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Application Form: Section A - Investor Details

This document is an application form for units in several investment funds offered by Instreet Structured Investment Pty Limited. The funds are linked to stock market indices and commodities. The application form requests information to identify the applicant such as name, address and tax details. It explains the minimum investment amount and documents required. The form contains sections for individual investors, partnerships, companies, trusts and others to provide their details.

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54 views3 pages

Application Form: Section A - Investor Details

This document is an application form for units in several investment funds offered by Instreet Structured Investment Pty Limited. The funds are linked to stock market indices and commodities. The application form requests information to identify the applicant such as name, address and tax details. It explains the minimum investment amount and documents required. The form contains sections for individual investors, partnerships, companies, trusts and others to provide their details.

Uploaded by

marianne10
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Instreet Link

Series XXV & XXVI - S&P/ASX 200 Index Linked Deferred Purchase
Agreements Application Form
Series XXVII - S&P Asia 50 Index Linked Deferred Purchase Agreements
Series XXVIII- ARC (Absolute Return from Commodities)
Deferred Purchase Agreements

This is an Application Form for Units in the Instreet Link Series XXV & XXVI - S&P/ASX 200 Index Linked Deferred Purchase Agreements, Link Series XXVII – S&P Asia 50
Index Linked Deferred Purchase Agreements and/or Series XXVIII – Absolute Return from Commodities Deferred Purchase Agreements issued by Instreet Structured
Investment Pty Limited ABN 82 140 407 558 (Issuer) and arranged by Instreet Investment Limited ABN 44 128 813 016 as authorized representative under AFSL 246801.
This Application Form accompanies the PDS dated 31 January 2011 and any supplementary PDS issued for the Units. It is important that you read the PDS in full and the
acknowledgements contained in this Application Form before applying for the Units. The Issuer will provide you with a copy of the PDS including any supplemental PDS and
the Application Form, on request without charge.
A person who gives another person access to the Application Form must at the same time and by the same means give the other person access to the PDS including
any supplemental PDS.
Please see the instructions on how to complete this Application Form in the
PDS. The Minimum Investment in each Series is 2,500 units.
This Application Form and your initial investment amount must be received by the Registrar by 4:00 pm in order to be processed that day.
Units in the Series are issued only on receipt of:
 this Application Form (including the signed Execution Page and (if applicable) the Direct Debit Request),
 verification of the applicant’s identity (if you are not investing through an advisor you must attach certified copies of the documents as described in section 2 of “How
to complete the Application Form”),
 payment in full.

SECTION A - INVESTOR DETAILS


What type of person or entity is applying? Please tick one box ONLY and complete all the sections indicated.
Individual, joint or sole trader - must complete A1, C, D, E, F, G (if you are not investing through an adviser), H, Direct Debit Request (if paying
by direct debit) and the Execution Page
Partnership - must complete A1, A4, C, D, E, F, G (if you are not investing through an adviser), H, Direct Debit Request (if paying by direct debit)
and the Execution Page
Australian Company - must complete A1 (Directors), A2, C, D, E, F, G (if you are not investing through an adviser), H, Direct Debit Request (if
paying
by direct debit) and the Execution Page
Trust / Super Fund with Individuals as Trustee - must complete A1 (Trustees), A3, C, D, E, F, G (if you are not investing through an adviser), H,
Direct
Debit Request (if paying by direct debit) and the Execution Page
Trust / Super Fund with Corporate Trustee - must complete A1 (Directors), A2 (Company), A3, C, D, E, F, G (if you are not investing through
an adviser), H, Direct Debit Request (if paying by direct debit) and the Execution Page
Others:
If you elect direct debit as your payment method in Section C, you must also complete the Direct Debit Request attached to this Application
Form. For other entities, including foreign companies, please contact us for an appropriate Application Form.
Please note that if you do not complete the relevant parts of sections A and G (including attaching the necessary documentation as set out in Section 2 of
“How to complete this Application Form”, we may refuse your application. We are not liable for any resulting loss.
Please note that you should complete Section B if you wish to provide alternative contact details for your account to those provided in Section A.
Please insert your preferred contact details in this section. If you do not complete this section, the Issuer will contact you using the details provided
in
Section A. In the case of joint investors, the Issuer will use the details of Investor 1 unless you complete this section.
You must complete Section G (and attach the necessary documentation as set out in Section 2 of “How to complete the Application Form”)
if you are not investing through an advisor.

A1 INDIVIDUAL INVESTOR DETAILS (MUST COMPLETE) (including individuals acting as trustee and corporate directors)
INVESTOR 1 (Your name MUST match your ID exactly.)

Title: Given Names (in full): Surname:

Date of Birth (dd/mm/yyyy) Country of Citizenship

Are you an Australian resident for tax purposes? Yes No

If not, please specify your country of tax residence.

Australian Tax File Number OR Exempt from quoting a tax file number

Exemption details (if applicable)

Residential Address

City/Suburb/Town State Postcode Country

Email Address

Telephone (home) Area code Number


Telephone (business hours) Area code

Mobile

Fax Area code


In the case of joint investors, please note that unless you indicate otherwise in Section B, the Issuer will use these contact details in relation to this application.

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INVESTOR 2 (Your name MUST match your ID exactly.)

Title: Given Names (in full): Surname:

Date of Birth (dd/mm/yyyy) Country of Citizenship

Are you an Australian resident for tax purposes? Yes No

If not, please specify your country of tax residence.

Australian Tax File Number OR Exempt from quoting a tax file number

Exemption details (if applicable)

Residential Address

City/Suburb/Town State Postcode Country

Email Address

Telephone (home) Area code Number


Telephone (business hours) Area code

Mobile

Fax Area code Number

COMPLETE THIS PART IF INDIVIDUAL IS A SOLE TRADER


Full Business Name (if any) ABN

Principal Place of Business (if any) (PO Box is NOT acceptable)

City/Suburb/Town State Postcode Country

Email Address

Telephone (home) Area code Number


Telephone (business hours) Area code

Mobile

Fax Area code Number

A2 AUSTRALIAN CORPORATIONS & CORPORATE TRUSTEES


Full name of the company as registered by ASIC ABN

Registered Office Address (PO Box is NOT acceptable)

City/Suburb/Town State Postcode Country

Principal Place of Business (if any) (PO Box is NOT acceptable)

City/Suburb/Town State Postcode Country

Main Contact

Email Address

Telephone (business hours) Area code Number


Fax Area code Number

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