New Business Investment Form - STANLIB

1 E-mail 0867 277 516 New Business Investment FormLinked Investments - IndividualsRegistration details: Classic Retirement Annuity Fund Registration number 12/8/34304 (SARS Registration number 18/20/4/41660), Classic Preservation Pension Plan Registration number12/8/34312 (SARS Registration number 18/20/4/39087), Classic Preservation Provident Plan Registration number 12/8/34309 (SARS Registration number 18/20/4/41669) IMPORTANT: NEW APPLICATION FORMS ARE ON THEIR WAY IN AUGUST 2018. WE WILL CONTINUE TO ACCEPT THIS VERSIONOF OUR form UNTIL 1 OCTOBER * CLASSIC Investment PLAN CLASSIC LINKED LIFE ANNUITY CLASSIC RETIREMENT ANNUITYFUND CLASSIC PRESERVATIONPENSION PLAN CLASSIC PRESERVATIONPROVIDENT PLAN STANLIB LINKED INVESTMENTSTAX-FREE SAVINGS PLANINSTRUCTION TYPE* NEW SECTION 37 TRANSFER SECTION 14 TRANSFER CASH TRANSFER UNIT TRANSFERCLIENT TYPE*IMPORTANT INFORMATIONAll sections applicable to this Investment must be completed in full and in block letters; all options must be indicated by a cross (X), failure to provideclear instruction will delay the processing of the instruction.

2 * Indicates compulsory fields/sections where applicablePlease refer to "what I need to know when completing this form (last two pages)" for more information. STANLIB will not be liable for any loss from the delay in the processing of Investment due to outstanding requirements such as thefollowing:Inability to verify the accuracy of the instructionMonies not received on time or identifiedSupporting documentation Please submit the Instruction together with the following documents:Application formCopy of the Identity documentsProof of Address (not older than 3 months)If required, FICA and FATCA documentsPlease note: If the portfolio range is not selected, Linked Range will apply. If the portfolio selected is not offered on the Linked Range, then theSelect portfolio range will apply. Access to FundsA clearance period of 21 calendar days for cheques and 45 calendar days for recurring and once-off debit orders will apply.

3 Withdrawals on Retirement Products: * Only one withdrawal will be allowed per contract. This means that for more than one transfer into a single contract, a member will not be permitted afurther withdrawal if a previous withdrawal has been taken (applicable to Classic Preservation Pension Plan and Classic Preservation Provident Plan).* A member with multiple contracts will be allowed a once off withdrawal from each contract (applicable to Classic Preservation Pension Plan andClassic Preservation Provident Plan).* Please remember no pre-retirement (RA) withdrawals will be allowed, unless the member share is below the current threshold of R7000 (applicable toClassic Retirement Annuity Fund).A Daily cut-off time for fully completed instructions received by STANLIB is before 15H30 on any Business completed instructions to STANLIB : E-mail: or Fax: +27(0) 867 277 516 STALIINV2252018/07/10HX3491 Page 1 of 10 < - - P a g e B r e a k - - >CLIENT DETAILSTITLE* NAME/S*SURNAME* ID NUMBER*PASSPORT NUMBER*PASSPORT EXPIRY DATE*--DDMMYYYY COUNTRY OF ISSUE* DATE OF BIRTH*--DDMMYYYY GENDER* FEMALE MALE RETIREMENT AGECELLPHONE NUMBER* TELEPHONE NUMBER(H)/ (W)

