APPLICATION FORM INVICTUS SICAVp.l.c. INVICTUS MACRO FUND This Form duly completed should be sent to the Company at the offices of the Administrator or through any duly authorised intermediary at the following address: Address: No.11, Level 2 Casal Naxaro, Labour Avenue Naxxar NXR 9021 Fax: +356 21385840 Email: fundadministrator@avm.com.mt I/We, the undersigned, having received and read a copy of the Prospectus of Invictus SICAVp.l.c. (the Company ) dated [ ] (the Prospectus ) and the Supplement of the Invictus Macro Fund (the Fund ) dated [ ], as amended, (the Supplement ), are hereby applying for: Class R Participating Shares or such number of Class R Participating Shares in the Fund as may be subscribed for with (amount in words), (EUR ), or on such other basis and upon such other terms as the Directors, in their sole discretion, shall determine in respect of any investor in accordance with the relative Fund Supplement; OR Class I Participating Shares or such number of Class I Participating Shares in the Fund as may be subscribed for with (amount in words), (EUR ), or on such other basis and upon such other terms as the Directors, in their sole discretion, shall determine in respect of any investor in accordance with the relative Fund Supplement. Applications for the purchase of Class R and I Participating Shares received in writing up to 14.00 hours Malta time at least three (3) Business Days preceding the close of the Initial Offer Period, if accepted, will be dealt at the Initial Price. Applications for the purchase of Class R and I Participating Shares received in writing up to 14.00 hours Malta time at least three (3) Business Days preceding any Dealing Day, if accepted, will be dealt at the NAV calculated as at the applicable Dealing Day.
In all cases, applications, if accepted, are to be accompanied by cleared funds via payment by means of a cheque, bank transfer or payment order. Payment should be made in the Base Currency of the Fund or other currency equivalent. Any applicable bank and currency exchange charges will be borne by the investor/s. Any Shares in the Company will not be issued on the relevant Dealing Day unless and until such payment has been cleared at least before 14.00 hours Malta time on the Business Day immediately preceding the close of the Initial Offer Period or the relevant Dealing Day, as the case may be. Bank of the beneficiary: Beneficiary Name: SWIFT: Sparkasse Bank Malta plc Invictus Macro Fund SBMTMTM1 IBAN number: MT17 SBMT 5550 5000 0100 0002 2673 000 I/We will instruct my/our remitting bank to send a SWIFT advice to advising details of remittance, including the name of applicant(s), for ease of identification. All capitalized terms used which are not defined herein, shall have the same meaning as ascribed thereto in the Prospectus and the relative Fund Supplement issued for and in respect of the Fund. I/We acknowledge that due to money laundering requirements operating within the relevant jurisdictions: (i) (ii) The Company, the Administrator and its agents, and the Manager may require further information and documents relating to the identification and source of subscription monies of the applicant(s) before the application can be processed; and The Administrator will not process applications if subscription monies are not remitted from an account in the applicant's name in a country which is a member of the Financial Action Task Force on Money Laundering ("FATF") at the relevant time. Where the subscription monies of an applicant are remitted from an account in the applicant's name in another jurisdiction, the Administrator will only process the application if the Administrator in its absolute discretion is of the opinion that it has obtained sufficient evidence to satisfy itself as to the provenance and legitimacy of such subscription monies. This means that if subscription monies come from an account in a non-fatf member country then such application for subscription may be delayed to allow the Administrator to make appropriate verification enquiries; and the Company and the Administrator shall each be held harmless and indemnified against any loss arising as a result of any delay, refusal or failure to process the application, if any information or document required by the Administrator has not been provided by me/us or if subscription monies are not remitted from an account in my/our name(s) in a FATF member country.
