary Bank and the Beneficiary Bank must be quoted on your transfer instructions. The following details should assist you with the transfer. You must wire the payment from an account in your name. Third party payments are not accepted. Euro denominated payments Intermediary Bank BIC: DEUTDEFF (Deutsche Bank, Frankfurt) BLZ Code: 500 700 10 Beneficiary Bank BIC: IRVTLULXLTA (The Bank of New York (Luxembourg) S.A.) IBAN: DE95500700100938294601 Special Instructions: FFC a/c 160157 9780 (IGNIS GLOBAL FUNDS) - Deal Reference Sterling denominated payments Intermediary Bank BIC: IRVTGB2X (The Bank of New York, London) Sort Code: 70 02 25 Beneficiary Bank BIC: IRVTLULXLTA (The Bank of New York (Luxembourg) S.A.) IBAN: GB34IRVT70022522004361 Special Instructions: FFC a/c 160157 8260 (IGNIS GLOBAL FUNDS) - Deal Reference US Dollar denominated payments Intermediary Bank BIC: IRVTUS3N (The Bank of New York) BLZ Code: 021 0000 18 Beneficiary Bank BIC: IRVTLULXLTA (The Bank of New York (Luxembourg) S.A.) A/C No: 890-0542-012 Special Instructions: FFC a/c 160157 8400 (IGNIS GLOBAL FUNDS) - Deal Reference Swiss Franc denominated payments Intermediary Bank BIC: Credit Swiss Swift code: CRESCHZZ80A Beneficiary Bank BIC: IRVTLULXLTA (The Bank of New York Mellon, Luxembourg S.A.) IBAN: 0835-0674144-33-000 Special Instructions: FFC 1601577560 (IGNIS GLOBAL FUNDS SICAV SR ACCOUNTS) - Deal Reference Swedish Krona denominated payments Intermediary Bank BIC: Skandinaviska Enskilda, Stockholm Swift Code: ESSESESS Beneficiary Bank BIC: IRVTLULXLTA (The Bank of New York (Luxembourg) S.A.) IBAN: 5000-0000-0520-1856-1006 Special Instructions: FFC a/c 160157 7520 (IGNIS GLOBAL FUNDS) - Deal Reference 6
Payment/Redemption Instructions Please complete the following section with your bank account details. These details will apply to all payments and redemptions. Name of bank Full postal address of your bank Swift/Sort code Intermediary Bank BIC BLZ Code For the Account of BIC Beneficiary Bank BIC Beneficiary Account No. Special Instruction IBAN No (mandatory for GBP and EUR payment account If within EU zone) Name of account holder Account number Signature 1 Signature 2 (if joint account) Swift/ Sort code Date 7
Correspondent/pay through bank Name of bank Full postal address of your bank Swift/Sort code Reporting Requirements Please specify how you want to receive contract notes and statements. (Please note if left blank, standard default position will apply as denoted by *). Fax* Post Encrypted Email If requesting email, please complete the form in Appendix 2. Non-US Persons I/We hereby confirm that I/we am/are not a US Person 1 and that the Shares hereby applied for are not being acquired directly or indirectly by or on behalf of, or for the account of, a US Person*. (please tick the relevant box) Yes No *Applicants who are unable to make this certification should contact the Transfer Agency. 1 U.S. Person means (1) a natural person who is a resident of the U.S.; (2) a Partnership, Corporation or other entity organised under the laws of a U.S. jurisdiction or which has a principal place of business in a U.S. jurisdiction; (3) an estate or trust, the income of which is subject to U.S. income tax regardless of the source, or if any Executor or Transfer Agency of such an estate or any Trustee of such a Trust, as the case may be, is a U.S. Person ; (4) an entity, even if organised under the laws of a non-u.s. jurisdiction and which has its principal place of business in a non-u.s. jurisdiction, organised principally for passive investment such as a pool, Investment Company or other similar entity, if (i) units of participation in such entity held by U.S. Persons represent in the aggregate 10 per cent or more of the beneficial interest in such entity; (ii) such entity was formed principally for the purpose of facilitating investment by U.S. Persons in a pool with respect to which the operator is exempt from certain requirements of Part 4 of the United States Commodity Futures Trading Commission s Regulations by virtue of its participants being non- U.S. Persons ; or (iii) such entity was formed by one or more U.S. Persons principally for the purpose of investing in securities not registered under the 1933 Act, as amended; and (5) a pension plan for the employees, officers or principals of an entity organised and with its principal place of business inside the U.S., or if such plan is established and administered in accordance with the laws of the U.S. 8
Adviser Details If the applicant was introduced to the Company, (any of its sub-funds or Share Classes) by a Third Party Distributor or similar Intermediary please complete the details below. Details of Professional Adviser / Distributor / Intermediary Name Address Regulated Number of Intermediary Name of Regulatory Body Email Address Telephone Number Fax Number Agent s stamp (please complete) FCA Reference No. or, relevant governing body Evidence of identity (advisers only). Is this a retail client? If selection not made, will default to retail client. Yes No Have you attached a completed Identification Verification Form (original or certified)? Yes No Have you verified the source of the Funds to be that of the clients? Yes No 9
