BEFORE YOU BEGIN

I am filling in this application as:

The investor or one of the investorsAn advisor, representative or person assisting the investor/s

Who can invest in the Fund

The Fund is only open to investors who qualify as Wholesale clients as defined in the Corporations Act.

An investor will generally be regarded as a Wholesale Client if:

the investment into the Fund is at least $500,000, or
a qualiﬁed accountant certiﬁes that the person has net assets of at least $2.5 million, or
a qualiﬁed accountant certiﬁes that the person had a gross income for each of the last two ﬁnancial
years of at least $250,000, or
the client is a professional investor, or
the client is a Sophisticated Investor.

If your investment is below $500,000.00, the applicant must provide a Wholesale Investor Certificate issued by a qualified accountant. For additional information, please visit ASIC’s website.

Please specify

CONTACT DETAILS

Your Email Address

Full Name

Contact Phone Number

APPLICATION CHECKLIST

Individual Entity Application

Information you will need to complete the Application Form:

Full name of investor.
Tax Details - If you are an Australian resident for tax purposes, please provide your tax file number (TFN) or reason for exemption. If you are an Australian resident and do not provide your TFN or reason for exemption, you will be taxed at the highest marginal tax rate plus the Medicare levy. Residential address (PO Box not accepted) of each applicant investor
A valid email address and mobile number
Proof that individual investors are 18 or older
Investor's Date of Birth
Sources of funds and wealth must be identified.
Bank statement showing the Bank Account Name, BSB and Account number of the applicant.
If your investment is below $500,000.00, the applicant must provide a Wholesale Investor Certificate issued by a qualified accountant. For additional information, please visit ASIC’s website.
Australia's Anti-Money Laundering and Counter-Terrorism Financing (“AML/CTF”) legislation oblige us to collect Identification Information from prospective Investors (this includes beneficial owners).

Sole Trader Entity Application

Information you will need to complete the Application Form:

Full name of each applicant investor.
Tax Details - If you are an Australian resident for tax purposes, please provide your tax file number (TFN) or reason for exemption. If you are an Australian resident and do not provide your TFN, or reason for exemption, you will be taxed at the highest marginal tax rate plus the Medicare levy. Residential address (PO Box not accepted) of each applicant investor.
Residential address (PO Box not accepted) of each applicant investor.
A valid email address and mobile number.
Proof that individual investors are 18 or older.
Date of birth of each applicant investor.
Sources of funds and wealth must be identified.
Bank statement displaying the applicant's Account Name, BSB, and Account number.
If your investment is below $500,000.00, the applicant must provide a Wholesale Investor Certificate issued by a qualified accountant. For additional information, please visit ASIC’s website.
Australia's Anti-Money Laundering and Counter-Terrorism Financing (“AML/CTF”) legislation oblige us to collect Identification Information from prospective Investors (this includes beneficial owners).

Joint Investment Entity Application

Information you will need to complete the Application Form:

Full name of each applicant investor.
Tax Details - If you are an Australian resident for tax purposes, please provide your tax file number (TFN) or reason for exemption. If you are an Australian resident and do not provide your TFN, or reason for exemption, you will be taxed at the highest marginal tax rate plus the Medicare levy. Residential address (PO Box not accepted) of each applicant investor.
Residential address (PO Box not accepted) of each applicant investor.
A valid email address and mobile number.
Proof that individual investors are 18 or older.
Date of birth of each applicant investor.
Sources of funds and wealth must be identified.
Bank statement showing the Bank Account Name, BSB and Account number of the applicant.
To apply for a joint investment account with us, you will require a joint bank account in the name of all investors
If your investment is below $500,000.00, the applicant must provide a Wholesale Investor Certificate issued by a qualified accountant. For additional information, please visit ASIC’s website.
Australia's Anti-Money Laundering and Counter-Terrorism Financing (“AML/CTF”) legislation oblige us to collect Identification Information from prospective Investors (this includes beneficial owners).

Partnership Entity Application

Information you will need to complete the Application Form:

Full name of Partnership.
Business trading name (if applicable).
Tax Details - If you are an Australian resident for tax purposes, please provide your tax file number (TFN) or reason for exemption. If you are an Australian resident and do not provide your TFN, or reason for exemption, you will be taxed at the highest marginal tax rate plus the Medicare levy. Residential address (PO Box not accepted) of each applicant investor.
A valid email address and mobile telephone number.
Registered Office address (PO Box not accepted).
Principle place of business (PO Box not accepted).
Sources of funds and wealth must be identified.
Full name of each Partner/s.
Copy or relevant extracts of the partnership agreement, full name of the partnership and any business name(s)used by the partnership.
Regulator information (if applicable).
If your investment is below $500,000.00, the applicant must provide a Wholesale Investor Certificate issued by a qualified accountant. For additional information, please visit ASIC’s website.
Australia's Anti-Money Laundering and Counter-Terrorism Financing (“AML/CTF”) legislation oblige us to collect Identification Information from prospective Investors (this includes beneficial owners).

Beneficial Owner(s) of a Partnership

You must provide details of each individual who (directly or indirectly):

Owns more than 25% of the Trust / Issued Capital of a Partnership; or Controls the Partnership.

If neither of these applies, we must collect details of the individual who holds the power to appoint or remove the Trustee of the Trust (‘Appointer’).

Company Entity Application

Information you will need to complete the Application Form:

Australian Companies

A current full company search of ASIC databases showing:

the full name of the company.
the ABN/ACN.
the registered office address of the company.
the principal place of business of the company.
Personal Information about Directors
Corporate Bank Account Information
If your investment is below $500,000.00, the applicant must provide a Wholesale Investor Certificate issued by a qualified accountant. For additional information, please visit ASIC’s website.
Australia's Anti-Money Laundering and Counter-Terrorism Financing (“AML/CTF”) legislation oblige us to collect Identification Information from prospective Investors (this includes beneficial owners).

