OFFSHORE APPLICATION FOR LEGAL ENTITIES BEFORE YOU INVEST ADDITIONAL INFORMATION Make an informed decision: Refer to the fund factsheets (minimum disclosure documents) and the Allan Gray Offshore Platform Fund List for information on the unit trusts we offer. Certain unit trusts are subject to availability. Please also refer to the schedules of similarities and differences between South African regulations and the regulations governing Foreign Collective Investment Schemes. Consider getting financial advice: Allan Gray does not provide financial advice. However, we believe in the merits of good independent advice. If you are not comfortable making your own investment decisions, consider using the services of an independent fi nancial adviser (IFA). To locate an IFA in your area, refer to the Find an adviser section of our website. South African companies and South African trusts need to obtain SARB approval. If you wish to make use of Allan Gray's preferred foreign exchange administrator, please complete section 6 of this form. For more information on foreign exchange administrators, please contact the Client Service Centre. Complete all the information on the form to ensure that there is no delay in processing your investment. Read and agree to the Offshore Terms and Conditions to understand the rules of your investment. STEP 1 COMPLETE THE FORM & AGREE TO THE Ts & Cs STEP 2 SEND DOCUMENTS STEP 3 MAKE PAYMENT CUT-OFF TIMES Send the following documents to: Email: instructions@allangray.co.za or Fax: 0860 000 655 or +27 (0)21 415 2492 Completed 'Offshore application for legal entities' form FICA documents as set out in Annexure A Resolution signed by all authorised signatories Proof of bank details (e.g. cancelled cheque or bank statement) SARB approval form (SA entities and SA trusts only) Please note that Allan Gray may request additional documents (over and above the documents listed here) in certain instances. This may require certification. You will be notifi ed of this by the administrator. Please make payment into the Administrator's relevant bank account and send us proof of payment Please refer to Annexure C for the relevant bank account details in order for you to make payment. The Allan Gray bank account details are also included in Annexure C, if you have chosen to pay your annual administration and annual fi nancial adviser fees from the Allan Gray Money Market Fund (ZAR). Refer to the Allan Gray Offshore Investment Platform fund list for each unit trust's trading frequency, cut-off day and trading day. Please note that if instructions and documents are received: Before 14:00 on a business day, we will start processing on that day. After 14:00 on a business day, we will start processing on the next business day. On a weekend or public holiday, we will start processing on the next business day. We need the following documents for all representatives acting on behalf of and the contact person for the legal entity: Completed Annexure B Proof of authority (e.g. power of attorney) Copy of South African bar-coded ID or valid passport (if foreign national) We will process your instruction once we receive all the required documents and your lump sum payment. You will receive confi rmation once your instruction has been processed. You will receive an Allan Gray Online account with this investment and will be contacted to activate your Allan Gray Online account within two business days of your instruction being processed. WHAT HAPPENS NEXT? Contact us if you need help: Call 0860 000 654 between 07:30-17:30 (Mon - Fri) or Email: info@allangray.co.za
No. 1.0 June 2016 1. Please provide us with your details OFFSHORE APPLICATION FOR LEGAL ENTITIES Allan Gray Investment Services Proprietary Limited ( The Administrator ), an authorised administrative fi nancial services provider, is the Administrator. Type of entity Foreign company Foreign trust Other (specify) In terms of an inter-governmental agreement between SARS and the IRS, we are required by law to establish the nature of legal entities investing with us. Are you a fi nancial institution (e.g. bulk dealer, stock broker, bank, etc)? Yes Provide us with your Global Intermediary Identifi cation Number (GIIN) No Do you derive more than 50 of your income from fi nancial investments? Yes No Details of the legal entity Registered name Registered number Trading name Tax identifi cation number VAT number Domicile Registered address (head office) Country of issue Business operating address If the same as the registered address (head offi ce), please tick this box Postal address If the same as the registered address (head offi ce), please tick this box If the same as the business operating address, please tick this box Details of the contact person Title Surname First name(s) Nationality Mobile Email Telephone (w) Fax Allan Gray Proprietary Limited is an authorised fi nancial services provider. 1 of 7