Please tick the appropriate box (adviser only). If selection not made, will default to advice received. Advised Execution-Only/Non-Advised RDR Exempt Platform/Aggregated Nominees Please complete the declaration below if you have carried out the Anti-Money Laundering checks on your client. I hereby confirm that I, acting as a regulated intermediary, subject to regulations equivalent to those in Luxembourg, have verified the identity of the client by viewing original identification documentation and will provide certified true copies of the same to the Company or the Transfer Agency upon reasonable request. I confirm that I have attached a completed Letter of Undertaking (Please refer to Appendix 3) Yes: No: Full Name Signature Date Facsimile Indemnity Please complete this section if you want to give your instructions by facsimile. I/We want to give instructions to you by facsimile (please tick box) This indemnity relates to holdings of shares of the Company in accounts in my/our name/company or in respect to which I am/we are authorised to give instructions. I/We want to have the flexibility to give instructions to you by facsimile. I/We acknowledge that facsimile transmission is not a secure form of communication and gives rise to higher risks of manipulation or attempted fraud. Facsimiles may also be of poor quality and thus unclear. Therefore, in consideration of your agreement, at my/our request, to act upon receipt of facsimile instructions with respect to such accounts: a) until you receive written notice to the contrary, I/we authorise you to act upon such instructions without any reference to or further authority from me/us and without enquiry whatsoever, provided that such instructions are or are seen to be given by me/us or by persons who have been notified to you for the purpose in the manner agreed between us; and b) I/We agree to keep you and the Company indemnified from and against all liabilities, losses, costs, actions, proceedings, claims and demands which may be incurred by or brought or made against you or the company arising directly or indirectly from you having acted upon such instructions in the circumstances referred to in (a) above. If this indemnity is given by more than one holder, it will be joint and several. This indemnity is given for the benefit of the Company and the Administrative Agent of the Company, The Bank of New York Mellon (Luxembourg) S.A. The indemnity is governed by and shall be interpreted in accordance with Luxembourg law. The courts of the Grand Duchy of Luxembourg will have exclusive jurisdiction of all disputes arising from this indemnity. Written confirmation may still be requested by The Bank of New York Mellon (Luxembourg) S.A. at their discretion. Redemption proceeds are payable only to the Registered Shareholder to the bank details on file. Such details cannot be changed by facsimile. 10 Governing Law and Submission to Jurisdiction The Application Form shall be governed by and construed in accordance with the laws of Luxembourg and the courts of Luxembourg will have exclusive jurisdiction to settle any dispute arising out of or in connection with this Application Form.
Data Protection Statement In accordance with the provisions of the Luxembourg law of 2 August 2002 on the protection of persons with regard to the processing of personal data, as amended, the Company has to inform the applicant that his/her/its personal data is kept by means of a computer system. The Company collects, stores and processes by electronic or other means the data supplied by applicants at the time of their application for the purpose of fulfilling the services required by the applicant(s) and complying with its legal obligations. The data processed includes the name, address, the account number, the positions and transaction flows, payment details and nationality of each applicant (the Personal Data ). In particular, the Personal Data supplied by the applicant is processed for the purpose of (i) account and distribution fee administration, (ii) anti-money laundering and terrorism financing identification, (iii) maintaining the register of Shareholders, (iv) processing subscription, redemption and conversion orders (if any) and (v) providing client-related services. The Company can delegate to another entity including the Administrator or Transfer Agency, the processing of the Personal Data, in compliance and within the limits of the applicable laws and regulations. For the purposes referred to above, the Company is permitted to transfer such data to other companies or entities within the group of the Administrator, Transfer Agency, Ignis Investment Services Limited (the Investment Manager ) (or affiliates thereof) or any third party and I/we expressly consent to such transfer. Each Shareholder has a right to access his/her/its Personal Data and may ask for a rectification thereof in cases where such data is inaccurate and incomplete. In relation thereto, the Shareholder can ask for a rectification by letter addressed to the Company. The Shareholder has a right of opposition regarding the use of his/her/its Personal Data for marketing purposes. The Shareholder s Personal Data shall not be held for longer than necessary with regard to the purpose of the data processing, observing the legal periods of limitation. Personal Data is usually kept for a period of five years after redemption. We or other companies within the Standard Life Investments group may contact you with details of other products or special offers. If you would like to receive this information please tick this box. 11
Tax regulations Instructions for completion We are obliged under tax regulations to collect certain information about each investor s tax arrangements. Please complete the sections below as directed and provide any additional information that is requested. Please note that in certain circumstances we may be legally obliged to share this information, and other financial information with respect to an investor s interests in the Fund with relevant tax authorities. This form is intended to request information only where such request is not prohibited by Luxembourg law. If you have any questions about this form or defining the investor s tax residency status, please refer to the OECD CRS Portal or speak to a tax adviser. For further information on FATCA or CRS please refer to the following websites: http://www.abbl.lu/en/professionnals/legaltax/fatca or the following link: http://www.oecd.org/tax/automatic-exchange/ in the case of CRS only. If any of the information below about the investor s tax residence or FATCA/CRS classification changes in the future, please advise of these changes promptly. Investors that are individuals should complete the section Individual Self Certification. Investors who are not indiviudals should complete the section Entity Self Certification. Please note that where there are joint or multiple account holders each investor is required to complete a separate Self-Certification form. This form must be completed by each individual unit holder. Where there is more than one investor, please refer to our web site for additional forms www.standardlifeinvestments.com 12
