Due Diligence Form DDF2 - Trust Accounts

Second Settlor or Protector

Please ensure all fields are completed to avoid delays in processing © Capital International Limited 2011 Page 2

1 Account Name

Trust Name

Please complete this section indicating how you wish to have the account registered/recorded for future reference

2 Trust Details

Trustees must complete the following details with the registered address of the Trust. ‘Care Of’ & PO Box addresses are not acceptable

Address

Post Code

Primary Contact

E-mail Address

Contact Number

Date of Establishment

Type of Trust

3 Trustee Details If there are more than the allocated number of Trustees, then please submit on a separate sheet

Forename(s)

Contact Number

E-mail Address

Passport No.

Employer

Y Y Y Y M M D D Date of Birth

Place of Birth

This section must be completed with the Trustees permanent residential address. ‘Care Of’ & PO Box addresses are not acceptable

Occupation

Address

If the Trustees have retired then please indicate this along with description of previous occupation

Post Code

Contact Number

E-mail Address

Passport No.

Employer

Y Y Y Y M M D D Date of Birth

Place of Birth

Occupation

Address

Post Code

Forename(s)

H W M H W M

Other/Former Names Other/Former Names

Where the Settlor, Trustees, and/or Protector are corporate entities, please utilise the personal fields to provide the relevant information

4 Settlor / Protector Details If there are more than the allocated number of Settlors or Protectors, then please submit on a separate sheet

Surname

Forename(s)

Passport No.

Y Y Y Y M M D D Date of Birth

Place of Birth

This section must be completed with the Settlors/Protectors permanent residential address. ‘Care Of’ & PO Box addresses are not acceptable

Address

Post Code

Passport No.

Y Y Y Y M M D D Date of Birth

Place of Birth

Address

Post Code

Forename(s)

Other/Former Names Other/Former Names

Nationality Nationality

Employer

Occupation

If Settlor/Protector has retired then please indicate this along with description of previous occupation

Employer

Occupation

Delete as appropriate

Title Surname Title

Second Trustee First Trustee

First Settlor S P

Surname Title Surname Title

Nationality Nationality

Name of Regulator (if applicable) Regulator Ref No.

Place of Establishment

Purpose of the Trust - e.g. asset protection, provision for children

Any Identification Number - e.g. Tax ID, VAT No, Charity Registration

Tax Residence Tax Residence

6 Correspondence Address

When contacting Capital International by telephone you may be asked to identify yourself. To assist us in this regard, please provide us with a codeword of your choice. In case you can not remember at the time of the call, we have provided space for a codeword prompt to help remind you:

i.e. ‘What is your place of birth?’

Codeword

Codeword Prompt

Address

Trusts may require correspondence to be sent to an alternative address.

‘Care Of’ & PO Box addresses are acceptable for this purpose only.

Account Security 7

8 Bank/Building Society Account Details Please complete this section with the Trust’s bank account details. Not only will these be used to fulfil our regulatory requirements but distributions and withdrawals can be made directly to the Trust’s bank or building society account.

Account Name

Bank/Building Society Name

Bank/Building Society Address

Please ensure all fields are completed to avoid delays in processing © Capital International Limited 2011 Page 3

5 Known Beneficiary Details If there are more than allocated number of known beneficiaries, then please submit on separate sheet

Forename(s)

Passport No.

Y Y Y Y M M D D Date of Birth

Nationality

This section must be completed with the Known Beneficiary’s permanent residential address. ‘Care Of’ & PO Box addresses are not acceptable

Address

Passport No.

Y Y Y Y M M D D Date of Birth

Nationality

Address

Post Code

Forename(s)

Other/Former Names Other/Former Names

Place of Birth Place of Birth

Employer

Occupation

If the Known Beneficiaries have retired then please indicate this along with description of previous occupation

Employer

Occupation

Surname Title Surname Title

Post Code

Post Code

Post Code

Second Beneficiary First Beneficiary

The sort code and account number, SWIFT/BIC Code or IBAN can be obtained from your Bank or Building Society branch. Please ensure your account will accept direct credit payments through the Banks Automated Clearing System. Capital International Limited does not accept instructions for payments to be made to an account other than the client’s own personal account. Should the quotation of account numbers and sort code, or IBAN made by the applicant prove incorrect, Capital International Limited will not accept responsibility for any loss incurred by the applicant.

Bank/Building Society Account Number or IBAN

Branch Sort Code

SWIFT/BIC Code

Account Currency GBP/USD/EUR or other_____ Please delete as appropriate

Y Y 0 2 M M D D

Acknowledged By:

Y Y 0 2 M M D D

Acknowledged By:

Y Y 0 2 M M D D

Acknowledged By:

Internal Use Only Received Date: Application Processed: Client Notification Sent:

11 Checklist

9 Declaration & Signature You must sign and date the form below

I/We understand that the information I/we provide on this application form, and any additional information supplied, will be processed in accordance with Capital International Limited’s data protection statement.

I/We declare that:

I/We am/are 18 years of age or over.

I/We understand that we are not obligated or bound by any contractual agreement - this application form is for account set-up and information purposes only.

I/We agree that the information contained within this application form is true and accurate.

Signatures of ALL Trustees who have supplied details on this application form. (YOU MUST SIGN HERE - Please ensure all relevant sections are completed as per the instructions on this form)

FIRST AUTHORISED SIGNATORY MUST SIGN HERE

M M 2 0 Y Y D

Date

D Print Name

First Authorised Signatory

SECOND AUTHORISED SIGNATORY MUST SIGN HERE

M M 2 0 Y Y D

Date

D Print Name

Second Authorised Signatory

We have provided a certified copy of the Trust Deed

We have fully completed this application form

We have signed the application form

We have provided a certified copy of the Authorised Signatory List

We have provided a certified copy of the Trustees minutes authorising the opening of the account with Capital International Limited

We have provided a certified copy of a valid piece of photographic ID per Trustee, Settlor, Protector and Authorised Signatory, i.e. current passport or driving licence

We have provided a certified copy of a valid piece of residential address verification per Trustee, Settlor, Protector and Authorised Signatory, i.e. bank statement or utility bill. This can not be more than six months old.

Unless you were introduced by an Intermediary, Capital International Limited may use your personal information to tell you of other products

and services, as well as others from within the Capital International Group of Companies, which they believe may be of interest to you.

If you do not wish for your personal information to be used in this way, please put an X in this box.

CIL

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