Foreign Companies

Company’s Certificate of Registration / Incorporation (issued by Regulatory or Government Authority stating the company type (public or private) and Registration Number; or
Articles of Association stating the Company’s name and type (public or private).
the registered office address of the company.
the principal place of business of the company.
Personal Information about Directors
Corporate Bank Account Information
If your investment is below $500,000.00, the applicant must provide a Wholesale Investor Certificate issued by a qualified accountant. For additional information, please visit ASIC’s website.
Australia's Anti-Money Laundering and Counter-Terrorism Financing (“AML/CTF”) legislation oblige us to collect Identification Information from prospective Investors (this includes beneficial owners).

Beneficial Owner(s) of a Company

You must provide details of each individual who (directly or indirectly):

owns more than 25% of the Issued Capital of a Company Controls the Company.

If neither of these applies, we must collect details of the individual who holds the power to appoint or remove the Trustee of the Trust (‘Appointer’).

Trust or Superfund/SMSF Entity Application

Information you will need to complete the Application Form:

A copy of the trust deed (including any variations to the trust deed) confirming the following:

The full name of the trust;
The type of trust;
The country where the trust was established and
The name of each beneficiary or class of beneficiary.
The ABN/ACN.
TFN details or reasons for exemption.
The registered office address.
Trustee Information (Individual or Corporate)
Directors and Beneficial Owners Information (if a Corporate Trustee) the principal place of business of the company.
Personal Information about Directors and Beneficiaries.
Trust/SMSF Bank Account Information
Australia's Anti-Money Laundering and Counter-Terrorism Financing (“AML/CTF”) legislation oblige us to collect Identification Information from prospective Investors (this includes beneficial owners).
If your investment is below $500,000.00, the applicant must provide a Wholesale Investor Certificate issued by a qualified accountant. For additional information, please visit ASIC’s website.

Beneficial Owner(s) of a: Trust or SMSF

You must provide details of each individual who (directly or indirectly):

owns more than 25% of the Trust / SMSF; or Controls the Trust / SMSF.

If neither of these applies, we must collect details of the individual who holds the power to appoint or remove the Trustee of the Trust (‘Appointer’).

Identity Verification

For Identity Verification, kindly provide a certified copy of either one document from Group 1. Alternatively, if this is not feasible, please provide certified copies of two documents from Group 2 for each individual applicant.

Group 1

Provide a certified copy of one of these:

Australian driver’s licence showing your photo, and please copy the front and back OR
Foreign driver’s licence showing your date of birth, signature and photo OR
Australian passport a passport that has expired within the preceding two years is acceptable, and please copy the pages which identify you OR
Foreign passport showing your signature and photo, and please copy the pages which identify you OR
Australian State or Territory Government issued ID card showing your date of birth, signature and photo OR
Foreign Government issued ID card showing your date of birth, signature and photo.

Group 2

If you can’t provide anything from Group 1, then provide a certified copy of one of the following:

Australian or Foreign government issued birth certificate OR
Australian or Foreign government issued citizenship certificate OR
Centrelink pension or health card please copy the front and back. PLUS provide a certified copy of one of the following:
a Government issued notice one which shows your name and residential address, not more than 12 months old OR
a Rates or Utilities notice one which shows your name and residential address, not more than 3 months old OR
ATO notice one which shows any debt owing to the ATO, your name and residential address, not more than 12 months old.

Power of Attorney
Applications submitted under a power of attorney must be accompanied by an original certified copy of the power of attorney document and a specimen signature of the relevant attorney(s).

ACCEPT THE TERMS AND CONDITIONS

By ticking each of the boxes below, you acknowledge and agree that:

You have read a copy of the offer document in relation to this fund, e.g. the Information Memorandum or Supplementary Information Memorandum. The offer document is an important document and is required by law. We strongly encourage you to read the offer document to help you decide if the investment meets your needs. *

You give consent to use your personal information for Anti-Money Laundering / Know Your Customer(AML/KYC) verification purposes. *

This application form may be accepted, executed or agreed to through the use of an electronic signature in accordance with the Electronic Transactions (Victoria) Act 2000 and the Electronic Transactions Act 1999 (Cth) and will be binding as if it were physically executed. *

Application Form

Agio Global, Fund II, Environmental Opportunities (Fund)

This Application Form is to be completed by Investors who wish to apply for Units as part of the Offer made through the Information Memorandum ("IM") for the Agio Global, Fund II, Environmental Opportunities (Fund) dated 1st November 2023. You should read the IM in full before completing this Application Form. It contains important information about the Offer and the Units.

Important: Applications must only be in the name of a natural person or persons, companies or other entities acceptable to the Trustee. If applying under a Trust structure, all account designations must be in the form (Trustee) ATF (Trust).

APPLICATION AMOUNT

I/We wish to apply for

Minimum Initial Investment Amount: $5,000,000.00 (AUD)

Payment of Investment Amount

Application Money equivalent to 25% of an Investor’s investment amount, being an Investor’s Committed Capital, must be paid upon application. The balance of each Investor’s Committed Capital may be called by the Trustee in one or more instalments during the 12-month period from when units in the Fund (Units) are first issued under this IM.

SECTION 1: INVESTOR DETAILS

Please complete this section in conjunction with the AML/CTF Checklist. If the AML/CTF information requirements are not satisfied, then your application will not be accepted.