Individual Self-Certification Section 1: Investor Identification (Mandatory fields are marked with an *) Investor Name*: Current Residential Address*: Number: Street: City, Town, State, Province or County: Postal/ZIP Code: Country: Place Of Birth* Town or City of Birth*: Country of Birth*: Date of Birth*: Section 2: FATCA Declaration of U.S. Citizenship or U.S. Residence for Tax purposes*: Please tick either (a) or (b) and complete as appropriate. (a) I confirm that [I am]/[the investor is] a U.S. citizen and/or resident in the U.S. for tax purposes and [my]/[its] U.S. federal taxpayer identifying number (U.S. TIN) is as follows: OR (b) I confirm that [I am not]/[the investor is not] a U.S. citizen or resident in the U.S. for tax purposes. Section 3: CRS Declaration of Tax Residency (please note you may chose more than one country)* Please indicate your/ the investor s country of tax residence (if resident in more than one country please detail all countries of tax residence and associated taxpayer identification numbers ( TIN ). Please see the CRS Portal for more information on Tax Residency. Country of Tax Residency Tax ID Number NOTE: Provision of a Tax ID number (TIN) is required unless you are tax resident in a Jurisdiction that does not issue a TIN. 13
Section 4: Declaration and Undertakings: I declare that the information provided in this form is, to the best of my knowledge and belief, accurate and complete. I acknowledge that the information contained in this form and information regarding the Account Holder may be reported to the tax authorities of the country in which this account(s) is/are maintained and exchanged with tax authorities of another country or countries in which the Account Holder may be tax resident where those countries (or tax authorities in those countries) have entered into Agreements to exchange financial account information. I undertake to advise the recipient promptly and provide an updated Self-Certification form where any change in circumstances occurs which causes any of the information contained in this form to be incorrect. Authorised Signature*: Print Name*: Date: (dd/mm/yyyy)*: Capacity*: 14
Entity Self-Certification for FATCA and CRS Section 1: FATCA Declaration Specified U.S. Person: Please tick either (a), (b) or (c) below and complete as appropriate. a) The Entity is a Specified U.S. Person and the Entity s U.S. Federal Taxpayer Identifying number (U.S. TIN) is as follows: U.S. TIN: Or b) The Entity is not a Specified U.S. Person (please also complete Sections 3, 4 and 5) Or c) The Entity is a US person but not a Specified U.S. Person (please also complete Sections 3, 4 and 5) Section 2: Entity s FATCA Classification* (the information provided in this section is for FATCA, please note your classification may differ from your CRS classification in Section 5): 2.1 Financial Institutions under FATCA: If the Entity is a Financial Institution, please tick one of the below categories and provide the Entity s GIIN at 3.2 I. Luxembourg Financial Institution or a Partner Jurisdiction Financial Institution II. Registered Deemed Compliant Foreign Financial Institution III. Participating Foreign Financial Institution 2.2 Please provide the Entity s Global Intermediary Identification number (GIIN) 2.3 If the Entity is a Financial Institution but unable to provide a GIIN, please tick one of the below reasons: I. The Entity has not yet obtained a GIIN but is sponsored by another entity which does have a GIIN Please provide the sponsor s name and sponsor s GIIN: Sponsor s Name: Sponsor s GIIN: II. III. IV. Exempt Beneficial Owner Certified Deemed Compliant Foreign Financial Institution (including a deemed compliant Financial Institution under Annex II of the Agreement) Non-Participating Foreign Financial Institution V. Excepted Foreign Financial Institution 2.4 Non-Financial Institutions under FATCA: If the Entity is not a Financial Institution, please tick one of the below categories I. Active Non-Financial Foreign Entity II. III. Passive Non-Financial Foreign Entity (If this box is ticked, please include self-certification forms for each of your Controlling Persons) Excepted Non-Financial Foreign Entity 15
Section3: CRS Declaration of Tax Residency (please note that you may choose more than one country)* Please indicate the Entity s country of tax residence for CRS purposes, (if resident in more than one country please detail all countries of tax residence and associated tax identification numbers ( TIN )). NOTE: Provision of a Tax ID number (TIN) is required unless you are tax resident in a Jurisdiction that does not issue a (TIN). If the Entity is not tax resident in any jurisdiction (e.g., because it is fiscally transparent), please indicate that below and provide its place of effective management or country in which its principal office is located. Country of Tax Residency Tax ID Number Section 4: Entity s CRS Classification*(The information provided in this section is for CRS. Please note an Entity s CRS classification may differ from its FATCA classification in Section 3): For more information please see