Fund Name: CCM Systematic Macro Plus Fund
ARSN: 657 853 177
Fund Manager: Cartwright Capital Management Pty Ltd
ABN: 12 660 805 952

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 761G of 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.

CONTACT DETAILS

Your Email Address *

Full Name *

Contact Phone Number *

AML/CTF 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).

Fund Name: CCM Systematic Macro Plus Fund
ARSN: 657 853 177
Fund Manager: Cartwright Capital Management Pty Ltd
ABN: 12 660 805 952

Application Form

This Application Form relates to the Information Memorandum relating to the CCM Systematic Macro Plus Fund (ARSN 657 853 177) (the “ Fund”), issued by Cartwright Capital Management Pty Ltd (ABN 12 660 805 952) (in its capacity as Investment Manager). Please read the Information Memorandum (IM) in full before completing this Application Form. Unless otherwise stated, terms defined in the Information Memorandum have the same meanings in this Application Form.

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 apply for *Minimum initial investment: $250,000.00

of Units at $1.00 per Unit

Please note that 100% of your Application Amount should accompany this form.

SECTION 1: INVESTOR DETAILS

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

A. Individual Application

A. Joint Application

Applicant 1

Title *

First name *

Middle name *

Last name *

Date of Birth *

Tax File Number or reason for exemption *

Residential address *

Street address *Street address line 2

City *

State *

Postcode *

Country

Country of residence for tax purposes

Business name

ABN(if any)

Phone (Work)

Phone (Home)

Mobile *

Applicant 2

Title *

First name *

Middle name *

Last name *

Date of Birth *

Tax File Number or reason for exemption *

Residential address *

Street address *Street address line 2 *

City *

State *

Postcode *

Country

Country of residence for tax purposes

Phone (Work)

Phone (Home)

Mobile *

B. Company / Corporate Trustee

Full name of Company or Corporate Trustee *

Tax file number or reason for exemption *

ACN or ABN *

Business name(if applicable)

Registered office address *

Street address *Street address line 2

City *

State *

Postcode *

Country

Not PO Box (Street Address is required)

Principal Place of Business *

Street address *Street address line 2

City *

State *

Postcode *

Country

Not PO Box (Street Address is required)

* 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 companyprivate company

Please provide details of the exchange on which it is listed *

Name of parent company *

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

Number of Directors *

Director 1

Title *

Given Name *

Surname *

Director 2

Title *

Given Name *

Surname *

Director 3

Title *

Given Name *

Surname *

Director 4

Title *

Given Name *

Surname *

Beneficial Owners

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.

Beneficial owner(s) is/are the same as Director(s).If Beneficial owners are different, provide details below.

Number of Beneficial Owners *

Beneficial Owner 1

Title *

Given Name *

Surname *

Date of birth *

Residential address *

Street address *Street address line 2

City *

State *

Postcode *

Country

Not PO Box (Street Address is required)

Beneficial Owner 2

Title *

Given Name *

Surname *

Date of birth *

Residential address *

Street address *Street address line 2

City *

State *

Postcode *

Country

Not PO Box (Street Address is required)

Beneficial Owner 3

Title *

Given Name *

Surname *

Date of birth *

Residential address *

Street address *Street address line 2

City *

State *

Postcode *

Country

Not PO Box (Street Address is required)

Beneficial Owner 4

Title *

Given Name *

Surname *

Date of birth *

Residential address *

Street address *Street address line 2

City *

State *

Postcode *

Country

Not PO Box (Street Address is required)

If there are more than four beneficial owners, please provide details below.

C. Partnerships

Full Name of Partnership *

Business Name *(if applicable)

Tax file number or reason for exemption *

Country of Establishment

Registered Office Address *

Street address *Street address line 2

City *

State *

Postcode *

Country

Not PO Box (Street Address is required)

Partner 1

Title *

First name *

Middle name *

Last name *

Date of birth *

Tax file number or reason for exemption *

Residential address *

Street address *Street address line 2

City *

State *

Postcode *

Country

Not PO Box (Street Address is required)

Country of residence for tax purposes

Phone (Work)

Phone (Home)

Mobile *

Partner 2

Title *

First name *

Middle name

Last name *

Date of birth *

Tax file number or reason for exemption *

Residential address *

Street address *Street address line 2

City *

State *

Postcode *

Country

Not PO Box (Street Address is required)

Country of residence for tax purposes

Phone (Work)

Phone (Home)

Mobile *

Regulation Information

Is the Partnership regulated by a Professional Body? *

YesNo

Association name

Association website

Partner’s membership number / reference

You must provide details of each partner. If there are more than two partners, please provide details below.