A. INDIVIDUAL INVESTOR PERSONAL DETAILS

Title

First Name

Middle Name

Last Name

Date of Birth

City of Birth

Country of Birth

Tax File Number or reason for exemption

Residential address (Not PO Box)

Street addressStreet address line 2

City

State

Postcode

Country

Country of residence for Tax purposes (if not Australia)If you are not an Australian resident for tax purposes, please indicate your country of residence for tax purposes.

Phone (Work)

Phone (Home)

Mobile

A. JOINT HOLDING DETAILS

INVESTOR 1 - PERSONAL DETAILS

Title

First Name

Middle Name

Last Name

Date of Birth

City of Birth

Country of Birth

Tax File Number or reason for exemption

Residential address (Not PO Box)

Street addressStreet address line 2

City

State

Postcode

Country

Country of residence for Tax purposes (if not Australia)If you are not an Australian resident for tax purposes, please indicate your country of residence for tax purposes.

Phone (Work)

Phone (Home)

Mobile

INVESTOR 2 - PERSONAL DETAILS

Title

First Name

Middle Name

Last Name

Date of Birth

City of Birth

Country of Birth

Tax File Number or reason for exemption

Residential address (Not PO Box)

Street addressStreet address line 2

City

State

Postcode

Country

Country of residence for Tax purposes (if not Australia)If you are not an Australian resident for tax purposes, please indicate your country of residence for tax purposes.

Phone (Work)

Phone (Home)

Mobile

A. SOLE TRADER PERSONAL DETAILS

Title

First Name

Middle Name

Last Name

Date of Birth

City of Birth

Country of Birth

Tax File Number or reason for exemption

Australian Business Number (ABN)

Business Name (for Sole Trader)

Residential address (Not PO Box)

Street addressStreet address line 2

City

State

Postcode

Country

Country of residence for tax purposes (if not Australia)If you are not an Australian resident for tax purposes, please indicate your country of residence for tax purposes.

Phone (Work)

Phone (Home)

Mobile

B. COMPANY / CORPORATE TRUSTEE DETAILS

ABN

Lookup

ACN

ABN Status

ABN Status Effective From

Entity Name

Entity Type

Entity Registered Postcode

Entity Type Code

Registered State

Tax File Number or reason for exemption

Business Name (if applicable)

Registered office address (not PO Box)

Street addressStreet address line 2

City

State

Postcode

Country

Principal Place of Business (not PO Box)

Street addressStreet address line 2

City

State

Postcode

Country

* For registered foreign companies, this may be the name (care of) and address of the Company’s local agent (if any).

Is this a

Public Companya majority owned subsidiary of a public company ora private company

If this entity is a public company, please provide details of the exchange on which it is listed:

If this entity is a majority owned subsidiary of a public company, please provide the following details:

Name of the parent company:

Details of the exchange on which the parent company is listed:

If this entity is a private company you must also provide details of the directors and beneficial owners.

DIRECTORS PERSONAL DETAILS

Number of Directors

Director 1 - Details

Title

First Name

Middle Name

Last Name

Date of Birth

City of Birth

Country of Birth

Director 1 - Residential address

Street addressStreet address line 2

City

State

Postcode

Country

Director 2 - Details

Title

First Name

Middle Name

Last Name

Date of Birth

City of Birth

Country of Birth

Director 2 - Residential address

Street addressStreet address line 2

City

State

Postcode

Country

Director 3 - Details

Title

First Name

Middle Name

Last Name

Date of Birth

City of Birth

Country of Birth

Director 3 - Residential address

Street addressStreet address line 2

City

State

Postcode

Country

Director 4 - Details

Title

Given Name

Middle Name

Last Name

Date of Birth

City of Birth

Country of Birth

Director 4 - Residential address

Street addressStreet address line 2

City

State

Postcode

Country

If there are more than four directors, please provide details to MSC Abacus via email at registry@msc.group and quote application details.

BENEFICIAL OWNERS PERSONAL DETAILS

Please provide details of all individuals who are beneficial owners through one or more shareholdings of more than 25% of the issued capital of the company.

Number of Beneficiaries

Beneficial Owner 1 - Details

Title

First Name

Middle Name

Last Name

Date of Birth

City of Birth

Country of Birth

Beneficial Owner 1 - Residential address

Street addressStreet address line 2

City

State

Postcode

Country

Beneficial Owner 2 - Details

Title

First Name

Middle Name

Last Name

Date of Birth

City of Birth

Country of Birth

Beneficial Owner 2 - Residential address

Street addressStreet address line 2

City

State

Postcode

Country

Beneficial Owner 3 - Details

Title

First Name

Middle Name

Last Name

Date of Birth

City of Birth

Country of Birth

Beneficial Owner 3 - Residential address

Street addressStreet address line 2

City

State

Postcode

Country

Beneficial Owner 4 - Details

Title

First Name

Middle Name

Last Name

Date of Birth

City of Birth

Country of Birth

Beneficial Owner 4 - Residential address

Street addressStreet address line 2

City

State

Postcode

Country

If there are more than four beneficiaries, please provide details to MSC Abacus via email at registry@msc.group and quote application details.

