Private Client Application Form For the Inheritance Tax Portfolio Service via a Financial Advisor The services we provide to you will be based upon the information in this application form. It is therefore important that you give us as much relevant detail as possible. By completing this form, you confirm that you have provided details of your investment objectives, risk tolerance and financial situation to your financial advisor and that you will notify your financial advisor in writing of any change. You confirm that you can financially bear the associated investment risks consistent with your investment objectives. If you are unsure about this you should contact your financial advisor regarding the risks involved. The capital you ask us to invest should be capital that you are comfortable to invest in the stockmarket where the future value of your investment may fluctuate. Section 1 - Personal Details Main account holder Title: Surname: Forename(s): Date of birth: Mother s maiden name: Nationality: Country of residence for tax purposes: Domicile: Occupation: Marital Status: National Insurance Number: Relationship between account holders (if applicable) Permanent residential address: Joint account holder (if applicable) Title: Surname: Forename(s): Date of birth: Mother s maiden name: Nationality: Country of residence for tax purposes: Domicile: Occupation: Marital Status: National Insurance Number: Relationship between account holders (if applicable) Permanent residential address: You will receive any electronic correspondence at this e-mail address. If you do not wish to receive e-mail correspondence please indicate your mailing address below: Same as above Address if different from above: You will receive any electronic correspondence at this e-mail address. If you do not wish to receive e-mail correspondence please indicate your mailing address below: Same as address above Address if different from above: Telephone (mobile): Telephone (mobile): APP0114 Private Client Application Form for the IHT Service via a Financial Advisor October 2013 www.canaccord.com/wm 1
Main account holder Telephone (home): Telephone (work): Fax: Joint account holder (if applicable) Telephone (home): Telephone (work): Fax: Security questions to help protect your account Main account holder Name of first school: Father s first name: Joint account holder (if applicable) Name of first school: Father s first name: We are required to ascertain the origin of the money that we will be investing on your behalf, e.g. sale of business, inheritance, savings. Please provide details: If you are a Channel Islands or EU resident, other than the UK, your Tax Identification Number: Section 2 - Assets and Authorities Nominee service All investments forming part of your portfolio will be held for you by our Nominee company. Your investments will be held in accordance with the rules of the FCA and as specified in our Nominee and Safe Custody Terms. Bank details - Your main bank/building society account Name of account holder(s): Name of bank/building society: Address of bank/building society: Account number: Sort code: Building society reference number (if applicable): IBAN: APP0114 Private Client Application Form for the IHT Service via a Financial Advisor October 2013 www.canaccord.com/wm 2
Requests for information Canaccord Genuity Wealth Management and its associates may give to the following people any information requested in relation to my/our account (tick box as appropriate): Accountant: Solicitor: Tax advisor: Other: Section 3 - Service Details Amount of money to be invested (Minimum 50,000) Section 4 - Risk Warning in Respect of This Service Before completing this section you should read our Guide to Risk and Investment. The Inheritance Tax Portfolio Service should be regarded as high risk as it exclusively invests in equity securities listed on the LSE s Alternative Investment Market (AIM). Portfolios are likely to have a significant exposure to small capitalisation stocks. By their nature small capitalisation stocks have more volatile prices and may have poor or no liquidity. The portfolio is therefore exposed to significant capital losses. We are not providing a tax advisor service and independent professional advice should be obtained. The value of shares purchased and any income derived from them may go down as well as up and investors may not get back the full amount invested. Past performance is not necessarily a guide to future performance. AIM shares tend to be relatively illiquid and therefore may be difficult to deal in. It may also be difficult to obtain reliable information as to the value and the risks to which the shares may be exposed. The Inheritance Tax Portfolio Service cannot guarantee that all investments made will continue to qualify for relief from Inheritance Tax or if they do initially qualify that they will continue to do so. The current Inheritance Tax rules may change in the future. Tax treatment depends upon individual circumstances of each client and may be subject to change in the future. The investments discussed in this document may not be suitable for all investors. Investors should make their own investment decisions based upon their own financial objectives and financial resources and, if in any doubt, should seek advice from an investment advisor. APP0114 Private Client Application Form for the IHT Service via a Financial Advisor October 2013 www.canaccord.com/wm 3
