INVESTMENT DETAILS. The applicant hereby applies for units in the Fund pursuant to the Fund Constitution: Value of units applied for (A$) Source of funds (please tell us the main source of the funds you are using for the investment) Distribution payment instructions (choose one payment instruction): Income from the units in the Fund will be automatically reinvested in additional units in the Fund unless you indicate here (or by notice to the Administrator not less than 20 Business Days before the relevant distribution day to which the notice is to apply) that you wish your income to be paid to you (tick the applicable box). □ Please reinvest my distributions in additional units in the Fund; OR □ Please pay my income directly to my nominated bank account (the bank account must be the same account from which your subscription funds derived). Details of Bank Account for Payment of Distributions and Redemption Proceeds Name of Bank: Name of Branch: Branch Address: Account Name: BSB: Account Number: REGAL FUNDS MANAGEMENT SUBSCRIPTION AGREEMENT JULY 2017 V2 6
INVESTMENT DETAILS. The applicant hereby applies for units in the Fund pursuant to the Fund Constitution: VALUE OF UNITS APPLIED FOR (A$) SOURCE OF FUNDS (PLEASE TELL US THE MAIN SOURCE OF THE FUNDS YOU ARE USING FOR THE INVESTMENT) DISTRIBUTION PAYMENT INSTRUCTIONS (CHOOSE ONE PAYMENT INSTRUCTION): Income from the units in the Fund will be automatically reinvested in additional units in the Fund unless you indicate here (or by notice to the Unit Registry not less than 20 Business Days before the relevant distribution day to which the notice is to apply) that you wish your income to be paid to you (tick the applicable box). Please reinvest my distributions in additional units in the Fund; OR Please pay my income directly to my nominated bank account (the bank account must be the same account from which your subscription funds derived). DETAILS OF BANK ACCOUNT FOR PAYMENT OF DISTRIBUTIONS AND REDEMPTION PROCEEDS NAME OF BANK: NAME OF BRANCH: BRANCH ADDRESS: ACCOUNT NAME: BSB: ACCOUNT NUMBER:
INVESTMENT DETAILS. 1 This address will be the registered address for the purpose of the Share Register. Evidence of such address is requested. PO Boxes or 'care of' addresses are not accepted.
INVESTMENT DETAILS. Part A – Unit class (please select the Unit class the Subscriber wishes to acquire Units in – please consult with your Financial Advisor) [ ] Class A (0.85% distribution fee) [ ] Class S (0.25% distribution fee) [ ] Class I (no distribution fee) Part B – Investment amount (please consult with your Financial Advisor and the Memorandum for applicable minimum investment amounts) Gross Subscription Amount: $ Less: Placement Fee* (not to exceed 3.5% of the gross subscription amount) $ Net Subscription Amount (to be invested and wired to State Street) $ * No Placement Fee may be charged with respect to Class I Units. Furthermore, no Placement Fee may be charged with respect to Class A Units without the express consent of Foreside Fund Services, LLC. PARTNERS GROUP NEXT GENERATION INFRASTRUCTURE, LLC B-3 SUBSCRIPTION AGREEMENT SIGNATURE PAGES
INVESTMENT DETAILS. You may apply for Units in one or more classes of Units by completing the information below. By signing this Subscription Agreement, you irrevocably undertake to purchase the Units below in compliance with the terms and conditions of the Offering Memorandum: Name of Partnership and Class Class of Units International security code (ISIN – common code) Currency (ISO Code) Currency (ISO Code) Invested Amount2 XXXXX Equity FX Global Fund Scsp A LU2168654304 EUR XXXXX Equity FX Global Fund Scsp B LU2168655616 EUR The invested amount represents your hard commitment and your total subscription in the relevant Class of Units within the Partnership Payment instructions Please use the following bank account(s) details to transfer your subscription payment with reference to the Name of Partnership and Class of Units (if any) invested. Cleared funds should be received before the relevant Cut-Off Time (as defined in the Offering Memorandum). Payment of your investment must be drawn on a bank account opened in your own name. No third party payments will be executed. We reserve the right to not accept a payment executed by a credit institution not governed by AML laws equivalent to those of European laws. Bank’s details Country BIC/SWIFT Code Banque de Patrimoines Privés 00, xxxxxxxxx Xxxxx, X-0000 Xxxxxxxxxx Xxxxxxxxxx XXXXXXXX XXXXX Equity FX Global Fund Scsp EUR XX000000000000000000 IN EUR : VIA CORRESPONDENT BANK : IBAN : XX000000000000000000 Swift code: BPPLULL Bank’s Name : BANQUE DE XXXXXXXXXXX PRIVES In favor of : XXXXX Equity FX Global Fund Scsp Correspondent Bank : Banque et Caisse d’Epargne Luxbg Swift code : XXXXXXXXXXX Bank’s full name: Banque et Caisse d’Epargne