D. Trust / Superannuation Funds

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 *

Full name of Trust / Superannuation fund *

Tax File Number or reason for exemption *

Country where Trust was established *

Registered office address *

Street address *Street address line 2

City *

State *

Postcode *

Country

Individual Trustee 1 (Full Name): *

Individual Trustee 1 (Tax File Number) *

Individual Trustee 1 - Date of Birth *

Individual Trustee 1 (Address) *

Street address *Street address line 2

City *

State *

Postcode *

Country

Mobile *

Work Phone

Home Phone

Email *

Individual Trustee 2 (Full Name): *

Individual Trustee 2 (Tax File Number) *

Individual Trustee 2 - Date of Birth *

Individual Trustee 2 (Address) *

Street address *Street address line 2

City *

State *

Postcode *

Country

Mobile *

Work Phone

Home Phone

Email *

Individual Trustee 3 (Full Name): *

Individual Trustee 3 (Tax File Number) *

Individual Trustee 3 - Date of Birth *

Individual Trustee 3 (Address) *

Street address *Street address line 2

City *

State *

Postcode *

Country

Mobile *

Work Phone

Home Phone

Email *

Individual Trustee 4 (Full Name): *

Individual Trustee 4 (Tax File Number) *

Individual Trustee 4 - Date of Birth *

Individual Trustee 4 (Address) *

Street address *Street address line 2

City *

State *

Postcode *

Country

Mobile *

Work Phone

Home Phone

Email *

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 FundRegistered Managed Investment SchemeOther Regulated Trust

ABN *

ARSN *

Name of regulator

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.

Beneficiary Details

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

YesNo

Provide details of membership classes (unitholders, family members of named person, charitable organisations)

Number of Beneficiary *

Beneficiary 1

Given Name *

Surname *

Beneficiary 2

Given Name *

Surname *

Beneficiary 3

Given Name *

Surname *

If there are more than three beneficial owners, please provide details below.

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 Settlor

Beneficial Owner(s) / Controller of the Trust

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

Owns more than 25% of the trust; or
Controls the trust.

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

Number of Beneficial Owner(s) / Controller of the Trust *

Beneficial Owner 1

Title *

Given Name *

Surname *

Date of Birth *

Residential address *

Street address *Street address line 2

City *

State *

Postcode *

Country

Not PO Box (Street Address is required)

Beneficial Owner 2

Title *

Given Name *

Surname *

Date of Birth *

Residential address *

Street address *Street address line 2

City *

State *

Postcode *

Country

Not PO Box (Street Address is required)

Beneficial Owner 3

Title *

Given Name *

Surname *

Date of Birth *

Residential address *

Street address *Street address line 2

City *

State *

Postcode *

Country

Not PO Box (Street Address is required)

If there are more than three beneficial owners, please provide details below.

E. Politically Exposed Persons (PEPs)

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 investor a Politically Exposed Person? (Please refer to more information in the the IM) *

NoYes

Provide a description of the PEP’s Position *

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

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, Licensee and Investment Manager are 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 tax payers, 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.

I. Joint Investors

FATCA

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

YesNo

Applicant 1

Full Name *

TIN *

Applicant 2

Full Name *

TIN *

Please provide details for each individual. If there are more than 2 individuals, please provide their details below.

CRS

2. Are you a tax resident of any country outside Australia? *

YesNo

Provide details below and skip to section 3. If you are a tax resident in more than one jurisdiction, please include details for all jurisdictions below (if more than 2 jurisdictions, please provide details below)

Applicant 1

Country of Tax Residence 1

Tax Identification Number 1

Reason Code if no TIN provided 1

Country of Tax Residence 2

Tax Identification Number 2

Reason Code if no TIN provided 2

Applicant 2

Country of Tax Residence 1

Tax Identification Number 1

Reason Code if no TIN provided 1

Country of Tax Residence 2

Tax Identification Number 2

Reason Code if no TIN provided 2

If TIN or equivalent is not provided, please provide reason from the following options

Reason A: The country/jurisdiction where the entity is resident does not issue TINs to its residentsReason B: The entity is otherwise unable to obtain a TIN or equivalent numberReason C: No TIN is required. (Note: Only select this reason if the domestic law of the relevant jurisdiction does not require the collection of the TIN issued by such jurisdiction)