C. PARTNERSHIPS DETAILS

Full Name of Partnership

Business Name (if applicable)

Tax file number or reason for exemption

Country of Establishment

Registered Office address (not PO Box)

Street addressStreet address line 2

City

State

Postcode

Country

PARTNER 1 - PERSONAL DETAILS

Title

First Name

Middle Name

Last Name

Date of Birth

City of Birth

Country of Birth

Residential address (not PO Box)

Street addressStreet address line 2

City

State

Postcode

Country

Tax file number or reason for exemption

Country of residence for tax purposes (if not Australia)

Phone (Work)

Phone (Home)

Mobile

PARTNER 2 - PERSONAL DETAILS

Title

First Name

Middle Name

Last Name

Date of Birth

City of Birth

Country of Birth

Residential address (not PO Box)

Street addressStreet address line 2

City

State

Postcode

Country

Tax file number or reason for exemption

Country of residence for tax purposes (if not Australia)

Phone (Work)

Phone (Home)

Mobile

REGULATION INFORMATION

Is the Partnership regulated by a Professional Body? *

Yes. Provide the following detailsNo

Association name

Association website

Partner’s membership number / reference

D. TRUST / SUPERANNUATION FUNDS DETAILS

Please select the structure of your Trust/Superfund *

Individual Trustee/(s)Corporate Trustee

No. of Individual Trustee/(s)

Full name of Company or Corporate Trustee

Registered office address

Street addressStreet address line 2

City

State

Postcode

Country

Trustee 1 Details

Title

First Name

Middle Name

Last Name

Date of Birth

City of Birth

Country of Birth

Individual Trustee 1 (Address)

Street addressStreet address line 2

City

State

Postcode

Country

Trustee 2 Details

Title

First Name

Middle Name

Last Name

Date of Birth

City of Birth

Country of Birth

Individual Trustee 2 (Address)

Street addressStreet address line 2

City

State

Postcode

Country

Trustee 3 Details

Title

First Name

Middle Name

Last Name

Date of Birth

City of Birth

Country of Birth

Individual Trustee 3 (Address)

Street addressStreet address line 2

City

State

Postcode

Country

Trustee 4 Details

Title

First Name

Middle Name

Last Name

Date of Birth

City of Birth

Country of Birth

Individual Trustee 4 (Address)

Street addressStreet address line 2

City

State

Postcode

Country

Full name of Trust

Full name of Superannuation fund

Tax file Number or Reason for Exemption

Country where Trust / Superannuation was established

REGULATED TRUST

If the Investment is via a Regulated Trust or SMSF, select and complete one of the following 3 options and then go to section E - Politically Exposed Persons.

Self-Managed Superannuation Fund

ABN

Registered Managed Investment Scheme

ARSN

Other Regulated Trust Name of Regulator

Please provide Name of Regulator and Registration/Licensing details

UNREGULATED TRUST

If the Investment is via an Unregulated Trust, select the Type of Unregulated Trust and provide Beneficiary details, Settlors details and Beneficial Owner details.

Please specify

BENEFICIARY DETAILS

Do the terms of the trust identify the beneficiaries by reference to membership of a class?

Yes. Provide details of membership classes (unitholders, family members of named person, charitable organisations).No. Please complete the following:

Number of Beneficiaries

Beneficiary 1 - Personal Details

Title

First Name

Middle Name

Last Name

Date of Birth

City of Birth

Country of Birth

Address (not PO Box)

Street addressStreet address line 2

City

State

Postcode

Country

Beneficiary 2 - Personal Details

Title

First Name

Middle Name

Last Name

Date of Birth

City of Birth

Country of Birth

Address (not PO Box)

Street addressStreet address line 2

City

State

Postcode

Country

Beneficiary 3 - Personal Details

Title

First Name

Middle Name

Last Name

Date of Birth

City of Birth

Country of Birth

Address (not PO Box)

Street addressStreet address line 2

City

State

Postcode

Country

Beneficiary 4 - Personal Details

Title

First Name

Middle Name

Last Name

Date of Birth

City of Birth

Country of Birth

Address (not PO Box)

Street addressStreet address line 2

City

State

Postcode

Country

If there are more than four beneficiaries, please provide details to MSC Abacus via email at registry@msc.group and quote application details.

SETTLOR DETAILS FOR UNREGULATED TRUST
This is only required if the amount used to establish the trust was greater than $10,000 unless the Settlor is deceased.

The full name of the SettlorPlease provide the full name of the Settlor

BENEFICIAL OWNER(S) / CONTROLLER OF THE TRUST

Please prove details of each individual who (directly or indirectly):

Owns more than 25% of the trust; orControls the trust.

If neither of these applies, then any individual who holds the power to appoint or remove the trustee of the trust (‘Appointer’).

Number of Beneficial Owners

Beneficial Owner 1 - Personal Details

Title

Given Name

Surname

Date of Birth

Residential address

Street addressStreet address line 2

City

State

Postcode

Country

Beneficial Owner 2 - Personal Details

Title

Given Name

Surname

Date of Birth

Residential address

Street addressStreet address line 2

City

State

Postcode

Country

Beneficial Owner 3 - Personal Details

Title

Given Name

Surname

Date of Birth

Residential address

Street addressStreet address line 2

City

State

Postcode

Country

Beneficial Owner 4 - Personal Details

Title

Given Name

Surname

Date of Birth

Residential address

Street addressStreet address line 2

City

State

Postcode

Country

If there are more than four beneficial owners, please provide details to MSC Abacus via email at registry@msc.group and quote application details.

E. POLITICALLY EXPOSED PERSON (‘PEP’)

A PEP is an individual who holds a prominent public position or role in a government body or international organisation, either in Australia or overseas. Immediate family members and/or close associates of these individuals are also considered PEPs.

Types of PEPs

The AML/CTF Act identifies three types of PEPs.

Domestic PEP – someone who holds a prominent public position or role in an Australian government body.
Foreign PEP – someone who holds a prominent public position or role with a government body in a country other than Australia. This would include foreign PEPs working or residing in Australia.
International organisation PEP – someone who holds a prominent public position or role in an international organisation, such as the United Nations (UN), the World Trade Organisation (WTO) or the North Atlantic Treaty Organisation (NATO).