the CRS Standard and associated commentary. http://www.oecd.org/tax/automatic-exchange/common-reporting-standard/common-reportingstandard-and-related-com mentaries/#d.en.345314 4.1 Financial Institutions under CRS: If the Entity is a Financial Institution, please tick one of the below categories I. Financial Institution under CRS(other than (II) below) II. An Investment Entity located in a Non-Participating Jurisdiction and managed by another Financial Institution (If this box is ticked, please indicate the name of any Controlling Person(s) of the Entity and complete a separate individual selfcertification forms for each of your Controlling Persons **) 4.2 Non Financial Institutions under CRS: If the Entity is a Non Financial Institution, please tick one of the below categories I. II. Active Non-Financial Entity a corporation the stock of which is regularly traded on an established securities market or a corporation which is a related entity of such a corporation Active Non-Financial Entity a Government Entity or Central Bank III. Active Non-Financial Entity an International Organisation IV. V. Active Non-Financial Entity other than (I)-(III) (for example a start-up NFE or a non-profit NFE) Passive Non-Financial Entity (If this box is ticked, please complete a separate Individual Self-Certification Form for each of your Controlling Person(s) ) **Controlling Person s: NB: Please note that each Controlling Person must complete a Separate Individual Self-Certification form. If there are no natural person(s) who exercise control of the Entity then the Controlling Person will be the natural person(s) who hold the position of senior managing official of the Entity. 16 For further information on Identification requirements under CRS for Controlling Persons, see the Commentary to Section VIII of the CRS Standard. http://www.oecd.org/tax/automatic-exchange/common-reporting-standard/common-reportingstandard-and-related-commenta ries/#d.en.345314
Section 5: Declarations and Undertakings I/We declare (as an authorised signatory of the Entity) that the information provided in this form is, to the best of my/our knowledge and belief, accurate and complete. I acknowledge that the information contained in this form and information regarding the Account Holder may be reported to the tax authorities of the country in which this account(s) is/are maintained and exchanged with tax authorities of another country or countries in which the Account Holder may be tax resident where those countries (or tax authorities in those countries) have entered into Agreements to exchange financial account information. I/We undertake to advise the recipient promptly and provide an updated Self-Certification where any change in circumstance occurs which causes any of the information contained in this form to be incorrect. Authorised Signature(s)*: Authorised Signature(s)*: Print Name(s)*: Print Name(s)*: Capacity in which declaration is made*: Capacity in which declaration is made*: Date: (dd/mm/yyyy):* 17
Declarations and Signature By signing hereunder, I/we expressly declare, confirm, acknowledge and agree the following: I. I/We confirm that I/we have received and read the information contained in this form and confirm that an up-to-date version of the Key Investor Information Document(s) has been provided to me/us. I/We confirm that I/we have read the Key Investor Information Document and that any additional future investments in the specific Sub-Fund or Share Class of the UCITS as selected by me/us on this form can also be transacted based on this confirmation. I/We understand that future investments in any other Sub-Funds and/or Share Classes of the UCITS will require me/us to complete and sign an additional Application Form. I/We confirm that I/we have regular access to the internet to use the website www.standardlifeinvestments.com to obtain the documents mentioned above and agree to the provision of the information via this medium or have otherwise been provided with paper versions of these documents. I/We request and authorise to act in accordance with my/our instructions. II. Subscription orders will only be accepted if (i) all supporting registration documentation has been received and validated by the Transfer Agency, and (ii) all Anti-Money Laundering supplements have been provided to the satisfaction of the Company and the Transfer Agency before the relevant cut-off time as detailed in the latest version of the Prospectus. III. I/We agree to transfer the correct subscription amount in the correct currency to be received in cleared funds into the correct bank account within the prescribed time limit (as set out in the Prospectus) for a subscription on the relevant Valuation Day (as defined in the Prospectus). IV. I/We hereby acknowledge that the Company reserves the right to reject any application for shares of the Company or any of it sub-funds in whole or in part. I/We hereby acknowledge that I/we have received and read the current Prospectus relating to the Company and that this application is made subject to the terms of the Prospectus and to the Articles of Incorporation of the Company. V. I/We have read a copy of the latest Prospectus of the Company and am/are fully aware of and understand the financial risk associated with a subscription for Shares of the Company or any of its sub-funds and I/we accept that any market fluctuations may lead to a loss of all or part of my/our investment. VI. I/We hereby declare that the Shares are not being acquired and will not be held in violation of any applicable laws. VII. I/We, the undersigned, declare that I/we are not acting on behalf of US Person1(s), nor do I/we intend selling or transferring any Shares which I/we may purchase to any person who is a US Person1. VIII. I/We hereby confirm that I/we shall be deemed to make, on a continuing basis, each of the statements contained herein unless I/we notify you to the contrary in relation to any Shares I/we may hold or obtain at any time. IX. I/We consent to details of our shareholding being disclosed to the Investment Manager or any companies within the Investment Manager s group of companies. 