Please explain why the entity is unable to obtain a TIN

I. Individual/Sole Trader Investor

FATCA

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

YesNo

Individual/Sole Trader Investor

Full Name *

TIN *

CRS

2. Are you a tax resident of any country outside Australia? *

YesNo

Individual/Sole Trader Investor

Country of Tax Residence 1

Tax Identification Number 1

Reason Code if no TIN provided 1

Country of Tax Residence 2

Tax Identification Number 2

Reason Code if no TIN provided 2

II. Superannuation Funds

Full legal name of the Superannuation Fund *

3. Are you an Australian Retirement Fund? (refer to FATCA status definitions)

Yes. Skip to section 3 - Distribution Payment DetailsNo. Continue to section III.

III. Entities (Company, Trust, Partnership, Association etc.)

Full legal name of the Entity

FATCA

4. Select only ONE of the following three FATCA categories that best describes the entity and provide the information requested.

4.1 - U.S. person as defined under FATCA and U.S. Internal Revenue Code4.2 - Financial institution (FFI). Select one of the options from (a) to (e) to confirm which type of FFI is applicable to your circumstances4.3 - Non-Financial Foreign Entity (NFFE). Select one of the options from (a) to (c) to confirm which type of NFFE is applicable to your circumstances.

This includes but is not limited to company, trust or partnership that is established under the laws of a U.S. and is considered a U.S. resident for tax purposes.

(a) U.S. federal tax classification. Please confirm entity’s U.S. federal tax classification below

Please provide detail

(b) Are you exempt from FATCA reporting?

YesNo

Please provide your FATCA exemption code

Please provide your US TIN

(a) Reporting IGA FFI or Participating FFI(b) Sponsored FFI or Trustee Documented Trust(c) FFI that does not need to register (e.g. Non-Reporting IGA FFI)(d) Non-participating FFI. Note that information about you will be reported to ATO and IRS. Continue to question 5(e) Exempt Beneficial Owner. Continue to question 5

Provide entity’s GIIN and continue to question 5

Name of Sponsoring entity or Trustee

GIIN of Sponsoring entity or Trustee

FATCA status

GIIN(if applicable)

(a) Active NFFE. Continue to question 5(b) Passive NFFE with no controlling U.S. persons. Continue to question 5(c) Passive NFFE with controlling persons (refer to FATCA definitions) who are U.S. citizens or U.S. residents for tax purposes

Provide details of each of the controlling U.S. persons below (if there are more than 2 controlling U.S. persons please provide their details below) and continue to question 5

US Person 1

Please specify

Full Name

Residential address

U.S. Taxpayer Identification Number (TIN)

US Person 2

Please specify

Full Name

Residential address

U.S. Taxpayer Identification Number (TIN)

CRS

5. Are you a tax resident of any other country outside of Australia?

YesNo

Continue to question 6.

Provide details below and continue to question 6. If resident in more than one jurisdiction please include details for all jurisdictions below (if more than 2 jurisdictions please provide details below)

Country of Tax Residence 1

Tax Identification Number 1

Reason Code if no TIN provided 1

Country of Tax Residence 2

Tax Identification Number 2

Reason Code if no TIN provided 2

If TIN or equivalent is not provided, please provide reason from the following options

Please explain why the entity is unable to obtain a TIN

6. Are you a Financial Institution for the purposes of CRS?

Yes. Continue to question 7No. Skip to question 8

7. Are you an Investment Entity (Financial Institution) located in a Non-Participating Jurisdiction for CRS purposes and managed by another Financial Institution?

Yes. Continue to question 9No. Skip to section 3 - Distribution Payment Details

8. Are you an Active Non-Financial Entity (Active NFE)?

Yes. Specify the type of Active NFE below and then skip to section 3 - Distribution Payment DetailsNo. You are a Passive Non-Financial Entity (Passive NFE). Continue to question 9

Less than 50% of the Active NFE’s gross income from the preceding calendar year is passive income and less than 50% of its assets during the preceding calendar year are assets held for the production of passive incomeCorporation that is regularly traded or a related entity of a regularly traded corporationGovernmental Entity, International Organisation or Central Bank

9. Controlling Persons – Does one or more of the following apply to you

Is any natural person that exercises control over you (for corporations, this would include directors or beneficial owners who ultimately own 25% or more of the share capital) a tax resident of any country outside of Australia?
If you are a trust, is any natural person, including trustee, protector, beneficiary, settlor or any other natural person exercising ultimate effective control over the trust a tax resident of any country outside of Australia?

