Product Application Form Share Dealing Services
PAF3
Please ensure all fields are completed to avoid delays in processing © Capital International Limited 2011 Page 2
4 Investment Details
Number of transactions Investment Amount Per month / annum
Reporting Currency Average transaction value Please indicate average transaction value
Do you intend to trade in, or hold, any of the following US Dollar denominated assets? US Shares US Bonds
Please specify if there are any special tax matters or status which we need to be aware of in connection with your dealing account with us:
Second Applicant
First Applicant
1 Account Name
Account Name
Please complete this section indicating how you wish to have the account registered/recorded for future reference
2 Applicant Details
Surname Forename(s)
Trust Name
Company Name
Title
Surname Forename(s) Title
3 Type of Service
Service Decision (delete as appropriate) Full Discretionary Managed Advisory Advisory Execution Only
Nominee Service (delete as appropriate) Full Nominee Foreign Nominee Non-Nominee
6 Source of Wealth
Business Profits
Life Savings
Please indicate the underlying source of your wealth, e.g. if your wealth is derived from salary/bonus please give an indication of your annualised salary
I/We confirm that the source of my/our wealth represented by the funds to be held in this account derive from:
Salary/Bonus
Business Share/Sale
House/Property Sale
Pension Settlement
Inheritance
Other
Description Details Amount / Value
The funds to be invested with Capital International Limited are to originate from: (please state bank or building society name and address)
Source of Funds
5 Source of Funds
Account Reference (for internal use only)
Please ensure all fields are completed to avoid delays in processing © Capital International Limited 2011 Page 3
9 Declaration & Signature You must sign and date the form below
Signatures of ALL Applicants
(YOU MUST SIGN HERE - Please ensure all relevant sections are completed as per the instructions on this form)
PLEASE SIGN HERE
M M 2 0 Y Y D
Date
D Print Name
First Signature
PLEASE SIGN HERE
M M 2 0 Y Y D
Date
D Print Name
Second Signature
Delete as appropriate - Signing Together / Signing Alone _______________________________ Please indicate who Signing Authority (Joint Accounts)
Portfolios may choose to have their distributions and income either: Retained or Paid-Away
Sterling US Dollars
Portfolios may choose to have their dealing account free money either: Retained or Paid-Away
Payment preference: Cheque CHAPS BACS
7 Dividend & Cash Instructions
8 Investment Objectives
Client Risk Profiles You should remember that by their very nature, investments involve a degree of risk over and above that of a bank deposit. Generally, investments
should be made on a medium to long-term basis and although we shall act in a way that we believe to be in accordance with your willingness to accept
risk, clients should not invest funds that they cannot afford to lose. In the event that you choose not to adopt a specific investment approach, we will
adopt a medium risk strategy by default.
Risk Profile Medium High Low
Income Requirement Medium High Low
Capital Growth Medium High Low
We authorise your entering into Non-readily realisable investments Underwriting or similar obligations
Investment Criteria
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 contained in the Terms of Business referred to below. By signing below, I/we confirm that I/we
have received the relevant documentation and advice relating to this investment, and Terms which I/we accept. I/We declare that:
I/We am/are 18 years of age or over.
I/We agree that the information contained within this application form is true and accurate.
I/We have received, read and understood the Capital International Limited Dealing & Advisory Services Brochure V1.01-08.10.
I/We have received, read, understood and agree to be bound by the Capital International Limited Dealing - Terms of Business as set out in the accompanying documents: Retail Terms of Business CINL V1.01-08.10
or Retail Terms of Business PSL V1.01-08.10 and PSL - Dealing Retail ToB V1.01-08.10 or Terms of Business CINL V1.01-08.10
or Terms of Business PSL V1.01-08.10 and PSL - Dealing Article II ToB V1.01-08.10
If you have not received all of the aforementioned documentation relating to the Capital International Limited Dealing & Advisory Services, or
do not fully understand the product offering then please contact your Financial Adviser or us immediately.
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.
Registered Address
This section should only be completed by Intermediaries. Please enter the appropriate details here and avoid supplying information on separate sheets.
I / we confirm that I / we am / are registered with / regulated by the following body to conduct investment business:
I am/am not registered for VAT:
Please tick the relevant commission structure:
If ‘Other’ is selected please specify the terms required on this application form; all terms must be agreed with Capital International Limited in advance.
Intermediary Stamp/Details:
X X X A B C D Other: .
10 Intermediary Details
Intermediary Name
Contact Name
Telephone Number
E-mail Address
Postcode
Firm Ref No
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:
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