Section 5 - Correspondence If this section is not completed, correspondence will be sent to the account holder as indicated in section 1. Please indicate other addresses where the following should be forwarded. First Addressee i. Copy Contracts ii. Copy Statements Second Addressee i. Copy Contracts ii. Copy Statements iii. Copy Valuations iii. Copy Valuations APP0114 Private Client Application Form for the IHT Service via a Financial Advisor October 2013 www.canaccord.com/wm 4
Section 6 - Financial Advisor s Details If you require copy contracts, statements and valuations please complete section 5. Financial Advisor s Financial Advisor s Financial Advisor s telephone number: Initial advisor fee payable (maximum 3%): Ongoing advisor fee payable (maximum of 0.5%): I/We certify, I/We confirm we have assessed the suitability of the service in accordance with the FCA and will notify Canaccord Genuity Wealth Management immediately of any change in the client s circumstances that may affect the management of the portfolio. I/We confirm the verification of identity of the Client(s) introduced in accordance with the Money Laundering Regulations 2007. We herby provide an introductory certificate along with supporting documentation. I/We have not been able to confirm the verification of the Client(s) for the following reasons: I/We will inform Canaccord Genuity Wealth Management of any change in the Financial Advisor VAT status. Introducers signature: Date: Introducer s Stamp: If you wish us to facilitate the payment of your financial advisor s initial and/or ongoing advisor fee, please indicate this on the signature page. APP0114 Private Client Application Form for the IHT Service via a Financial Advisor October 2013 www.canaccord.com/wm 5
Section 7 - Assent These are standard terms upon which Canaccord Genuity Wealth Limited intends to rely. For your own benefit and protection you should read these terms carefully before signing them. If you do not understand any point please ask for further information. 1. I/we have received, read and understood the Discretionary Portfolio Management Agreement, the Terms of Business, ISA and Junior ISA terms, Nominee and Safe Custody Services Agreement, where applicable, and confirm that I/we have read and agreed to such terms and agree that they will apply from 31st January 2013. 2. I/we accept the charges set out in the Schedule of Charges in respect of the services provided to me/us by Canaccord Genuity Wealth Limited. 3. I/we have provided details of my/our investment objectives, risk tolerance and financial situation to my financial advisor and will notify my/our financial advisor in writing of any change. I/we confirm that I/we can financially bear the associated risks consistent with my investment objectives. 4. I/we have read your Order Execution Policy for Retail Clients and confirm that I/we accept the terms thereof including but not limited to: a. Consent to orders being executed outside a regulated market / Multilateral Trading Facility (MTF); and b. Consent not to publish limit orders. 5. I/we are investing excess capital and understand the value will fluctuate. 6. Where more than one person has signed this agreement, Canaccord Genuity Wealth Limited may rely on information provided by either party regarding the others circumstances and make their recommendations accordingly. 7. Where we are also Trustees of the Trust, I/we confirm that this Client Agreement and accompanying Schedules are also accepted on behalf of the Trust. 8. I/we understand that my financial advisor listed below providing me/us with financial advice will charge me/us a fee for that advice and I/we instruct and consent to Canaccord Genuity Limited until 31st January and thereafter Canaccord Genuity Wealth Limited facilitating the payment of such fee to that intermediary directly from my account with you. 9. I/We agree that CGWM may communicate with us electronically (including the provision of documents), for which purposes I/we have provided my/our e-mail address in Section 1. Financial advisor: (insert name) (Block Capitals) Signed: Date: (Block Capitals) Signed: Date: Please use additional signature pages as may be required by you or your consultation/trust requirements if applicable. Canaccord Genuity Wealth Limited is authorised and regulated by the Financial Conduct Authority, and is a wholly owned subsidiary of Canaccord Genuity Group Inc. Registered office: 41 Lothbury, London, EC2R 7AE. Registered in England & Wales no.03739694. APP0114 Private Client Application Form for the IHT Service via a Financial Advisor October 2013 www.canaccord.com/wm 6