4 EMAIL ADDRESS* TAX REFERENCENUMBER*SOUTH AFRICANRESIDENT* YES NO COUNTRY OFRESIDENCENATIONALITY COUNTRY OF BIRTHSOURCE OF FUNDS* INHERITANCE ESTATE DONATION OTHERIF OTHER PLEASESPECIFY*SOURCE OF INCOME* SALARY/WAGES PENSION Investment INCOME ANNUITY INCOME OTHERIF OTHER PLEASESPECIFY*WITHHOLDING TAX WITHHOLDING TAX EXEMPT WITHHOLDING TAX REDUCEDRATE REDUCED RATE INTEREST TAX EXEMPT FROM TAX ONINTEREST REDUCED INTEREST TAX RATE REDUCED RATEREIT TAX EXEMPT FROM TAX ON REIT REDUCED REIT TAX RATE REDUCED RATE* Compulsory fieldsADDRESS DETAILSPHYSICAL ADDRESSCOMPLEX/UNIT/NUMBER* COMPLEX NAME*STREET NUMBER STREET NAME*SUBURB* CITY*COUNTRY* POSTAL CODE** Compulsory fieldsPOSTAL ADDRESS SAME AS PHYSICAL ADDRESSADDRESS TYPE PO BOX PRIVATE BAG POSTNETSUITE POSTNET SUITE NUMBERNUMBER POST OFFICE NAME POSTALCODECORRESPONDENCE ADDRESSIf you wish for correspondence to be sent to a different address to your physical or postal address, please complete this COMPLEX NAMESTREET NUMBER STREET NAMESUBURB CITYCOUNTRY POSTAL CODE STALIINV2252018/07/10HX3491 Page 2 of 10 ADDRESS TYPE PO BOX PRIVATE BAG POSTNETSUITE POSTNET SUITE NUMBERNUMBER POST OFFICE NAME POSTALCODECORRESPONDENCE PREFERENCE*PREFERRED CORRESPONDENCE ELECTRONIC POSTTAX INFORMATION FOR CLASSIC Investment PLAN ONLYARE YOU A REGISTERED TAX PAYER: YES NOIf Yes, please indicate all countries (including South Africa) in which you are resident for tax purposes and the associated tax identificationnumbers in the table below as mandatory information.

5 Country(ies) of Tax Residency *Tax Identification Number * (If you do not have a TIN, please provide reason) Investment DETAILS* Investment TYPE LUMP SUM RECURRING COMBINATION LUMP SUM LUMP SUM: ONCE-OFF DEBIT AMOUNTR DATE--DDMMYYYY LUMP SUM: DIRECT DEPOSITAMOUNTR DATE--DDMMYYYY LUMP SUM: TRANSFER (UNIT) AMOUNTRMULTIPLE DEPOSITS INVEST AS AND WHEN DEPOSITS ARE RECEIVEDIf the option above is not selected, STANLIB will invest total amount once all deposits have been FROM STANLIB UNITTRUST YES STANLIB UNIT TRUST ENTITY NUMBERRECURRING RECURRING DEBIT ORDER AMOUNTR DEBIT ORDER DATE-MMYYYYRECURRING DEBIT ORDERFREQUENCY MONTHLY ANNUALLY RECURRING DEBIT ORDER DAY 1ST 15 THANNUAL CONTRIBUTION INCREASEPERCENTAGE 0% 5% 10% 15% 20%PHASE-IN OPTIONNUMBER OF PHASE INMONTHS 3 6 9 12 15 18 24 FIRST PHASE-IN DATE-MMYYYYCOMMENCEMENT DAY 3RD OR 17TH OF THE MONTH PHASE-IN Portfolio NamePortfolio RangePercentageLinkedRangeSelectClassic% %% STALIINV2252018/07/10HX3491 Page 3 of 10 Portfolio NamePortfolio RangePercentageLinkedRangeSelectClassic% LUMP SUM PORTFOLIOS* Portfolio NamePortfolio

6 RangePercentageAmountLinkedRangeSelectCl assic%R%R%R%R%R%R%RIf you have selected a model portfolio and it is not managed by STANLIB Multi-Manager or Morningstar, please submit the applicationform with a mandate. PERSONAL SHARE PORTFOLIO TRANSFER DETAILS*Source (From)Personal Share Portfolio NameTransfer TypeDestination (To)Personal Share Portfolio NameAmount/ValueCash Share/ScriptRRRRRECURRING DEBIT ORDER PORTFOLIOS* Portfolio NamePortfolio RangePercentageAmountLinkedRangeSelectCl assic%R%R%R%R%R%R%RIf you have selected a model portfolio and it is not managed by STANLIB Multi-Manager or Morningstar, please submit the applicationform with a mandate. STALIINV2252018/07/10HX3491 Page 4 of 10 < - - P a g e B r e a k - - >BANK DETAILS*DetailsRecurring debit OrderOnce Off Debit BANKBRANCHBRANCH CODEACCOUNT TYPE CHEQUE SAVINGS TRANSMISSION CHEQUE SAVINGS TRANSMISSIONACCOUNT NUMBERACCOUNT HOLDER'S NAMEACCOUNT HOLDERID/REGISTRATION NUMBERSIGNATURE OF BANKACCOUNT HOLDER/AUTHORISED SIGNATORY **Please sign if the bank details provided above are third party bank details.