Is the Applicant a Politically Exposed Person? *

NoYes

Please provide the name of anyone that is named in this Application Form as a PEP or is an immediate family member or close associate of a PEP. *

SECTION 2: APPLICANT’S TAX RESIDENCY AND CLASSIFICATION - FATCA AND CRS

Important

This certification must be completed by all investors to declare their FATCA and CRS status. Please refer to explanations of FATCA terms before completing this form. The Trustee is unable to provide you with tax or professional advice in respect of FATCA or CRS, and we strongly encourage you to seek the advice of an experienced tax or professional adviser in relation to completing this form.

What are FATCA & CRS?

The U.S. Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) are two ways in which a large number of governments are seeking the same thing – to improve global tax compliance. Both require financial institutions to capture relevant information on foreign taxpayers, as follows:

FATCA promotes cross-border tax compliance by U.S. taxpayers by implementing an international standard for the automatic exchange of information related to those taxpayers. Australia has entered into an inter-governmental agreement (IGA) with the U.S. to implement FATCA in Australia, to be administered through the ATO. The AUS-USA FATCA IGA requires the ATO to obtain detailed account information for U.S. citizens and/or taxpayers on an annual basis. The effect of this is that to satisfy their FATCA obligations, relevant Australian financial institutions must identify any U.S. taxpayers and report those taxpayers’ financial account data to the ATO.
CRS is a global reporting standard developed by the OECD for the automatic exchange of information (AEoI). Its goal is to allow tax authorities to obtain a clearer understanding of financial assets held abroad by their residents for tax purposes. Over 88 countries (refer to OECD link in section IV for participating jurisdictions) have agreed to share information on residents’ assets and incomes in accordance with defined reporting standards. Once again, this means that financial institutions around the globe must provide tax authorities with taxpayer financial account data, and the financial institutions must therefore collect this information from their customers and pass it on.

If you are unable to complete Section 2, please seek appropriate advice relating to the tax information required. For further details relating to the implementation of FATCA and CRS, please refer to the Australian Taxation Office (ATO) website.

Further information about FATCA & CRS can be found at:

A. TAX RESIDENCE – INDIVIDUAL

A. TAX RESIDENCE – SOLE TRADER

Please provide details for all jurisdictions in which the Applicant is resident for tax purposes.

Are you a Tax Resident (outside Australia) *

YesNo

If so, how many? *

Country of Tax Residence 1 *

Taxpayer Identification Number (TIN) 1

Country of Tax Residence 2 (if applicable) *

Taxpayer Identification Number (TIN) 2 (if applicable)

Country of Tax Residence 3 (if applicable) *

Taxpayer Identification Number (TIN) 3 (if applicable)

I certify the tax residence countries provided represent all countries in which I am considered a tax resident.
If Applicant has more than three countries of tax residence please attach a statement to this form containing Applicant, the Country and TIN for each such additional country.

Are you a U.S. citizen or U.S. resident for tax purposes?

A US person includes a US citizen or resident alien of the US even if residing outside the US

Yes. If ‘Yes’, the Applicant’s US country of residence and US Tax Identification Number must be provided above.No. Go to Section 3.

A. TAX RESIDENCE – JOINT HOLDING

INVESTOR 1

Please provide details for all jurisdictions in which the Applicant is resident for tax purposes.

Are you a Tax Resident (outside Australia) *

YesNo

If so, how many? *

Country of Tax Residence 1 *

Taxpayer Identification Number (TIN) 1

Country of Tax Residence 2 (if applicable) *

Taxpayer Identification Number (TIN) 2* (if applicable)

Country of Tax Residence 3 (if applicable) *

Taxpayer Identification Number (TIN) 3* (if applicable)

Are you a U.S. citizen or U.S. resident for tax purposes?

A US person includes a US citizen or resident alien of the US even if residing outside the US

Yes. If ‘Yes’, the Applicant’s US country of residence and US Tax Identification Number must be provided above.No. Go to Section 3.

INVESTOR 2

Are you a Tax Resident (outside Australia) *

YesNo

If so, how many? *

Country of Tax Residence 1 *

Taxpayer Identification Number (TIN) 1*

Country of Tax Residence 2 (if applicable) *

Taxpayer Identification Number (TIN) 2* (if applicable)

Country of Tax Residence 3 (if applicable) *

Taxpayer Identification Number (TIN) 3* (if applicable)

Are you a U.S. citizen or U.S. resident for tax purposes?

A US person includes a US citizen or resident alien of the US even if residing outside the US

Yes. If ‘Yes’, the Applicant’s US country of residence and US Tax Identification Number must be provided above.No. Go to Section 3.

* TIN is the number assigned by each country, for the purpose of administering tax laws (equivalent of a Tax File Number in Australia).

B. COMPANIES, TRUSTS, PARTNERSHIPS AND OTHER ENTITIES

I. TAX RESIDENCE – COMPANIES, TRUSTS AND OTHER ENTITIES

Please provide details for all jurisdictions in which the Applicant is resident for tax purposes.

Are you a Tax Resident (outside Australia) *

YesNo

If so, how many? *

Country of Tax Residence 1 *

Taxpayer Identification Number (TIN) 1

Country of Tax Residence 2 (if applicable) *

Taxpayer Identification Number (TIN) 2 (if applicable)

Country of Tax Residence 3 (if applicable) *

Taxpayer Identification Number (TIN) 3 (if applicable)

I certify the tax residence countries provided represent all countries in which I am considered a tax resident.

If Applicant has more than three countries of tax residence, please provide details below.

II. FATCA STATUS – COMPANIES, PARTNERSHIPS, TRUSTS AND OTHER ENTITIES

US Person Certification

Is the Applicant a specified US person?