18 X. I/We understand that the subscription will be effected within three (3) Business Days from the relevant Valuation Day; or in the case of late payment of subscription amounts or non-payment of the correct subscription amounts, such subscription may be cancelled. I/We understand and agree that, in determining whether cleared subscription monies have been received into the relevant subscription account prior to the payment cut-off time for subscriptions of the relevant currency on the relevant Valuation Day, the records of the Transfer Agency s receiving bank shall be conclusive and shall take precedence in the event of any discrepancy with the records of my/our transferring bank. I/We hereby agree that none of the Company, the Directors, the Investment Manager or the Transfer Agency shall have any liability whatsoever in respect of any late or non-payment of subscription monies (including without limitation any dispute in respect
of the timing of receipt of subscription monies) and I/we hereby agree to indemnify and hold harmless the Company, the Directors, the Investment Manager and the Transfer Agency against any loss, liability, cost or expense (including without limitation legal fees, taxes and penalties) which may result directly or indirectly, from any late or non-payment of subscription monies. XI. I/We understand and acknowledge that all subscriptions are subject to, and will only be effected after, the necessary Anti-Money Laundering checks have been completed to the satisfaction of the Company, the Transfer Agency and/or the Investment Manager. I/We understand and acknowledge that, in certain circumstances, applications submitted prior to the applicable cut-off time for the relevant Valuation Day may not afford sufficient time for the completion of the necessary checks in time to process such subscription on the requested Valuation Day and that, consequently, subscriptions may be effected on a subsequent Valuation Day once such checks have been satisfactorily completed. I/We hereby acknowledge and agree that none of the Company, the Directors, the Investment Manager or the Transfer Agency shall have any liability whatsoever in respect of any loss, liability, cost or expense (including without limitation legal fees, taxes and penalties) which may result, directly or indirectly, from any delay in processing any subscription application (including without limitation any failure to process any subscription application on the requested Valuation Day), due to carrying out such Anti-Money Laundering checks. XII. I/We hereby confirm that I/we and the persons I/we represent as agent or nominee or our beneficial owners or persons who control us or are controlled by us are not a prohibited country, territory, individual or entity listed on the US Department of Treasury s Office of Foreign Assets Control ( OFAC ) website at www.treas.gov/ofac or that any of them is, as described in the website, a foreign shell bank or a senior foreign political figure or an immediate family member or close associate of a senior foreign political figure and subscription monies are not directly or indirectly derived from activities that may contravene United States federal or state, or international, laws and regulations, including anti-money laundering laws and regulations. XIII. When making and signing an application all authorised signatories must authorise any dealing or other instructions in writing unless a separate signing authority has been completed and received by the Transfer Agency. Please request separate signing authority from the Transfer Agency if required. XIV. I/We hereby agree to indemnify and hold harmless the Company, the Directors, the Investment Manager and Transfer Agency, against any loss, liability, cost or expense (including without limitation legal fees, taxes and penalties) which may result directly or indirectly, from any misrepresentation or breach of any warranty, condition, covenant or agreement contained herein or in any other document delivered by the undersigned to the Company. XV. I/We hereby confirm that the Company, the Directors, the Investment Manager and the Transfer Agency are each authorised and instructed to accept and execute any instructions in respect of the shares to which this Application Form relates given by me/us by facsimile. I/We hereby agree to indemnify the Company, the Directors, the Investment Manager and the Transfer Agency and agree to keep each of them indemnified against any loss, liability, cost or expense (including without limitation legal fees, taxes and penalties) of any nature whatsoever arising to each of them as a result of any of them acting on such facsimile instructions. The Company, the Directors, the Investment Manager and the Transfer Agency may rely conclusively upon and shall incur no liability in respect of any action taken upon any notice, consent, request, instructions or other instrument believed, in good faith, to be genuine or to be signed by properly authorised persons. 19