2. How much would you like to invest? You must invest a lump sum of at least US$10 000 (or foreign currency equivalent). You must invest a minimum of US$1 000 (or foreign currency equivalent) per unit trust. Complete your total investment amount in transfer currency US$ EUR AUD GBP JPY ZAR How would you like to invest your money? You must allocate your lump sum into one or more unit trusts. Indicate the percentage per unit trust in the table below: Unit trust code Unit trust Currency Percentage Please ensure that the percentage allocated across funds add up to 100. Would you like to pay your annual financial adviser and/or administration fees from a money market unit trust? If you are investing with the help of an independent financial adviser, you may choose to have your annual financial adviser fees deducted from either the Allan Gray Money Market Fund (in rands), or from a foreign currency Money Market Unit Trust (in the relevant currency). The same applies for your annual administration fees. If you choose to have these fees deducted from a foreign currency Money Market Unit Trust, please tick this box and complete the unit trust details below: Unit trust code Unit trust Currency Ensure that you have allocated a portion of your investment to this unit trust in the table above.. If you choose to have these fees deducted from the Allan Gray Money Market Fund, please tick this box and complete the details of your money market investment below: Investment amount (a minimum of R10 000 applies) R My investment into the Allan Gray Money Market Fund for the purpose of paying fees will be via: Electronic transfer (refer to Annexure C for our bank details) A transfer from my Allan Gray Money Market Fund held in my existing local Allan Gray investment account AGUT account AGLP account The Allan Gray Money Market Fund is only available on the offshore platform for the purposes of paying these fees, not for general investment. You do not need to add the Allan Gray Money Market Fund to your unit trust selection in the table above. 2 of 7
3. How to pay us your lump sum It is your responsibility to transfer your money to the relevant bank account held at Citibank. Please use the legal entity s name as a reference to enable the Administrator to identify your money and start processing your investment. This is also required by international money laundering legislation. All bank accounts can be found in Annexure C of this application form. The Administrator (Allan Gray Investment Services) only accepts GBP, US$, EUR, JPY and AUD deposits via bank transfer. Cheques are not accepted. Please note that routing costs will apply (after conversion) if a correspondent bank is used to make payment to Allan Gray. Do you hold the currency of the unit trust you want to invest in? Electronic transfers should be made in favour of Beneficiary customer: Allan Gray Investment Services Client Subscription Account. Do you hold foreign currency that is different to the unit trust you want to invest in? Instruct your bank to convert your money into the currency of the unit trust(s) you want to invest in and transfer it into the relevant currency bank account(s) with the Administrator. Transfer your money in the currency you hold to the matching currency bank account with the Administrator. The Administrator will convert your money to the correct currency, or split the money and convert it to the correct currencies if the unit trusts you selected are not all offered in the same currency. Do you hold South African rands? Use the services of an independent foreign exchange administrator (refer to section 6). Instruct your bank to convert your money into the currency of the unit trust(s) you want to invest in and then transfer it into the relevant currency bank account(s) with the Administrator. The Administrator will convert your money to the correct currency, or split the money and convert it to the correct currencies if the unit trusts you selected are not all offered in the same currency. 4. Where does the money come from? This information is required by legislation and we need it in order to process your investment. Please make a selection below: Existing Allan Gray account Capital/savings Company profit Donation Transfer from other financial services provider Other (specify) 5. Where is the legal entity registered for tax purposes? The legal entity may be required to pay Interest Withholding Tax (IWT) on local interest distributed, depending on where it is registered for tax purposes. If the legal entity is registered in South Africa for tax purposes, please tick this box. IWT will not apply. If the legal entity is not registered in South Africa for tax purposes, please tick this box. A default IWT rate of 15 will apply except if a reduced IWT rate is applicable. Country of residence for tax purposes (Country where the entity was incorporated) Effective date of tax residency D D M M Y Y Y Y 3 of 7
The legal entity may qualify for a reduced rate if there is a Double Taxation Agreement (DTA) in place between South Africa and their country of residence. If the legal entity qualifies for a reduced rate for IWT, Allan Gray will apply the reduced rate as contained in the article number as referenced in the Withholding Tax Annexure on www.allangray.co.za, based on the country of residence for tax purposes. By selecting a country of residence for tax purposes (other than South Africa) you declare that the legal entity is not registered in South Africa for tax purposes and that the reduced rate and article number as contained in the Withholding Tax Annexure applies to your investment. I have seen and read the Withholding Tax Annexure as available on www.allangray.co.za 6. Incompass - Foreign exchange administration services Allan Gray has negotiated with Incompass, an authorised financial services provider, to provide foreign exchange administration services to you at preferential rates. By completing and signing this section of the form, you request Incompass to provide you with foreign exchange administration services. Do you want to make use of Incompass s services? Yes No Incompass will be in contact to provide all the necessary information pertaining to the foreign exchange transaction. Who