Yes, Provide a US TIN below.If No, complete the section below - Non-US Person Certification.

US Taxpayer Identification Number (‘TIN’): *

Non-US Person Certification

APPLICANT’S GLOBAL INTERMEDIARY IDENTIFICATION NUMBER (‘GIIN’) (IF ANY) – COMPANIES, TRUSTS AND OTHER ENTITIESApplicant’s GIIN (if any)

* TIN is the number assigned by each country, for the purpose of administering tax laws (equivalent of a Tax File Number in Australia).

IS THE APPLICANT A FINANCIAL INSTITUTION?

Financial Institution

Is the Applicant an Investment Entity located in a non-CRS Participating Jurisdiction managed by another Financial Institution? *

Yes, If yes, please complete the section – Controlling Persons.No, If no, please complete the section below.

Describe the CRS Status

CONTROLLING PERSONS

This section is considered an integral part of the self-certification to which it is associated. If there is a change in Controlling Persons / Beneficial Ownership, please submit an updated form within 30 days.

Number of Controlling Persons

Controlling Person 1 - Title

Given Name

Surname

Are you a Tax Resident (outside Australia) *

YesNo

If so, how many? *

Country of Tax Residence 1

Taxpayer Identification Number (TIN) 1

Country of Tax Residence 2 (if applicable)

Taxpayer Identification Number (TIN) 2 (if applicable)

Country of Tax Residence 3 (if applicable)

Taxpayer Identification Number (TIN) 3 (if applicable)

Controlling Person 2 - Title

Given Name

Surname

Are you a Tax Resident (outside Australia) *

YesNo

If so, how many? *

Country of Tax Residence 1

Taxpayer Identification Number (TIN) 1*

Country of Tax Residence 2

Taxpayer Identification Number (TIN) 2* (if applicable)

Country of Tax Residence 3

Taxpayer Identification Number (TIN) 3* (if applicable)

If there are more than 2 Controlling Persons or Beneficial Owners or Countries of Tax Residence, please provide the details below.

SECTION 3: DISTRIBUTION PAYMENT DETAILS

Please make deposits and redemptions to the following account:

Pay to the bank account (below)

Bank Name:

Account Name:

BSB Number:

Account Number:

Important
When depositing funds, please include a reference to: ‘ YOUR NAME OR INVESTING ENTITY’ to enable us to identify the funds. Please ensure the amount you pay is net of any taxes or bank fees that your bank may levy in connection with your application.

For us to process your application, please select either option 1 or option 2

Option 1 - Important: Please provide a copy or an extract of your bank statement reflecting your Name, BSB and Account number so that we can verify the details against the application form.Option 2 - I / We opt for a call-back verification

Important: Please provide a copy or an extract of your bank statement reflecting your Name , BSB and Account number so we can verify the details provided.

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Please provide a suitable time and contact phone number, and we will give you a call to verify the details.

SECTION 4: METHOD OF PAYMENT

Please ensure the amount you pay is net of any taxes or bank fees that your bank may levy in connection with your application.

Application Amount PayableApplication Money equivalent to 25% of an Investor’s investment amount, being an Investor’s Committed Capital, must be paid upon application. The balance of each Investor’s Committed Capital may be called by the Trustee in one or more instalments during the 12-month period from when units in the Fund (Units) are first issued under this IM.

Method of Payment *

$AUD DIRECT DEPOSIT

Fund Bank Account Details

Bank Name:	National Australia Bank Limited (NAB)
Bank Address:	27 Scarborough St, Southport QLD 4215
Account Name:	Agio Global Funds Management Pty Ltd ATF Agio Global Fund II, Environmental Opportunities
BSB Number:	084 917
Account Number:	31 570 6980

When depositing funds, please include a reference to: ‘ YOUR NAME OR INVESTING ENTITY ’ to enable us to identify the funds. Please ensure the amount you pay is net of any taxes or bank fees that your bank may levy in connection with your application.

SECTION 5: REPORTING

Primary EmailPlease indicate your preferred email address to receive communications about your Investment.

Full NamePrimary Contact

Contact Phone NumberPrimary Contact

Secondary EmailSecondary Contact Email

Full NameSecondary Contact

Contact Phone NumberSecondary Contact

Accountant Details

Accountant/Financial Contact Name

Accountant/Financial Contact Email

If you would like copies of the correspondence emailed to your Financial Adviser, and if you authorise your Financial Adviser to access your investmentinformation (in respect of all your investments) on the Investor Portal, please have your Financial Adviser complete the section on the next page.

SECTION 6: MARKETING PREFERENCES

Please select your marketing preferences below in order to receive communications regarding new investment opportunities, events and other business updates from the Fund Manager.

Marketing to Advisor OnlyMarketing to Advisor and InvestorI/We do not want to receive marketing materials.

SECTION 7: ADVISER USE ONLY

Dealer Group:

Dealer Group AFSL:

Adviser Firm:

Adviser Firm AFSL:

Adviser Name:

Authorized Representative Number:

Adviser Email Address:

Adviser Contact Phone Number:

Adviser Signature

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Eligibility Certificate

For investments less than $500,000.00, Section 708 of the Corporations Act specifies that a qualified accountant will be required to certify that the investing entity can be classified as a Wholesale Investor. Please download the following document and forward it to your accountant for completion. Once complete, please upload the signed copy below.

Download the Eligibility Certificate and Professional Investor Declaration Template

Please note that the Accountant’s Certificate will need to be reconfirmed every two years. If an Accountant’s Certificate (in the name of the investor) has previously been provided to the Trustee, Investment Manager or Unit Registry Administrator, it is valid for two years from the date it is signed. If you wish to make an investment within six months of the Accountant’s Certificate expiring, you will be required to provide a new one.

