Investment Amendment Request - Absa

1 Absa Investment Management Services Investment Amendment Request Confidential Absa Investment Management Services is an Authorised Financial Services Provider. All relevant sections must be completed in full. Please indicate all options selected by means of a tick ( ). The investor must initial next to any amendments made. Please send fully completed instructions to Investment number The following sections have been completed: [Please tick ( )]. Current investor details Change Income from Investment Change investor details Change Debit order Investment Change investor contact details Change nomination of beneficiaries Change of Financial Services Provider/Representative information Change a Life Assured details Change Financial Services Provider/Representative fees/Commission Distribution method Fee deduction method Current investor details (Mandatory).

2 Individual investor details Title Initials Surname First name(s) Date of birth D D M M C C Y Y. Identity/Passport No If passport, state a reason Lost ID Stolen ID. Country of origin Country of residence Legal entity investor details Name of entity Registration number Inception date D D M M C C Y Y. Country of operation Country of registration Address details Residential/Registered address Postal address Suburb Suburb Town/City Postal code Town/City Postal code Country Country Trading address (if company). Town/City Postal code Country Occupational status: Full-time Part-time Self-employed Temporarily Other If other, please specify Employment sector/Type of business (if company) Occupation Source of income: Salary Savings/ Investment Policy Maintenance Other If other, please specify Gross monthly income 1/7.

3 Absa Investment Management Services (AIMS). Authorised Financial Services Provider FSP 524. PO Box 974, Johannesburg 2000. Fax: 0861 339 265/Internet website: Absa 4690 EX (CPA) (13/07/2018). Change investor details to Individual investor details Please attach proof of change of surname marriage certificate (if applicable). Title Initials Surname First name(s) Date of birth D D M M C C Y Y. Identity/Passport No If passport, state a reason: Lost ID Stolen ID. Country of origin Country of residence Language: English Afrikaans Marital status: Married Single Divorced Widowed Other If other, please specify Legal entity investor details Please attach proof of change of registered name of institution or trust.

4 Name of entity Registration number Inception date D D M M C C Y Y. Country of operation Country of registration Language: English Afrikaans Investor type: Individual Public Company Private Company Trust Partnership Sole Proprietor NPO Provident Fund Pension Fund Foreign Company Other If other, please specify Address details Please attach a recent original or certified copy of utility bill showing the investor's residential address not older than 3 (three) months (municipal lights, water and rates account, telephone account). Residential/Registered address Postal address Suburb Suburb Town/City Postal code Town/City Postal code Country Country Trading address (if company).

5 Town/City Postal code Country Change investor contact details to Notification preference: Email SMS Communication preference: Email SMS. Email Cellphone Change investor bank details to Please show with a tick ( ) if we must change a specific portfolio or all portfolios. Portfolio number or All portfolios Name of accountholder Initials Name of accountholder (if company/close corporation/trust). Name of bank Branch code Account number Account type: Current Savings Transmission 2/7. Change Financial Services Provider/Representative information Please show with a tick ( ) if we must change a specific portfolio or all portfolios.

6 Portfolio number or All portfolios Please indicate with a tick ( ) Change FSP/Representative or Cancel FSP/Representative Change of FSP/Representative Name of Financial Services Provider Name of Representative AIMS Representative code AIMS adviser code Postal address Town/City Postal code Country Telephone (W) Fax Cellphone Email Change Financial Services Provider/Representative fees/Commission Please show with a tick ( ) whether change must be done on a specific portfolio or all portfolios. Portfolio number or All portfolios Name of Financial Services Provider Name of Representative AIMS Representative code AIMS adviser code Current annual advice fee.

7 % Amended annual advice fee . %. Current recurring initial advice fee . % Amended recurring initial advice fee . %. I confirm that the above details are true and correct. Signed at on Investors signature [or duly authorised person(s) where applicable] Financial Services Provider/Representative signature (if applicable). Change regular income from Investment Please note that the only Amendment that can be made to the Living Annuity product is the income disinvestment option. Please indicate with a tick ( ) whether change must be done on a specific portfolio or on all portfolios. Portfolio number or All portfolios Please indicate with a tick ( ) New income Request or Amend current income Amend current income to New income Request Total income amount per frequency Income frequency please indicate with a tick ( ).

8 Monthly Quarterly Half-yearly Annually Annual escalation rate %. Cancel income payment Yes No Last income payment to be made (if yes) D D M M C C Y Y. New income Request Income amount per frequency First income payment due D D M M C C Y Y. Income frequency please indicate with a tick ( ). Monthly Quarterly Half-yearly Annually Annual escalation rate %. Annual escalation date 2 5 M M C C Y Y. 3/7. Select income disinvestment choice by making a tick ( ). From specific funds (please list funds below) Pro rata across fund selection (default option). *Premium range Fund code Fund name %. ( ). *Please ensure that the % allocation adds up to 100% in total.

9 1 0 0. Please note Where an income is deducted from an Exchange-traded Fund (ETF), the amount paid may be greater than specified due to whole units being repurchased. Amend debit order (Recurring Investment ). Please indicate with a tick ( ) whether change must be done on a specific portfolio or on all portfolios Portfolio number or All portfolios Please indicate with a tick ( ) Amend current debit order or New debit order Request Amend current debit order to Total income amount per frequency . Minimum recurring Investment : R500 per month Investment Intervals: Monthly Quarterly Half-yearly Annually Debit order dates 3rd, 10th, 17th or 25th of the month Annual increase in recurring Investment % First debit order date D D M M C C Y Y.

10 Cancel debit order Yes No Next increase in recurring Investment D D M M C C Y Y. New debit order Request Total debit order amount per frequency . Minimum recurring Investment : R500 per month Investment Intervals Monthly Quarterly Half-yearly Annually Debit order dates are the 3rd, 10th, 17th or 25th of the month Annual increase in recurring Investment % First debit order date D D M M C C Y Y. Next increase in recurring Investment D D M M C C Y Y. Fund code Fund name %. 1 0 0. Debit order authority I/We hereby Request , instruct and authorise AIMS, its successors or assignees to draw against my/our account with the bank noted above (or any bank or branch to which I/we may transfer my account).