Investor Signals Fund - Individual Client Application form

Initial Information Sheet

Individual Client Application for Investor Signals Fund
Please Note: The following is a data collection form. Please complete the required details below and hit submit at the bottom of the page. Your data collection form will be emailed through to myself for review, if you’ve missed any required data I’ll call you to obtain the extra details. Otherwise, our back office will complete your account application forms and we will send a hard copy by post to you for your review and signature. Thank you for your interest and I look forward to working with you as an Investor Signals’ client.

Regards Leon Hinde
Investment Class

Please enter amounts for Class A and B, minimum total is $50,000 AUD.
Amount Class A
Amount to invest in Class A of the Fund.
Amount Class B
Amount to invest in Class B of the Fund.
Source of Investment Funds
Please select all options applicable for the source of funds you are investing in the Fund.

Salary/WagesBusiness income, earnings or profitsInvestment income/earnings/saleInheritance/giftOther
Investor Details
Mailing address you would like correspondence sent to for this account

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Individual 1
Name of Individual 1

TitleGiven NamesSurname
Any other name known by
Date of Birth

DayMonthYear
Country of birth
Country of citizenship or lawful permanent residency
Occupation
Mother’s Maiden Name
If Director, please specify the industry & nature of business
Are you a foreign citizen or resident for tax purposes?*

No - Enter TFN belowYes - Enter country of residence below
TFN
Country of residence
RESIDENTIAL ADDRESS DETAILS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email address *
(Where confirmation notes will be mailed)
Mobile Number*
Home or Business Number

Country CodeArea CodePhone Number
Individual 2
Name of Individual 2

TitleGiven NamesSurname
Any other name known by
Date of Birth

DayMonthYear
Country of birth
Country of Citizenship or lawful permanent residency
Occupation
Mother’s Maiden Name
If Director, please specify the industry & nature of business
Are you a foreign citizen or resident for tax purposes?

No - Enter TFN belowYes - Enter country of residence below
TFN
Country of residence
RESIDENTIAL ADDRESS DETAILS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email address *
(Where confirmation notes will be mailed)
Mobile Number*
Home or Business Number

Country CodeArea CodePhone Number
If you wish to print this form, click "Print Form" below before clicking "Submit"
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Should be Empty:

Initial Information Sheet

Investment Class

Source of Investment Funds

Investor Details

Individual 1

Individual 2