Investor Signals Fund - Discretionary Trust Client Application form

Initial Information Sheet

Discretionary Trust 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
Name of Trust
Trading Name of Trust
Trust ABN/ACN
Trust ARBN
Type of Trust

DiscretionaryFamilyOther
Name of Settlor?
Date of Birth of Settlor?
Is the Trust a foreign entity for tax purposes?

No - Enter Trust TFN belowYes - Enter Trust's country of domicile below
Trust TFN
Trust's country of domicile
Number of beneficial owners of the Trust
Mailing address you would like correspondence sent to for this account

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Beneficial Owner 1
Full Name 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
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
Beneficial Owner 2
Full Name 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
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
Trustees
Is the Trustee of the Trust an*

IndividualCorporate or Company
Individual Trustee details:
Trustees Full Name

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
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
Company Details
Company Name
Company Type

ProprietaryPublicOther
Company ABN / ACN:
Company TFN
Country of Incorporation
Number of Directors
Nature of the business activity
Approval to perform Company search on your behalf to verify Company details, Directors and Owners*

YesNo
Principal place of office

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Registered Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Is your postal address the same as the registered address?

YesNo
Postal Address

Street Address / P O Box

Address Line 2

CityState / Province

Postal / Zip CodeCountry
Company Officer Details
Company Officer 1 (Sole Director, Director or Secretary)
Corporate Title
Company Officer 1 Full Name

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
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
Company Officer 2 (Director or Secretary)
Corporate Title
Company Officer 2 Full Name

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
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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Initial Information Sheet

Investment Class

Source of Investment Funds

Investor Details

Beneficial Owner 1

Beneficial Owner 2

Trustees

Individual Trustee details:

Company Details

Company Officer Details

Company Officer 1 (Sole Director, Director or Secretary)

Company Officer 2 (Director or Secretary)