* Qualified accountant means any member of:

CPA Australia (CPAA) who is entitled to use the post nominals ‘CPA’ or ‘FCPA’;
Institute of Chartered Accountants Australia and New Zealand (CA ANZ) who is entitled to use the post-nominals ‘CA’, ‘ACA’ or ‘FCA’;
Institute of Public Accountants (IPA) who is entitled to use the post-nominals ‘AIPA’, ‘MIPA’ or ‘FIPA’; or
Accountants belonging to any of the following foreign bodies who have at least three years’ experience in accounting or auditing and is providing this certificate to a person who is a resident in the same country:
- American Institute of Public Certified Accountants.
- Association of Certified Chartered Accountants (United Kingdom).
- Canadian Institute of Chartered Accountants.
- Institute of Chartered Accountants of New Zealand.
- The Institute of Chartered Accountants in England and Wales.
- The Institute of Chartered Accountants in Ireland.
- The Institute of Chartered Accountants of Scotland.

I.D. Verification

To comply with Australia’s Anti-Money Laundering and Counter-Terrorism Financing (AML/CTF) legislation, we must collect certain information from prospective investors and their Beneficial Owners supported by either original certified copies of relevant identification documents or reliable and independent electronic data.

By selecting ‘I/We consent’ below and agree to MSC Abacus performing an online identity verification check using the supplied information. The supplied information will be used to confirm your identity with the Australian Government. Your ID document details will be submitted to the Australian Government's Document Verification Service (DVS). The DVS is a national online system that allows organisations to compare an individual’s identifying information with a government record. More information about the DVS is available on their website.

By providing your consent, you agree that:

You are authorised to provide the ID document of the applicant; and
You understand that the ID document details will be checked against records held by the Issuer or Official Record Holder (including the supplied information and any documents to be verified with the document issuer or official record holder through the DVS).

I/We consent *

Document Upload

Applicant 1 - Eligibility Certificate and Professional Investor Declaration (if required)

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If your investment is below $500,000.00, the applicant must provide a Wholesale Investor Certificate issued by a qualified accountant. For additional information, please visit ASIC’s website.

Applicant 1 - Australian or Overseas Passport

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Current passport issued by the Australian Commonwealth (or current within the preceding two years provided not cancelled) or Current passport or similar document issued for the purpose of international travel that contains a photograph and signature of the person and is issued by a foreign government, UN or UN Agency (accompanied where relevant by English language translation by an accredited translator).

Applicant 1 - Australian or Overseas Driver's Licence (Front)

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Driver’s Licence (Australian State or Territory), or foreign country equivalent containing a photograph and signature of the holder (accompanied, where relevant, by English language translation by an accredited translator).

Applicant 1 - Australian or Overseas Driver's Licence (Back)

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Applicant 2 - Eligibility Certificate and Professional Investor Declaration

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If your investment is below $500,000.00, the applicant must provide a Wholesale Investor Certificate issued by a qualified accountant. For additional information, please visit ASIC’s website.

Applicant 2 - Australian or Overseas Passport

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Applicant 2 - Australian or Overseas Driver's Licence (Front)

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Applicant 2 - Australian or Overseas Driver's Licence (Back)

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Company - Certificate of Registration

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Australian Company - A current full company search of ASIC databases showing the following: the full name of the company, the ABN/ACN, the registered office address of the company, and the principal place of business of the company. Foreign Company: Company’s Certificate of Registration / Incorporation (issued by ASIC or by a regulatory or Government Authority stating the company type (public or private) and Registration Number; or Articles of Association stating the Company’s name and type (public or private).

Director 1/Trustee 1/Beneficial Owner 1 - Eligibility Certificate and Professional Investor Declaration

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If your investment is below $500,000.00, the applicant must provide a Wholesale Investor Certificate issued by a qualified accountant. For additional information, please visit ASIC’s website.

Director 1/Trustee 1/Beneficial Owner 1 - Australian or Overseas Passport

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Director 1/Trustee 1/Beneficial Owner 1 - Australian or Overseas Driver's Licence (Front)

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Director 1/Trustee 1/Beneficial Owner 1 - Australian or Overseas Driver's Licence (Back)

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Director 2/Trustee 2/Beneficial Owner 2 - Eligibility Certificate and Professional Investor Declaration (if required)

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If your investment is below $500,000.00, the applicant must provide a Wholesale Investor Certificate issued by a qualified accountant. For additional information, please visit ASIC’s website.

Director 2/Trustee 2/Beneficial Owner 2 - Australian or Overseas Passport

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Director 2/Trustee 2/Beneficial Owner 2 - Australian or Overseas Driver's Licence (Front)

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Director 2/Trustee 2/Beneficial Owner 2 - Australian or Overseas Driver's Licence (Back)

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Director 3/Trustee 3/Beneficial Owner 3 - Eligibility Certificate and Professional Investor Declaration (if required)

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If your investment is below $500,000.00, the applicant must provide a Wholesale Investor Certificate issued by a qualified accountant. For additional information, please visit ASIC’s website.

Director 3/Trustee 3/Beneficial Owner 3 - Australian or Overseas Passport

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Director 3/Trustee 3/Beneficial Owner 3 - Australian or Overseas Driver's Licence (Front)

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Director 3/Trustee 3/Beneficial Owner 3 - Australian or Overseas Driver's Licence (Front)

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Partnership Applicant - Partnership Agreement

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Please upload a certified copy or relevant extracts of the partnership agreement, the full name of the partnership and any business name(s) used by the partnership.