Legal Persons I/We hereby declare that I am/we are:- (i) a legal person not being an individual and not acting in a representative capacity on behalf of an individual; or (ii) an entity liable to corporation tax in Luxembourg or an equivalent tax in another country; or (iii) an undertaking for collective investment in transferable securities ( UCITS ) or have elected for the purpose of the EU Savings Directive to be treated as a UCITS. If the Legal Person is unable to make any of these declarations please contact the Transfer Agency. For corporate applications, the full title of the corporation and its registered office must be provided within the Registered Shareholder Details Section. An application on behalf of a Company must be executed by two duly authorised officers whose capacity must be stated. New investors should also attach an original/certified copy authorised signatory list. In the case of a Partnership/Firm (not a limited company) applications should be in the name(s) of and signed by all Partners/Proprietor(s). If there is insufficient space below to provide details of all the relevant individuals, please tick here and continue onto a separate sheet of paper which should be attached to this form. Person 1 Person 2 Full Name Full Name Capacity Capacity Signature Signature Date Date Natural Persons 1. I/We hereby declare that I am/we are making this investment on my/our own behalf and not on behalf of any other person or entity. 2. I/We acknowledge that I/we will provide a certified copy of my/our Passport or a national identity card which must display a photograph, signature and give details of my/our date and place of birth. I/We will also provide details of my/our tax identification number if this does not appear on the Passport or other identity card provided. Documentary proof such as a certificate of tax residency from a relevant tax authority may also be required. 3. I/We confirm that I am/we are over 18 years of age. 4. I/We agree to undertake to ensure all such information is up to date and will notify the Transfer Agency of any change in the information provided as soon as reasonably possible. 20 5. I/We agree to indemnify and hold harmless the Transfer Agency in its capacity as Paying Agent against any loss liability costs or expenses which may be incurred by the Transfer Agency as a result of my/our failure to provide the information required. I/We acknowledge that Shares may not be issued and repurchase proceeds may be frozen until all required information and documentation required by the Transfer Agency pursuant to the EU Savings Directive is provided.
Applicant Signatures (All applicants must sign) Signature (First Authorised Signatory) Date Signature (Second Authorised Signatory) Date Signature (Third Authorised Signatory) Date Signature (Fourth Authorised Signatory) Date When complete, please return this Application Form and the relevant payment to Transfer Agency, The Bank of New York Mellon (Luxembourg) S.A., Attn AIS Investor Services,, 2-4, Rue Eugène Ruppert, L-2453 Luxembourg. Telephone + (352) 24 52 4363 or Fax + (352) 24 52 4237. 21
APPENDIX 1 Anti-Money Laundering Supplement You (the Investor ) must complete this supplement (the Anti-Money Laundering Supplement ) in order to become an Investor in the Fund. Your subscription agreement will not be deemed complete, and you will not be deemed an investor in the Fund, regardless of whether you have already wired funds, until all of the required documentation listed below is received by The Bank of New York Mellon (Luxembourg) S.A. ( BNYM ), the Transfer Agency. Any delay in providing documentation may result in delayed processing of the application and or delayed payment of any future payment proceeds. Depending on its risk assessment of an Investor, the Transfer Agency reserves the right to request additional documentation as may be required from time to time. Enhanced Due Diligence is required on investors and/or related parties who are Politically Exposed Persons (PEPs). The Transfer Agency will require additional information where the investor and/or related parties is a PEP or in order to disregard the investor as a possible PEP. See Section III (c) for further information. Section II details the documentation requirements per the more frequently seen Investor types, for further information, please contact the Investor Services Department on +352-24 52 43 63 or by email at LUXMB-TA_AIS@bnymellon.com I. APPLICANT DETAILS: Name of Applicant: Residential/Registered Address: Occupation (if applicable): Business / Economic sector: Country (ies) where operations are based: Date of Birth / Date of Incorporation: Place of Birth: Country of Birth: Beneficial Owners (For Companies the natural persons with a controlling interest and for Trusts the settlor, the trustee or person exercising effective control over the trust, and the beneficiaries) 22
II. ADDITIONAL INFORMATION The following materials must be provided to the Transfer Agency (BNYM) and all copies must be certified by an appropriate authority^ 1. Intermediary 1 - Supervised and based in an AML equivalent jurisdiction Please provide the name of your Regulator and Licence or Registration Number: Name of Regulatory Authority or website URL: Registration/License No: Certificate of Supervision or proof of supervision extracted from an official register of the Supervisory Authority. Certified true copy or if appropriate, originals of a current and dated list on company letterhead of all authorised signatories or an officially published booklet of authorised signatories (there is no certification required for the booklet). 