7 If the debit order is funded by a 3rd party (spouse included):For individuals: Certified copy of the third party s identity document with a specimen signature. For Juristic: Standard Bank Bank account mandate. Other banks Letter from the bank confirming signing authority and a certified copy of identity document with a specimen signature of the WITHDRAWAL AND ANNUITY INCOME DETAILSINCOME AMOUNTR. INCOME PERCENTAGE*.%FREQUENCY TAX RATE** FIRST PAYMENT MONTH-MMYYYYBANK NAME BRANCHBRANCH CODE ACCOUNT NUMBERACCOUNT TYPE CHEQUE SAVINGS TRANSMISSION ACCOUNT HOLDER'SNAME ** Applicable to Classic Linked Life Annuity onlyPORTFOLIO NOMINATION FOR FEE/INCOMEPORTFOLIO(S) SELECTED FOR INCOMEPORTFOLIO(S) SELECTED FOR ONGOING FEE DEDUCTIONSTRANSFER DETAILSName of AdministratorAccount NumberProduct TypeEstimated AmountRRRRBENEFICIARY NOMINATIONYou can nominate beneficiaries that the Fund should consider to receive the benefit on your death.

8 This person does not need to be financiallydependent on you. NameSurnameID/Passport NumberRelationship to InvestorPercentage%% STALIINV2252018/07/10HX3491 Page 5 of 10 NameSurnameID/Passport NumberRelationship to InvestorPercentage%%Total%FINANCIAL ADVISER DETAILS* DetailsFinancial Adviser 1 Financial Adviser 2 FINANCIAL SERVICE PROVIDERLICENCE NO: STANLIB IDNAME OF SOLE PROPRIETOR ORREPRESENTATIVEFEE SPLIT*%%*Fee Split: Only available to financial advisers from the same Financial Service SERVICE PROVIDER CHARGES (EXCLUDING VAT) Where the client has not specified an initial FSP charge for lump sum or recurring investments, and / or an ongoing service charge, a fee of zeropercent will apply. STANLIB cannot adjust these fees Lump Sum InvestmentInitial Recurring InvestmentOngoing Service ChargeFSP Charge%%%APPOINTMENT OF MODEL PORTFOLIO FINANCIAL SERVICES PROVIDER*If you have selected a model portfolio and it is not managed by STANLIB Multi-Manager or Morningstar, please submit the application form with OF FSP / ENTITY FSP / ENTITY LICENCENONAME OF SOLEPROPRIETOR ORREPRESENTATIVE MODEL PORTFOLIOMANAGER CHARGEThis will be calculated on the last Business day prior to the 10th day of each month on the market value of the model portfolio/portfolios selected by the Client.

9 The Client hereby appoints theFSP as the discretionary financial service provider with effect from the date of client s signature of this form on the terms and conditions set out herein and subject to applicable OF APPOINTMENT YES NOPERSONAL SHARE PORTFOLIOS Investment MANAGEMENT FEES* Investment MANAGERMAXIMUM FEE INVESTMENTMANAGEMENT DECLARATION (FINANCIAL ADVISERS NOT SUBMITTING FICA DOCUMENTATION)I confirm that I am the primary accountable institution (as described in the FICA regulations) in respect of the investor on whose behalf I am establishing a Business relationship orconcluding a single transaction with the Manager (the secondary accountable institution). I confirm that I have established and verified the identity of the investor in terms of section 21 ofFICA. I confirm that I will keep a record of the investor s records as is required in terms of section 21 of FICA.

10 I will make available copies of these documents and details of the verificationprocedures followed on request from any party entitled thereto in terms of FICA within 5 Business days of OF FINANCIAL ADVISERDATE--DDMMYYYYSIGNED AT STALIINV2252018/07/10HX3491 Page 6 of 10 < - - P a g e B r e a k - - >DECLARATION*The terms and conditions are available on: OR and STANLIB are required to collect, process and share your Personal Information (PI). Your PI is collected and processed by our staff, representatives or sub-contractors and we make every effort toprotect and secure your PI. You are entitled at any time to request access to the information STANLIB has collected, processed and give consent to STANLIB to debit my bank account for the debit order agree to provide all documentation and information required in terms of the Financial Intelligence Centre Act, No.