Certified copy of Trust Deed - Unregulated Trusts and Self-Managed Superannuation Funds

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Please upload a certified copy of the trust deed (including any variations to the trust deed) confirming the full name of the trust, the type of trust, the country where the trust was established, and the name of each beneficiary or class of beneficiary.

Settlor - Australian or Overseas Passport

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Settlor - Australian or Overseas Driver's Licence (Front)

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Settlor - Australian or Overseas Driver's Licence (Back)

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Power of Attorney (if applicable)

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Applications submitted under a power of attorney must be accompanied by an original certified copy of the power of attorney document and a specimen signature of the relevant attorney(s).

Power of Attorney (if applicable)

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Applications submitted under a power of attorney must be accompanied by an original certified copy of the power of attorney document and a specimen signature of the relevant attorney(s).

DECLARATION AND SIGNING

By completing, signing and lodging this Application Form, you acknowledge and agree that:

You have read in full and understood the IM to which this Application Form relates, including understanding the risks set out in the IM.
You will promptly notify the Trustee and the Investment Manager of any change to the information you have previously provided to the Trustee or the Investment Manager, including any changes which result in a person or entity controlling, owning or otherwise holding an interest in the Proposed Fund.
You consent to the Trustee and the Investment Manager disclosing any information it has in compliance with its obligations under the US Foreign Account Tax Compliance Act (‘FATCA’) and the OECD Common Reporting Standards for Automatic Exchange of Financial Account Information (‘CRS’) and any related Australian law and guidance implementing the same. This may include disclosing information to the Australian Taxation Office, who may in turn report that information to the relevant tax authorities as required.
The details you have inserted into the Application Form are complete and accurate and where applicable reflects your tax status for purposes of FATCA/CRS.
You acknowledge that the collection of your personal information may be required by the Financial Transaction Reports Act 1988, the Corporations Act 2001, the Income Tax Assessment Act 1936, the Income Tax Assessment Act 1997, the Taxation Administration Act 1953, the FATCA and CRS (includes any related Australian law and guidance) and the Anti-Money Laundering and Counter- Terrorism Financing Act 2006.
You will provide the Trustee and the Investment Manager with all additional information and assistance that the Trustee and the Investment Manager may request in order for the Trustee and the Investment Manager to comply with the AML/CTF Law, FATCA and CRS.
You will be bound by the Trust Deeds and the terms on which the Units are being issued (as explained in the IM).
If you are sole signatory signing on behalf of a company, you confirm that you are signing as sole director and sole secretary of the company or as duly authorised representative or agent of the company.
If you are investing as a trustee, on behalf of a superannuation fund or a trust, you confirm that you are acting in accordance with your designated powers and authority under the trust deed. In the case of a superannuation fund, you also confirm that it is a complying fund under the Superannuation Industry (Supervision) Act.

If you sign this Application Form under a power of attorney, then a certified copy of the power of attorney is submitted with this Application Form, which as at the date of this application, has not been revoked.
You are over the age of 18.
You have made an offer for Units in the Proposed Fund and that offer cannot be revoked.
You acknowledge that an updated IM will not be reissued after the establishment of the Trust Deeds and the Proposed Fund, unless there is a material change to the IM.
We may accept or reject this application in whole or in part.
You may not be allocated any Units, and the Trustee has absolute discretion to allocate Units as it sees fit.
You have had the opportunity to seek independent professional advice regarding the legal, taxation and financial implications of investing in the Units and in the Proposed Fund generally.
You have not relied on any statements or representations made by anybody (including the Trustee, Investment Manager, Licensee or their officers, employees or agents) prior to applying, other than those representations made in this IM.
Monies invested in the Proposed Fund do not represent an investment in or a deposit of or other liability of the Trustee, Licensee or Investment Manager and an investment is subject to investment risk, including possible delays in the repayment and loss of income and capital investment.
You have provided all documentation requested for AML/CTF investor identification purposes.
If your investment is via a trust that is not a registered managed investment scheme or a government superannuation fund and you have not provided details of the name of each beneficiary or class of beneficiary, you certify that the trust is an unregistered managed investment scheme that only has wholesale clients as beneficiaries and does not make small scale offerings under section 1012E of the Corporations Act.
If an adviser’s details are provided in the Application Form, the Trustee, Investment Manager and Unit Registry Administrator are authorised to provide information directly to that adviser and their AFSL.
I/We confirm that I/we have read and understood the privacy section contained in the IM.

DECLARATION AND SIGNING (continued)

This Application Form must not be handed out or used unless accompanied by the IM. If received through electronic means, you declare you received the Application Form accompanied by or attached to a print out or paper copy of this IM. Units will only be issued on receipt of an Application Form issued together with the IM.

Applicant #1

NameApplicant 1 or Individual or Sole Director and Sole Company Secretary

Date

Individual

Sole Trader

Sole Director and Company SecretaryDirectorTrustee

Signature *

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Applicant 1 or Individual or Sole Director and Sole Company Secretary

Applicant #2

NameJoint Applicant 2 or Partner 2 or Director/Company Secretary

Date

Joint Applicant

Company Secretary (for company investments only)DirectorTrustee

Signature

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Joint Applicant 2 or Partner 2 or Director/Company Secretary

SIGNING INSTRUCTIONS

This form should be signed by the investor. If a joint holding, all investors should sign unless indicated otherwise on your latest operating instructions. If signed by the investor’s attorney, the power of attorney must have been previously noted by the registry or a certified copy attached to this form. If executed by a company, the form must be executed in accordance with the company’s constitution and the Corporations Act 2001 (Cth) (or for New Zealand companies, the Companies Act 1993).

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