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Beneficiaries Information

NAME ID NO. DOB TEL NUMBER RELATIONSHIP %SHARE Actions
Will Smith 12345 28/01/1999 254700000000 Son 50

General Details

Have you previously invested in the CIC Unit Trust Funds?
Yes
No


Are you a CIC Insurance Group Ltd employee?
Yes
No


How did you hear about CIC Unit Trusts?


Name and contact of your wealth advisor(if you have any)


CIC Branch Name


DECLARATIONS AND INDEMNITY

We apply for investments into CIC Unit Trust Scheme on terms, conditions and regulatory information set out in the information memorandum. The information memorandum is available at CIC Offices.

We have read and understood the information memorandum, the charges made by CIC Asset Management Limited and the terms and conditions of this application.

We confirm that the units are not being acquired directly or indirectly both or on behalf of any person restricted by the law of any jurisdiction from acquiring such units and that We will not sell, transfer or otherwise dispose of any such Units directly or indirectly to or for the account of such person.

We hereby agree that all proceeds for redemption and income distribution will be paid in accordance to the applicable payment instructions.

We confirm that the money used for the investment in the CIC Unit Trust Scheme are not arising out of the proceeds of any money laundering or other illicit activities.

We agree that CIC Asset Management Limited is not responsible for any liability, losses or damages resulting from e-mail or fax instructions, except when such liability or loss results from negligence or willful default on CIC’s part.

We warrant that all the information given on this proposal and in all documents which have been or will be signed by me in connection with the proposed application whether in my handwriting or not, is true and complete.

We hereby irrevocably and unconditionally agree that all fax, internet, electronic mails and scanned copies of any documentation and / or instructions issued by us in respect of our account(s) or dealings with the Company shall be binding and enforceable against us.

We further agree to fully indemnify CIC Asset Management against any proceedings, claims, expenses and liabilities whatsoever which may be taken or made against or incurred by the Fund manager by reason of the Fund Manager accepting the fax, internet, electronic mails, scanned copies of the documentation and / or instructions.

We further confirm that the Fund Manager may see-off any such expenses/ costs incurred by it in respect of our obligations herein against any of our account(s) with the Fund Manager.

WE THE UNDERSIGNED CONFIRM THAT WE HAVE READ AND UNDERSTOOD THIS DECLARATION AND ITS IMPLICATIONS.

By clicking the "finish" button below ,you AGREE to the above Clause

Do you agree to the above clause? Yes