I/We agree that if my/our this application is not accepted for any reason, my/our subscription monies will be returned by the Administrator to the bank which had remitted my/our subscription monies, at my/our sole risk and expense. I/We hereby agree to be bound by the Prospectus and the Fund Supplement, collectively the Fund Documents, as the same may be amended and supplemented from time to time in accordance with the laws of Malta. I/We hereby declare that I/we have carefully and fully read the Fund Documents and that I/we fully understand their contents and the risks described therein and am/are willing to accept such risks. I/We hereby undertake to observe and be bound by the provisions of the Memorandum and Articles of Association constituting the Company, as the same may be amended from time to time in accordance with the laws of Malta. I/We confirm that I am/we are 18 years of age or over. I/We declare that these Participating Shares are not being acquired directly or indirectly in violation of any applicable law, nor by or on behalf of a US Person and that I am/ we qualify to be holders thereof. I/We hereby accept such lesser number of Participating Shares, if any, than may be specified above in respect of which this application/transfer may be accepted. I/We request that the Participating Shares issued pursuant to this application are registered in the name(s) and address set out below. The Administrator and the Company are each hereby authorised and instructed to accept and execute any instructions in respect of the Participating Shares to which this application relates given by me/us in written form or by facsimile. If the instructions are given by me/us by facsimile, I/we undertake to confirm them in writing. I/We hereby agree to indemnify the Administrator and the Company and agree to keep them indemnified against any loss of any nature whatsoever arising to any of them as a result of it acting upon facsimile instructions. The Administrator and the Company may rely conclusively upon and shall incur no liability in respect of any action taken upon any notice, consent, request, instruction or other instrument believed in good faith to be genuine or to be signed by properly authorized persons. I/We are fully empowered and have authority to make this investment whether the investment is on my/our own behalf or on the behalf of another person or institution. I/We confirm that I/we have the right and authority to request a redemption of the Participating Shares to which this application relates and confirm that I/we will comply with the redemption procedures set out in the Fund Documents. All redemption instructions must be given in writing, quoting the relevant account number. By signing and submitting this Application Form and accompanying documentation and information, I/We hereby consent (and is deemed to consent) to the processing of personal data by the Company or the Administrator, which processing may take place before, during and after the time that I/We hold Participating Shares in the Fund and even in the event that this Application Form is rejected. Processing of
personal data may validly take place, even without my/our consent, in the circumstances and for the purposes mentioned in the Data Protection Act (Chapter 440 of the Laws of Malta). Under the Data Protection Act a natural person in relation to whom personal data are processed by or on behalf of the Company ( data subject ), has the right to request the Company to provide him or her with information about the processing of his or her personal data and to request the rectification (and, where applicable, the erasure) of personal data concerning him or her, in accordance with the provisions of the Data Protection Act. Furthermore, by ticking the first check box below, I/We explicitly consent/s to the receipt of unsolicited communications (including by fax or electronic mail) for the purpose of direct marketing by or on behalf of the Company. I/We may at any time, oppose such processing for the purposes of direct marketing and request that the unsolicited communications cease, at no cost, by giving notice to the Company. By ticking the second check box below, I/We explicitly consent/s to the disclosure by the Company, the Administrator and/or any other Service Provider of the Fund to members of the Administrator s and/or other Service Providers subsidiary or group or affiliated companies and agents and their respective directors, managers and employees, and to the processing of such personal data by such persons as aforesaid, strictly for the purposes of consolidated anti-money laundering monitoring and compliance purposes of the said group/affiliated companies/agents, in compliance with anti-money laundering legislation. I/We may at any time, revoke my/our consent to the processing of personal data as aforesaid for compelling legitimate grounds relating to my/our particular situation, in which case I/We shall specify in respect of which data and which processing such revocation relates; all this without prejudice to the provisions of the Data Protection Act which permit the processing of personal data, even without the consent of the data subject, in the circumstances and for the purposes mentioned in such Act (in which case the right of the data subject to object to such processing shall be available in the circumstances and as provided in the Data Protection Act). I/We consent to the receipt of unsolicited communications (including by fax or electronic mail), for the purpose of direct marketing by or on behalf of the Company. I/We consent to the disclosure by the Company, the Administrator and/or any other Service Provider of the Fund to members of the Administrator s and/or other Service Providers subsidiary or group or affiliated companies and agents and their respective directors, managers and employees, and to the processing of personal data by such persons, for the purposes of consolidated anti-money laundering monitoring and compliance purposes of the said group/affiliated companies/agents. Further to the above, I/we agree that: (i) information supplied on this Application Form and otherwise in connection with my/our subscription for Participating Shares referred to herein may be held by the Administrator and will be used for the purposes of processing my/our subscription and investment in the relevant Fund and completion of information on the Register of Shareholders of the Company, and may also