2. Intermediary 2 - Based in an AML equivalent jurisdiction where parent is a Supervised Financial Institution also based in an AML equivalent country Certified true copy or if appropriate, originals of a current and dated list on company letterhead of all authorised signatories or an officially published booklet of authorised signatories (there is no certification required for the booklet). Certified true copy or if appropriate, originals of the evidence of registration e.g. extract of commercial register, Certificate of Incorporation (Certificate of Good Standing available in certain countries only) or extract from an official governmental website Certified true copy of the shareholders register and analysis to prove the ownership of the intermediary by a Parent Financial Institution in an AML country or documented analysis of the beneficial owner(s) should be undertaken and the verification of their identity(ies) performed as per requirements listed under private individual at section II 6. of this Anti-Money Laundering supplement Certificate of Supervision or proof of supervision for the Parent Company extracted from an official register of the Supervisory Authority (no certification needed). Please provide the name of the Supervisory Authority and Licence or Registration Number of the Parent Company: Name of Regulatory Authority or website URL: Registration/License No: ^All documents have to be certified true by a local competent authority e.g. embassy, consulate, notary, police commissioner, or by a financial institution which is subject to customer identification standards equivalent to those in force in Luxembourg. Each document should be stamped, Certified as True Copy of Original documentation, dated, signed, and include the address, telephone number and contact details of the certifying body. 23
3. Intermediary 3 - Supervised and based in an non-aml equivalent jurisdiction in Lower Risk Countries. Please contact BNYM for confirmation of country risk rating Please provide the name of your Regulator and Licence or Registration Number: Name of Regulatory Authority or website URL: Registration/License No: Certificate of Supervision or proof of supervision extracted from an official register of the Supervisory Authority. Certified true copy or if appropriate, originals of a current and dated list on company letterhead of all authorised signatories or an officially published booklet of authorised signatories (there is no certification required for the booklet). Certified true copy of the shareholders register and analysis to prove the ownership of the intermediary by a Parent Financial Institution in an AML country or documented analysis of the beneficial owner(s) should be undertaken and the verification of their identity(ies) performed as per requirements listed under private individual at section II 6. of this Anti-Money Laundering supplement Certified true copy of the most recent register of Directors Identification documents of the signatories who signed the application form as per performed as per requirements listed under private individual at section II 6. of this Anti-Money Laundering supplement Copy of the latest Audited Financial Report 4. Intermediary 4 - Supervised and based in an non-aml equivalent jurisdiction in Higher Risk Countries. Please contact BNYM for confirmation of country risk rating Please provide the name of your Regulator and Licence or Registration Number: Name of Regulatory Authority or website URL: Registration/License No: Certificate of Supervision or proof of supervision extracted from an official register of the Supervisory Authority. Certified true copy or if appropriate, originals of a current and dated list on company letterhead of all authorised signatories or an officially published booklet of authorised signatories (there is no certification required for the booklet). Certified true copy of the shareholders register and analysis to prove the ownership of the intermediary by a Parent Financial Institution in an AML country or documented analysis of the beneficial owner(s) should be undertaken and the verification of their identity(ies) performed as per requirements listed under private individual at section II 6. of this Anti-Money Laundering supplement Certified true copy of the most recent register of Directors Identification documents of the signatories who signed the application form as per performed as per requirements listed under private individual at section II 6. of this Anti-Money Laundering supplement 24 Copy of the latest Audited Financial Report
5. Private individual, national or resident in a low/medium-risk country (please check country classification with the BNYM) (Documentation is required for each Joint holder as applicable) Certified true copy of a valid Passport including name, identification number, signature, photo ID, place and date of birth as well as the expiration date or Certified true copy of a valid Identity Card including name, identification number, signature, photo ID, place and date of birth as well as the expiration date or Certified true copy of a valid Driving License including name, signature and photo ID (only accepted if Passport or Identity Card are unobtainable). Certified true copy of a recent proof of residence i.e. utility bill, broker statement (less than 3 months old). Individual confirms that they are investing on their own behalf. Yes: No: 6. Private individual, national or resident in a high-risk country (please check country classification with BNYM) as well as Politically Exposed People (PEPs) (Documentation is required for each Joint holder as applicable) Certified true copy of a valid Passport including name, identification number, signature, photo ID, place and date of birth as well as the expiration date. Certified true copy of a valid Identity Card including name, identification number, signature, photo ID, place and date of birth as well as the expiration date. Certified true copy of a valid Driving License including name, signature and photo ID (only accepted if Passport or Identity Card are unobtainable). Certified true copy of a recent proof of residence i.e. utility bill, broker statement (less than 3 months old). Source of Wealth: Occupation of the investor(s): 7. Supervised Financial Institution based in an AML Equivalent country Evidence of Supervision or proof of supervision extracted from an official register of the Supervisory Authority. Please provide the name of your Supervisory Authority and Licence or Registration Number: Name of Supervisory Authority or website URL: Registration/License No: Certified true copy or if appropriate, originals of a current and dated list on company letterhead of all authorised signatories or an officially published booklet of authorised signatories (there is no certification required for the booklet). 25