No. Continue to section 3 - Distribution Payment Details.Yes. Complete details below for these persons and continue to section 3 - Distribution Payment Details.

Controlling Person 1

Name

Date of Birth

Residential Address

Country of Tax Residence

Tax Identification Number

Reason Code if no TIN provided

Controlling Person 2

Name

Date of Birth

Residential Address

Country of Tax Residence

Tax Identification Number

Reason Code if no TIN provided

If there are more than 2 controlling persons, please provide the details below.

If TIN or equivalent is not provided, please provide reason from the following options

Please explain why the entity is unable to obtain a TIN

IV. EXPLANATIONS

Common Terms

Financial institution (also referred to as Foreign financial institution or “FFI” under FATCA) - an entity created or organised outside of the U.S. and includes:

a) Depository institution – entity that accepts deposits in the ordinary course of banking or similar business (banks, credit unions), or

b) Custodial institution – entity that holds financial assets for the account of others as a substantial portion of its business (brokers, custodians), or

c) Investments entity –means any entity that conducts as a business (or is managed by an entity that conducts as a business) one or more of the following activities or operations for or on behalf of a customer:

trading in money market instruments (cheques, bills, certificates of deposit, derivatives, etc.); foreign exchange; exchange; interest rate and index instruments; transferable securities; or commodity futures trading;
individual and collective portfolio management; o
otherwise investing, administering, or managing funds or money on behalf of other persons.

Non-Financial Foreign Entity (“NFFE”) - any non-U.S. entity that is not a financial institution. NFFE can be either Active NFFE or Passive NFFE (refer below for more details).
U.S. citizen or U.S. resident for tax purposes – includes:

anyone born in the U.S. (who hasn’t renounced their citizenship)
anyone living in the U.S.
a green card holder
U.S. passport holder
U.S. companies, trusts or partnerships

Controlling Persons - means the natural persons who exercise control over an Entity. In the case of a trust, such term means the settlor, the trustees, the protector (if any), the beneficiaries or class of beneficiaries, and any other natural person exercising ultimate effective control over the trust, and in the case of a legal arrangement other than a trust, such term means persons in equivalent or similar positions. The term “Controlling Persons” shall be interpreted in a manner consistent with the Financial Action Task Force Recommendations.

GIIN - Global Intermediary Identification Number is an IRS registration number for financial institutions.

TIN – is U.S. Taxpayer Identification Number and may include Social Security Number (SSN) or Employer Identification Number (EIN).

IGA - Agreement between the Government of Australia and the Government of the United States of America to Improve International Tax Compliance and to Implement FATCA.

Australian Retirement Fund

Any plan, scheme, fund, trust, or other arrangement operated principally to administer or provide pension, retirement, superannuation, or death benefits that is a superannuation entity or public sector superannuation scheme (including an exempt public sector superannuation scheme) as defined in the Superannuation Industry (Supervision) Act 1993, or a constitutionally protected fund as defined in the Income Tax Assessment Act 1997.
A pooled superannuation trust as defined in the Income Tax Assessment Act 1997.
Any Entity that is wholly owned by, and conducts investment activities, accepts deposits from, or holds financial assets exclusively for or on behalf of, one or more plans, schemes, funds, trusts, or other arrangements referred to in subparagraphs (1) or (2) of this paragraph.

FATCA Status

FATCA status refers to entity classification under FATCA and may include:

1. Active NFFE - any NFFE that meets following criteria:

NFFE where less than 50% of income is passive income (i.e. dividends, interest, annuities etc.) and less than 50% of its assets produce passive income; or
Entity’s stock is regularly traded on established securities market (e.g. entity listed on ASX) or affiliated group of such entity; or
Entity organised in U.S. Territory and owned by its residents; or
Foreign government; or
International organisation; or
Foreign Central Bank of Issue; or
Any other specifically identified class of entities, including those posing a low risk of tax evasion, as determined by the IRS (e.g. start-up entities, entities in liquidation, not-for profit entities etc.)

2. Passive NFFE with controlling U.S. persons - any NFFE that is not an Active NFFE or is not a withholding foreign partnership or trust and has controlling U.S. persons.

3. Passive NFFE with no controlling U.S. persons - any NFFE that is not an Active NFFE or is not a withholding foreign partnership or trust and where none of the entity’s controlling persons are U.S. persons.