would you like Incompass to contact? Me My financial adviser If you select My financial adviser, please complete the independent financial adviser section at the end of this form in full. Signature of investor Date D D M M Y Y Y Y 7. Provide us with your bank account details Payments will be made in the currency of your unit trust. Please make sure that your bank account is able to accept multiple currencies. We make all payments electronically to a bank account in the investor s name. We will not make any payments to credit cards, market-linked accounts or third party bank accounts. Name of account holder Name of bank SWIFT code IBAN/Account number Type of account Current/Cheque Savings Currency of account US$ GBP EUR ZAR JPY AUD 8. How should we communicate with you? We will send all communications to you via email. If you prefer post or do not have an email address, please tick this box. Your quarterly statements and other communications relating to your account may reflect the currency of your choice. Please select currency US$ GBP EUR ZAR JPY AUD Manage your investments online You will receive an Allan Gray Online account with this investment. Allan Gray Online enables you to view your personal and investment details (e.g. bank account details, account balance, transaction history) and manage your investments (e.g. perform transactions) online. We need an email address to set up your online account. If you do not want online access, please tick this box. 4 of 7
9. Investor declaration I confirm that all information provided in this form and all other documents signed by me in connection with this application, whether in my handwriting or not, are correct. I am responsible for the accuracy and completeness of all answers, statements or other information provided by me or on my behalf. I have not received advice from the Administrator regarding this application. I confirm that the Administrator may accept instructions from any authorised third party who has been authorised by me in writing. I confirm that the Administrator may accept instructions in the prescribed format by fax or via other electronic means. I have read and understood the Allan Gray Offshore Investment Platform fund list or the investment overview as well as the relevant fund factsheet (minimum disclosure document) of the unit trusts I wish to invest in. I have read, understood and agree to the Terms and Conditions. I confirm that I will take responsibility for any tax requirements governed by my country of residence at the time of this investment. I confirm that I will take responsibility for, and have received, the necessary exchange control approvals and/or authorisations as may be necessary to undertake this investment. I agree that my contractual relationship with the Administrator will be subject to South African law and regulation (including but not limited to Exchange Control and tax requirements). I confirm that if I am not a South African resident, my investment through the Administrator is based on my own initiative and not due to any offer or solicitation by the Administrator. I declare that I comply with the relevant provisions in the Income Tax Act and, where applicable, the requirements in terms of the relevant double taxation agreement (DTA) in force between the Republic of South Africa and the country of residence I have specified above as contained in the article number as referenced in the Withholding Tax Annexure. I undertake to inform the Administrator in writing if the circumstances referred to in the declaration above change. Signature of representative (1) Signature of representative (2) Date D D M M Y Y Y Y If you have an independent financial adviser for this investment, please tick this box and complete the next section of this form. 5 of 7
10. Complete this section if you have an independent financial adviser Provide us with your financial adviser s details Name and surname of fi nancial adviser Name of Financial Services Provider (FSP) Financial adviser code Financial adviser assistant dealing with this transaction What negotiable fees must be paid to your financial adviser for this investment? I agree to pay the following negotiated fees on this and all future transactions until otherwise specifi ed: Initial. Annual. Maximum 3.0 (excluding VAT) deducted prior to the investment being made. Where the annual fees are more than 0.5, initial fees are capped at 1.5. If it is agreed that no initial fee is payable, please insert 0. No initial fees are applicable to unit transfers. Maximum 1.0 (excluding VAT) of the investment account. Where the initial fee is more than 1.5, the maximum annual fee is 0.5. If no annual fee is payable, please insert 0. Who should we communicate with? We will send you/your fi nancial adviser confi rmation that your transactions have been processed. Who should we send your transaction confi rmations to? Me Financial adviser Both If no option is selected, your transaction confi rmations will be sent to both you and your fi nancial adviser. We will send you/your fi nancial adviser account statements and other communications. Who should we send your statements and other communications to? Me Financial adviser Both If no option is selected, your communications will be sent to you only. Provide authorisation for your financial adviser to submit instructions on your behalf You may authorise the Financial Service Provider (FSP) to submit instructions for this investment on your behalf, either online or via forms. If the FSP holds a Category II licence with the Financial Services Board (FSB), it is licensed to exercise discretion and submit instructions on your behalf. To do this for all your investments the FSP will need a mandate (instruction) from you. Have you entered into a mandate with this FSP to exercise discretion and submit instructions on your behalf? Yes No Alternatively, if your fi nancial adviser holds a Category I licence with the FSB, they are not licensed to exercise discretion and submit instructions on your behalf. However, you may authorise them to submit online instructions for this investment only on your behalf. Do you authorise this fi nancial adviser to submit instructions (excluding withdrawals and regular withdrawals) on your behalf via Allan Gray Online? Yes No Additionally, do you authorise this fi nancial adviser to submit withdrawal instructions on your behalf via Allan Gray Online? Yes No In all cases money will be paid into your bank account that Allan Gray has on record and the bank account can only be changed with your prior written consent. 11. Investor declaration for clients with a financial adviser I confi rm that this financial adviser, as authorised representative of the FSP above, is my appointed fi nancial adviser. I confi rm that the Administrator may accept instructions from my financial adviser who has been appointed by me in writing. I confi rm that my appointed fi nancial adviser and any other third parties with whom I have an agreement to manage this investment (e.g. a discretionary investment manager) will have access to my investment details via a secure electronic channel. I understand and agree that all instructions submitted by my fi nancial adviser will be governed by the relevant and latest Terms and Conditions in force as at the date the instruction is submitted. I acknowledge and agree that the Administrator will not be held liable for acting on any instructions submitted by my financial adviser and I indemnify the Administrator from all direct or indirect claims (including claims for consequential damages) in this regard. I have read and agree to the investor declaration in section 9. Signature of representative (1) Signature of representative (2) Date D D M M Y Y Y Y 6 of 7
12. This section must be completed by your financial adviser Financial adviser FAIS declaration I have made the disclosures required in terms of the Financial Advisory and Intermediary Services (FAIS) Act, No. 37 of 2002 to the investor. I have explained all fees that relate to this investment to the investor. I understand and accept that the investor may write to the Administrator to cancel future fees. Financial adviser online instruction declaration In the absence of a mandate, I acknowledge and agree that I will only act on my client s instruction when submitting instructions via Allan Gray Online. I have read, understood and agree to the Terms and Conditions applicable to submitting instructions via Allan Gray Online. I acknowledge and agree that the Administrator will not be held liable for acting on any instructions submitted by me, and I indemnify the Administrator from all direct or indirect claims (including claims for consequential damages) in this regard. I understand the Administrator reserves the right, at any time, to review my licence and/or to audit or request copies of my client s consent (whichever applicable) for instructions that I have submitted via Allan Gray Online. Signature of financial adviser Date D D M M Y Y Y Y 7 of 7
Annexure A Before we can enter into a transaction with you the Financial Intelligence Centre Act (FICA) requires that we verify the identity of all members, directors and other representatives. We require a copy of all members, directors and authorised representatives green bar-coded identity documents (South African citisens) or a copy of a valid passport (foreign nationals). We require proof of the legal entity s physical business address that is not older than three months We require the following documents for legal entities: Close corporations (CCs) incorporated before the Act The Founding Statement and Certificate of Incorporation (CK1) Where the CC has changed its members we require an amended Founding Statement CK2 stamped by the Registrar of Companies A document less than three months old containing the trade name and the business address (if the address is not the same as the CK2 document) A resolution on the CC s letterhead signed by all members appointing the authorised signatories The completed Annexure B (attached to this application form) for all members and authorised signatories Identity documents for all members and authorised signatories Trusts The Trust Deed (including Testamentary (Will) Trusts) A Will and letter of Executorship in the case of Testamentary Trust The Letter of Authority (if the trust is registered in South Africa) stamped by the Master of the High Court A Resolution signed by all trustees appointing the authorised signatories of the Trust Annexure B (attached to this application form) for all trustees and beneficiaries Identity documents for founders of the Trust, trustees, beneficiaries and authorised signatories SA companies Registration Certificate CM1/CoR14.3 Where the company has changed its name we require the Certificate of Name Change CM9/CoR14.3 Notice of registered office and postal address stamped by the Registrar of Companies and signed by the company secretary CM22 / CoR21.1 A document less than three months old containing the trade name and the business address (if the address is not the same as the CM22 / CoR21.1 document) A resolution on the company s letterhead