8. Supervised Financial Institution based in a non-aml Equivalent country but not Higher Risk Countries. Please contact BNYM for confirmation of country risk rating Evidence of Supervision via an extract of the Supervisory Authority register. Please provide the name of your Supervisory Authority and Licence or Registration Number: Name of Supervisory Authority or website URL: Registration/License No: Certified true copy or if appropriate, originals of a current and dated list on company letterhead of all authorised signatories or an officially published booklet of authorised signatories (there is no certification required for the booklet). Certified true copy of original identification documents of the signatories who signed the application form as per requirements listed under private individual on Page S-4 of this supplement (i.e. ID card or passport plus proof of residence). Certified true copy of the Article of Association / Incorporation Certified true copies or if appropriate, originals of the Certificate of Incorporation or extract from an official governmental register (not required if evidence of supervision has been provided from the Supervisory Authority) Certified true copy of the latest register of Directors (Certificate of Incumbency available in certain countries only) Certified true copy or if appropriate, originals of the evidence of registration e.g. extract of commercial register, Certificate of Incorporation (not required if supervised and if evidence of supervision has been provided from the Supervisory Authority). Certified true copy of the shareholders register and / or inventory of beneficiaries. Based on the shareholder register, a documented analysis of the beneficiaries holding (directly or indirectly) more than 25% of the company shares owner(s) should be undertaken and validated by the investor. Verification of the identity(ies) of the beneficiary(ies) holding (directly or indirectly) more than 25% of the company shares should be performed as per requirements listed under private individual on Page S-4 of this supplement (i.e. ID card or passport plus proof of residence). Copy of the latest Audited Financial Report 9. Supervised Financial Institution based in a non-aml Equivalent country and Higher Risk Countries. Please contact BNYM for confirmation of country risk rating Evidence of Supervision via an extract of the Supervisory Authority register. Please provide the name of your Supervisory Authority and Licence or Registration Number: Name of Supervisory Authority or website URL: Registration/License No: 26 Certified true copy or if appropriate, originals of a current and dated list on company letterhead of all authorised signatories or an officially published booklet of authorised signatories (there is no certification required for the booklet).
Certified true copy of original identification documents of the signatories who signed the application form as per requirements listed under private individual at section II 6. of this Anti-Money Laundering supplement(i.e. ID card or passport plus proof of residence). Certified true copy of the Article of Association / Incorporation Certified true copies or if appropriate, originals of the Certificate of Incorporation or extract from an official governmental register (not required if evidence of supervision has been provided from the Supervisory Authority) Certified true copy of the latest register of Directors (Certificate of Incumbency available in certain countries only) Certified true copy or if appropriate, originals of the evidence of registration e.g. extract of commercial register, Certificate of Incorporation (not required if supervised and if evidence of supervision has been provided from the Supervisory Authority). Certified true copy of the shareholders register and / or inventory of beneficiaries. Based on the shareholder register, a documented analysis of the beneficiaries holding (directly or indirectly) more than 25% of the company shares owner(s) should be undertaken and validated by the investor. Verification of the identity(ies) of the beneficiary(ies) holding (directly or indirectly) more than 25% of the company shares should be performed as per requirements listed under private individual at section II 6. of this Anti-Money Laundering supplement (i.e. ID card or passport plus proof of residence). Copy of the latest Audited Financial Report Source of Funds for the investment: 10. Trusts (including Pension Schemes/Plans/Funds set up as a Trust) where the Trustee is a Supervised Financial Professional in an AML Equivalent country Identification of the Trustee where it is a Financial Professional in an AML equivalent country: Trustee s evidence of Supervision or proof of supervision extracted from an official register of the Supervisory Authority Please provide the name of your Supervisory Authority and Licence or Registration Number: Name of Supervisory Authority or website URL: Registration/License No: Trustee s certified true copy or if appropriate, originals of its current and dated list on company letterhead of Signing Powers (including specimen signatures and powers of the persons who instructs the transactions ) or an officially published booklet of Signing Powers (including specimen signatures and powers of the persons who instructs the transactions - there is no certification required for the booklet) Certified copy of trust deed or a certified extract of the latest Trust Deed which identifies the purpose of the trust: the settlor the source of funds the protector (if applicable) 27