be used for the purpose of carrying out my/our instructions or responding to any enquiry purporting to be given by me/us or on my/our behalf, dealing in any other matters relating to my/our holding of Participating Shares (including the mailing of reports or notices), forming part of the records of the recipient as to the business carried on by it, observing any legal, governmental or regulatory requirements of any relevant jurisdiction (including any disclosure or notification requirements to which any recipient of the data is subject) and to provide a marketing database for product and market research or to provide information for the dispatch of information on other products or services to me/us from the Manager or any connected person of the Manager. All such information may be retained after my/our Participating Shares have been redeemed; and (ii) the Administrator may disclose and transfer such information to the Auditors and the Manager, including any of their employees, officers, directors and agents and/or to the ultimate holding company of the Manager and the Administrator and/or their subsidiaries and/or affiliates or to any third party employed to provide administrative, computer or other services or facilities to any person to whom data is provided or may be transferred as aforesaid and/or to any regulatory authority entitled thereto by law or regulation (whether statutory or not) in connection with my/our investment in the relevant Fund. I/We agree to notify the Administrator immediately if I/we become aware that any of these confirmations are no longer accurate and complete in all respects and agree immediately either to sell or to tender to the Administrator for redemption a sufficient number of Participating Shares to allow the confirmation to be made. I/We agree to provide such confirmations to the Administrator at such times as the Administrator may request, and to provide on request such certifications, documents or other evidence as the Administrator may reasonably require to substantiate such representations. (In respect of Joint applicants only) We direct that on the death of one of us the Participating Shares for which we hereby apply be held in the name of and to the order of the survivor or survivors of us or the executor or administrator of such survivor or survivors. (COMPLETE IN BLOCK LETTERS PLEASE) Applicant's Name(s) (in full) Passport No Citizenship Address: Telephone No: Fax No: Applicant's signature:
NOTES: 1. The original of this application must be received by the Company at the offices of the Administrator. 2. To be valid, application forms must be signed by each applicant. 3. In the case of a firm (not a limited company) applications should be in the name(s) of and signed by the proprietor(s) or partners. 4. A corporation should complete this form under seal or under the hand of a duly authorised official who should state his capacity and furnish a certified copy of the authority pursuant to which such official is authorised. 5. If this application form is signed under a power of attorney, such power of attorney or a duly certified copy thereof must accompany this application form. 6. If this form is not fully completed to the satisfaction of the Administrator, the application may not be accepted by the Company. 7. Individual investors please enclose a certified true (by any solicitor, bank officer, commissioner for oaths, notary public or Justice of the Peace) copy of ID/Passport with picture page, together with independent confirmation of home address (e.g. certified copy of utility bill or letter of reference from a professional person). 8. Corporate investors - please enclose certified true copies of the following: i. memorandum and articles of association, certificate of incorporation and business registration certificate (if any) of the corporation; ii. a list of authorized signatories; iii. a list of shareholders who hold more than 10 per cent (10%) of the share capital of the corporation; and iv. a board resolution authorizing the corporation to enter into the transaction. 9. All individual investors have the right of access to, and to update, all their records (whether held on computer files or manually) held by the Administrator. A copy of such record will be provided to an investor who requests it, upon the payment of a nominal administration charge to cover the costs of complying with such request. Requests should be made in writing to Company at the offices of the Administrator at the address set out in the Prospectus. 10. Where the applicant is a financial institution, broker or other person applying to acquire Participating Shares on behalf of its individual client(s) the applicant represents and warrants by signing this form that it has full power and authority on behalf of the individual investor to subscribe for such Participating Shares and to execute any necessary subscription documentation, including
this Application Form and, in particular but without limitation to the aforesaid, to make the representations above on behalf of such individual investor as to the agreement of such individual investor regarding the use of personal data. 11. Unless otherwise notified, it will be assumed that redemption proceeds from the redemption of any Participating Shares subscribed herein will be paid back to the applicant but if that is not the case evidence of identification will be required in respect of the applicant and the payment of any redemption proceeds will not be made until such evidence is received.