INVESTMENT DETAILS. You may apply for Units in one or more Sub-Funds by completing the information below. By signing this subscription form, you irrevocably undertake to purchase the Units below: Name of Sub-Fund Class of Units International security code (ISIN – common code) Currency (ISO Code) Invested Amount2 Blockchain Strategies Fund S.C.Sp EUR Class EUR LU1738363925 - 173836392 EUR Blockchain Strategies Fund S.C.Sp USD Class USD LU1738364063 - 173836406 USD A subscription fee of up to five per cent (5%) may be levied for both classes of Units (i.e. classes of Units denominated in US Dollars and Euro). The invested amount represents your hard commitment and your total subscription in the relevant Sub-Fund Payment instructions Please use the following bank account(s) details to transfer your subscription payment with reference to the Name of Partnership, Class of Units (if any) invested. Cleared funds should be received before the relevant Cut-Off Time (as defined in the Issuing Document). Payment of your investment must be drawn on a bank account opened in your own name. No third party payments will be executed. We reserve the right to not accept a payment executed by a credit institution not governed by AML laws equivalent to those of European laws. Bank’s details Country BIC/SWIFT Code Banque de Patrimoines Privés 00, xxxxxxxxx Xxxxx, X-0000 Xxxxxxxxxx Xxxxxxxxxx XXXXXXXX IN EUR : VIA TARGET IBAN: XX00 0000 0000 0000 0000 Swift code: XXXXXXXX Bank’s Name : BANQUE DE XXXXXXXXXXX PRIVES In favor of: Blockchain Strategies Fund S.C.Sp VIA CORRESPONDENT BANK : IBAN: XX00 0000 0000 0000 0000 Swift code: XXXXXXXXXXX Bank’s Name: BANQUE DE XXXXXXXXXXX PRIVES In favor of: Blockchain Strategies Fund S.C.Sp Correspondent Bank : Banque et Caisse d’Epargne Luxbg Swift code : XXXXXXXXXXX Bank’s full name: Banque et Xxxxxx d’Epargne IN USD : IBAN: XX00 0000 0000 0000 0000 Swift code: XXXXXXXXXXX 2 Certains sub funds or Class of Units may impose minimum subscription amount – please refer to the Issuing Document as to the applicable minimum subscription amount. Bank’s Name : BANQUE DE PATRIMOINES PRIVES In favor of: Blockchain Strategies Fund S.C.Sp Correspondent Bank: XXXXXX0XXXX Full name of institution: Bank of New York Account nr: 8901 3709 24
INVESTMENT DETAILS. Please specify the investment amounts for each fund that you require. Please note that if you invest in “FOUR in One Option” then your investment will be automatically split across the four funds. FUND in England Foreign Exchange Capital Management is named Bergamot. Please choose one of the following for your investment: Fund Information: Select Fund Code Fund Name Period Yeild Less Than Year Withdrawal Period G+%9 Bergamot GOLD+9 Per Year %9 %7 3 Months BERGS Bergamot Silver Per Year Min %9 %7 3 Months BERGG Bergamot Gold BERGP Bergamot Platinum Four In One Any time EFX is enable to change the percentage: Please select if you need consultant in your investment on each of the above funds and the risk. Income Option: If you have chosen income funds the income will be automatically re- invested unless you complete your bank details overleaf in Section D.
INVESTMENT DETAILS. The cost estimate of the ICT programme is US$ 20 million, summarised in Table 3-1. Table 3-1 ICT Program Cost Estimate ICT Components Cost Estimate US$ million Operational Hydraulic modelling and training 0.3 Geographic information system (GIS); 7.4 Supervisory (SCADA); control and data acquisition 1.7 Financial Information System (FIS) including billing and accounting system upgrade, Management Information System (MIS), including human resources development, business and strategic planning and customer relation (pro-poor); Asset Inventory and Management System (AIMS) 10.6 Total US$20.00 M
INVESTMENT DETAILS. Loan Amount: $2,250,000 Date of Loan: October 24, 2016 Warrant Shares: 340,000 Exhibit A Promissory Note (attached) Exhibit B Warrant (attached)
INVESTMENT DETAILS. Source of Funds for initial investment (please tick multiple boxes if applicable): Inheritance Salary Sale of Assets (please specify) Gift Pension Lottery Sale of Business Investment Incom Further supporting documentation may be requested if deemed necessary to verify the above information. Source of Wealth i.e aggregation of accumulated wealth (please tick multiple boxes if applicable): Inheritance Salary Sale of Assets (please specify) Gift Pension Lottery Sale of Business Investment Incom Further supporting documentation may be requested if deemed necessary to verify the above information. Subscription Amount €