4. Participating FFI – an FFI that enters into an agreement with the IRS to undertake certain due diligence, withholding and reporting requirements for U.S. account holders in accordance with FATCA and is generally able to provide GIIN.

5. Exempt Beneficial Owner - this is non-reporting entity under FATCA and may include:

the Australian Government, State and local governments and local authorities and their wholly owned agencies or instrumentalities, including certain named entities;
International, intergovernmental and supranational organisations;
Reserve Bank of Australia and its subsidiaries;
Complying Australian superannuation funds (including self-managed super funds);
Investment entity wholly owned by exempt beneficial owners;
Non-Reporting IGA FFI – this is non-reporting entity (certified or registered deemed-compliant FFI) under FATCA and may include:
Financial institution with Australian client base (must satisfy all condition listed in paragraph III. A of Annex II of the IGA, including at least 98% of the U.S. dollar value of all account balances must be held by Australian residents);
Small local banks that meet criteria listed in the IGA;
Financial Institution that is not an Investment Entity with only Low-Value Accounts (i.e. with value of U.S.$ 50,000 or less) and with total assets of no more than U.S.$50 million; Qualified credit card issuer (with customer deposits of U.S.$50,000 or less);
Trustee-Documented Trust – A trust established under the laws of Australia to the extent that the trustee of the trust is a Reporting U.S. Financial Institution, Reporting Model 1 FFI, or Participating FFI and reports all information required to be reported pursuant to the Agreement with respect to all U.S. Reportable Accounts of the trust;
Sponsored investment entity - an investment entity established in Australia that has a Sponsoring entity;
Certain Investment Manager and Investment Advisors; Certain Collective Investment Vehicles that meet criteria listed in the IGA.
Non-Participating FFI - an entity that does not comply with FATCA and generally will not fall into any of the below categories:
- Participating FFI; or
- Reporting FFI; or
- Exempt Beneficial Owner

Further information about FATCA & CRS can found at:

http://www.irs.gov/fatca
http://treasury.gov.au/Policy-Topics/Taxation/Tax-Treaties/HTML/Intergovernmental-Agreement
http://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/rp1314/QG/FATCA
http://www.oecd.org/tax/automatic-exchange/international-framework-for-the-crs/
http://www.oecd.org/tax/automatic-exchange/international-framework-for-the-crs/MCAA-Signatories.pdf

SECTION 3: DISTRIBUTION & REDEMPTION PAYMENT DETAILS

Please make deposits and redemptions to the following account:

Bank Name *

Account Name *

BSB Number *

Account Number *

Important: For us to process your application, please tick 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

Application Amount

Method of Payment *

$AUD DIRECT DEPOSIT

Bank Name:	ANZ BANK
Bank Address:	388 Collins Street, Melbourne VIC 3000
Account Name:	MSC Abacus Pty Ltd
BSB Number:	013-006
Account Number:	838412439

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

SECTION 5: REPORTING

Please indicate your preferred email address to receive communications about your investment:

Name

Email Address

Mobile

Secondary Contact Name

Secondary Contact Email

Third Contact Name

Third Contact Email

Fourth Contact Name

Fourth Contact Email

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 investment information (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 Investor

SECTION 7: ADVISER USE ONLY

By providing your adviser details, you certify that you are appropriately authorised to provide financial services in relation to this product.

ADVISER’S CONTACT DETAILS

Dealer Group

Dealer Group AFSL

Adviser Firm

Adviser Firm AFSL

Adviser Name

Authorised Representative Number

Adviser email address

Adviser contact phone number

Please provide certified copies of the identification documentation specified in the AML section under the relevant investor type with this Application Form

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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.

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

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Applicant 2 - Eligibility Certificate and Professional Investor Declaration

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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 - 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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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

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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

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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 (Back)

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Partnership Agreement

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Copy or relevant extracts of the partnership agreement, 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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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

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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.
No person or entity controlling, owning or otherwise holding an interest in the Applicant is a United States citizen or resident of the United States for taxation purposes.
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 (see page 45 of the IM).
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 on Section 6 of 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.

PLEASE NOTE

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

Name *

Date *

Individual

Sole Trader

Position of applicant

Sole DirectorDirectorTrustee

(if applicable)

Signature *

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Applicant #2

Name *

Date *

Joint Applicant

Position of applicant

Company Secretary (for company investments only)DirectorTrustee

(if applicable)

Signature *

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(if joint applicants, then both applicants must sign)

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