Investor Funnel Multi Step Form Step 1 of 7 14% For more information: info@think10capital.com ِ This Application Form is given solely to the recipient of the Information Memorandum for the Think10 Capital Management Digital Yield Fund. Please confirm that you have carefully considered the content of the Information Memorandum for this fund I confirm I have read the Information Memorandum for the Fund.(Required) I confirm I have read the Information Memorandum for the Fund. Know Your Customer (KYC) Requirements We are required to verify information about you (and your investment entity) to comply with Anti-Money Laundering and Counter Terrorism Financing (AML/CTF) and Know Your Customer (KYC) legislation. I agree my information can be shared with for AML/CTF and KYC purposes(Required) I agree my information can be shared with for AML/CTF and KYC purposes I agree my information can be used for AML purposed to verify my identity, to verify my entity details and those of any beneficial owners with 25% or more interest in the entity(Required) I agree my information can be used for AML purposed to verify my identity, to verify my entity details and those of any beneficial owners with 25% or more interest in the entity CAPTCHA Select Investor Type(Required)IndividualCompanyTrusts/SMFsIndividual Form If applicable, please select ‘joint holdings below’ Given Name(Required) Surname(Required) Registered for tax in australia(Required) Yes No Tax File Number(Required) It is not compulsory to supply a TFN or ABN for tax reasons, but if you don’t and the entity is the taxable we will withhold tax at the highest marginal tax rate from distributions we pay to you. This account is joint holdings?(Required) Yes This account is a sole trader?(Required) Yes Company FormAustralian Company / Foreign Company / Proprietary / PublicCompany Registration Name Type of Trust(Required)Private CompanyPublic CompanyJoint VenturePartnershipLimited PartnershipIncorporated SocietyNomineeOtherPlease select the Country of incorporation(Required)AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsRegistered for tax in australia(Required) Yes No Company ABN Company TFN It is not compulsory to supply a TFN or ABN for tax reasons, but if you don’t and the entity is the taxable we will withhold tax at the highest marginal tax rate from distributions we pay to you Trusts / SMSFsTrustee / Self Managed Super Fund / Other Trust etc. Individual or Corporate Trustee(s)(Required)Individual TrusteeCorporate TrusteeTrustee Name(Required) Type of Trust(Required)Unit TrustSuperannuation FundDiscretionary TrustTrust PartnershipTestamentary TrustEstateNominatorSyndicateCooperativeTrustCharityFundOtherFull Name of Trust(Required) Registered for tax in australia(Required) Yes No Company TFN CAN / ABN / ABRN Contact DetailsGiven Name Surname Email Please provide a primary contact email for your application Phone (Mobile)(Required)Phone (work)Address Address City State / Province / Region Zip / Postal Code Country(Required)AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCommunication Preferences Do you want to add an advisor to receive fund communications? Send correspondence to my financial advisor Advisor Name Advisor Name Advisor Email Advisor PhoneAdvisor Address Advisor Address 2 City State / Province / Region Zip / Postal Code Country(Required)AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Account DetailsAustralian Bank AccountForeign Bank AccountAustralian Bank Account Bank Details Account Name(Required) Bank Name(Required) Bank Account Number(Required) BSB Number(Required) Distributions Note Depending on the Investment Manager, any net income distributions may be reinvested for you into new units in the Fund. Please contact the Investment Manager or consult the Information Memorandum if you wish to have your distributions paid to your bank account instead. Distributions Instructions* Reinvest my Distributions Pay my distributions into my bank account Foreign Bank Account Bank DetailsAccount Name(Required) Bank Name(Required) Bank Account Number(Required) Bank Branch Swift Code(Required) Bank Address Address Line 2 City State / Province / Region Zip / Postal Code Country(Required)AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Distributions Note Depending on the Investment Manager, any net income distributions may be reinvested for you into new units in the Fund. Please contact the Investment Manager or consult the Information Memorandum if you wish to have your distributions paid to your bank account instead. Distributions Instructions* Reinvest my Distributions Pay my distributions into my bank account Investment Investment amount*(Required)Please specify the applicant investment amount.Accountant’s Certificate Payment Method Think10 Capital Management Digital Yield Fund accepts payments via electronic transfer to: BSB XXX-XXX Acc No: XX-XXX-XXXX Account Name: XXX Bank Name: XXXX Please include the applicant name in the narration/reference section, and if possible email a copy of the receipt to accounts@think10capital.com - a copy of these payment instructions have been emailed to your email address For alternative payment options - please contact accounts@think10capital.com Payment will need to be received 5 business days prior to the end of the month to ensure entry into the Fund before month end cut-off. Beware of fraudulent emails: Think10 Capital Management or the Investment Manager will never solicit a transfer different to the bank details above, if you suspect a fraud email please forward to accounts@think10capital.com FACTA Self Certification Declaration This certification must be completed by all investors to declare their FATCA status or U.S. tax status. U.S. IRS Form W-8 or W-9 is accepted in place of this declaration. Please refer to section 8 for explanations of FATCA terms before completing this form. We strongly encourage you to seek the advice of an experienced tax or professional adviser in relation to completing this form. PURPOSE OF THIS FORM The Foreign Account Tax Compliance Act (FATCA), a United States regulatory requirement that aims to deter tax evasion by U.S. taxpayers, was introduced in 2010. From 1 July 2014 financial institutions (being managed investment funds) are required to identify investors that hold certain “financial accounts” and are U.S. persons or that are entities with substantial U.S. owners. Information on accounts and investments held by these U.S. investors must then be reported to the U.S. Internal Revenue Service (IRS) via the Australian Taxation Office (ATO). Hyperlink: ‘FACTA Terms Glossary Full Legal Name Personal / Trust / Superannuation Fund / CompanySelect only ONE of the following options that best describes the Superannuation Fund and provide the information requested. I am an Australian Retirement Fund I am not an Australian Retirement Fund We’ll record your FATCA status as an Exempt Beneficial Owner GIIN (if applicable) FACTA status FACTA Declaration*(Required)▪ I/we declare that the information provided in this form is correct and where relevant reflects my/our tax status for purposes of FATCA ▪ I/we will promptly notify A4 Funds and provide it with any changes to the information provided by me/us in connection with this form and on request provide any further information reasonably required by Think10 Capital Management to comply with any obligation under FATCA I agree by completing this form Declaration Consent* I am classified as a sophisticated investor I am an individual over 18 years of age or I am a duly incorporated body. I have read carefully and understood I am applying solely on the basis of the Fund’s Information Memorandum and this completed Application Form. I understand that the information contained in the Information Memorandum is not legal, financial or tax advice nor a recommendation that the Fund is suitable to my/our needs. I agree to be bound by the terms of the Constitution governing the Fund, this completed Application Form and the current Information Memorandum, as amended or issued from time to time. That holding units in the Fund is subject to investment risk, including possible delays in repayment, loss of income and principal invested I acknowledge and declare that all the details supplied are true and correct and agree to the terms above.(Required) I acknowledge and declare that all the details supplied are true and correct and agree to the terms above. Name of person making the declaration