signed by all members appointing the authorised signatories Identity documents for all managers, authorised signatories and individuals holding 25 or more of the voting rights at a general meeting Annexure B (attached to this application form) for all members and authorised signatories Foreign companies Official documents from the foreign regulator witnessing incorporation, bearing the name, number and address A document less than three months old containing the trade name and the business address (if the address is not the same as the one on the official registration document) Identity documents for all managers, authorised signatories and individuals holding 25 or more of the voting rights at a general meeting A resolution on the company s letterhead signed by all members appointing the authorised signatories Annexure B (attached to this application form) for all members and authorised signatories Partnerships A partnership agreement or signed letter from all the partners confirming the informal partnership A resolution signed by all partners appointing the authorised signatories Identity documents for all partners Annexure B (attached to this application form) for all partners Other legal entities (e.g. clubs, associations, churches) The copy of the constitution or other founding documents for the legal entity Resolution of authorised signatories Identity documents for the authorised signatories Annexure B (attached to this application form) for authorised signatories Retirement funds Registration certificate from the Registrar of Pension Funds (FSB) Approval certificate from the Commissioner of Inland Revenue (SARS) List of authorised signatories and specimen signatures Identity documents for the authorised signatories Board resolution
Annexure B In terms of the Financial Intelligence Centre Act 38 of 2001, the accountable institution must verify the identity of its clients. Please tick the boxes below to indicate the roles individuals play in your organisation. Each of these people must complete this annexure (please attach copies of this section, if necessary): Manager Partner Persons exercising executive control Trustee, beneficiary and founder of trust Member Authorised representative Person holding 25 or more of the voting rights Natural person Capacity Title Surname First name(s) Date of birth D D M M Y Y Y Y Country of birth ID number (passport number if foreign national) Tax identification number Nationality Email Mobile Fax Residential address Country of issue Telephone (h) Telephone (w) Postal address (If the same as residential address please tick this box) I want secure online access to this investment Yes No In addition to the information given above, does any controlling persons associated with this investment (e.g. authorised signatory, trustee etc) have a non-south African income tax number, tax residency or nationality? Yes No Legal entity Capacity Registered name Registration number Trading name Tax identification number GIIN* (if the controlling person is a financial institution) VAT number Email Telephone (w) Registered address (Head office) Country of issue Fax Postal address (if the same as registered address please tick this box) The requirement to collect certain information about each clients tax arrangements specifically pertaining to the US is required in terms of an inter-governmental agreement between SARS and the IRS. As a financial services company, we are required to collect this information. * Global Intermediary Identification Number
Annexure C: Allan Gray bank accounts Foreign currency accounts Please deposit/transfer your money into the relevant bank account Electronic transfers should be made in favour of Beneficiary customer: Allan Gray Investment Services Client Subscription Account Please use your name as a reference For US$ deposits: Beneficiary bank: Citibank N.A, 399 Park Avenue, NY 10043, USA CITIUS33 FEDWIRE: 021000089 Beneficiary address: 1 Silo Square, V&A Waterfront, Cape Town, 8001 Beneficiary account number: Currency Account number IBAN number US$ 36885568 n/a For GBP and EUR deposits: Beneficiary bank: Citibank London, Citigroup Centre, 33 Canary Wharf, E14 5LB, UK CITIGB2L Sort code: 185008 Beneficiary address: 1 Silo Square, V&A Waterfront, Cape Town, 8001 Beneficiary account number: Currency Account number IBAN number GBP 11826522 GB07CITI18500811826522 EUR 11826387 GB63CITI18500811826387 For JPY deposits: Intermediary/Correspondent bank: Citibank Tokyo CITIJPJT Beneficiary bank: Citibank London, Citigroup Centre, 33 Canary Wharf, E14 5LB, UK CITIGB2L Beneficiary address: 1 Silo Square, V&A Waterfront, Cape Town, 8001 Beneficiary account number: Currency Account number IBAN number JPY 11826492 GB41CITI18500811826492 For AUD deposits: Beneficiary bank: Citibank N.A. Australia, 2 Park Street, Sydney, NSW 2000 CITIAU2X BSB: 242-000 Beneficiary address: 1 Silo Square, V&A Waterfront, Cape Town, 8001 Beneficiary account number: Currency Account number IBAN number AUD 233323004 n/a Allan Gray Money Market Fund bank details for the purpose of paying fees If you have chosen to pay your annual administration and annual financial adviser fees from the Allan Gray Money Market Fund, please deposit/transfer your money into the following bank account: Beneficiary bank: FNB, Ground Floor, Great Westerford Building, 240 Main Road, Rondebosch, 7700 Branch Code: 204109 FIRNZAJJ Beneficiary customer: Allan Gray Investment Services Proprietary Limited Beneficiary address: 1 Silo Square, V&A Waterfront, Cape Town, 8001 Beneficiary account number: 62202932837