Mayar Capital UCITS ICAV Application Form Logo

  • UCITS ICAV Application Form

  • If you prefer to print, complete, and send to us, and not use the digital application form here, please print the PDF from the frame below. Once completed, please email to ir@mayarcapital.com

    To complete the application online, please continue as normal.

  • INSTRUCTIONS FOR COMPLETING THE APPLICATION

    Your application (this “Application”) to invest in Mayar Capital UCITS ICAV (the “ICAV”) should be made by sending this Application Form (the “Application Form”) to the details noted on the cover page.

    Apex Fund Services (Ireland) Limited (the “Administrator”), acting on the ICAV’s behalf, must receive a completed Application Form for each initial subscription together with relevant anti-money laundering documents. Where an application is made by email with a pdf attachment, the original signed Application Form, if required, must be mailed to the Administrator at the address noted on the cover page.

    Applicants (the “Applicants”) must read the ICAV’s Prospectus (the “Prospectus”) before completing this Application Form.

    Terms defined in the Prospectus have the same meaning in this Application Form.

    This Application Form is the property of the ICAV and may not be tampered with or amended without the consent of the ICAV. Any breach of the foregoing may render the Application Form void.

  • GENERAL INFORMATION

    The ICAV reserves the right to reject any application in whole or in part, without giving any reason for such rejection in which event any application moneys will be returned without interest, expenses, or compensation by transfer to the Applicant’s designated bank account at the risk of the Applicant.

    CONTRACT NOTES

    It is anticipated that contract notes will normally be sent to Applicants as soon as possible, following the Valuation Day. Please ensure that appropriate email contact details are provided.

    IMPORTANT: It is the responsibility of the Applicant to check the accuracy of information provided to you in any confirmation of ownership, any valuation statements, and other reports issued by, or on behalf of, the ICAV. You should contact the Administrator immediately in the event that you believe the information to be incorrect. It will be assumed that you have received contract notes and that the details contained therein are correct unless you contact the Administrator within 24 hours of the date of issue.

    SUBSCRIPTIONS

    Subscription requests must be sent to the Administrator by email with PDF attachment (with the originals to follow, where required, immediately thereafter) at the address detailed on the cover page.

    Please refer to the Prospectus for details of the Minimum Initial Subscription amount in respect of each Share Class.

    Payment in respect of subscriptions must be received in cleared funds by the Administrator no later than the Subscription Settlement Cut-Off time as outlined in the Prospectus.

    REDEMPTIONS

    No redemption payment will be made unless the original subscription Application Form if required, and all documentation required by or on behalf of the ICAV (including any documents in connection with anti-money laundering procedures) has been received from the investor by the Administrator on behalf of the ICAV and the anti-money laundering procedures have been completed. Failure to comply with the above will result in redemption proceeds not being paid.

    Redemption requests must be received by the Administrator prior to the relevant Dealing Deadline as detailed in the relevant Supplement.

    Redemption requests may be delivered by email as a PDF attachment, at the address noted on the cover page.

    QUERIES

    All queries regarding the completion of the Application Form should be addressed to the ICAV c/o the Investment Manager.

    The Administrator can be contacted by phone at +44 20 8050 2515 or by email at ir@mayarcapital.com.

  • APPLICANT DETAILS

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  • If you are NOT a resident of Saudi Arabia: Proof Of Address Instructions:

    1. Please upload proof such as a utility bill, rent or mortgage statement, etc. 

  • If you are a resident of Saudi Arabia: Proof Of Address Instructions:

    1. Go to https://www.address.gov.sa/
    2. Click on the login button at the top corner of the page
    3. Enter your National Address / Saudi Post login details or use the National Single Sign On (Abshir) login details
    4. Choose "Manage Your National Address" in the side menu
    5. Click on your home national address
    6. Click on the link "Print Proof of national address" at the bottom of the page (usually under the map)
    7. The system will then generate a PDF with your national address, download it or print it and upload it below.
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  • INVESTMENT DETAILS

  • FUND NAME: Mayar Responsible Global Equity Fund

  • INVESTOR BANK DETAILS

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  • DECLARATION OF RESIDENCE OUTSIDE OF IRELAND

  • Applicants resident outside Ireland is required by the Irish Revenue Commissioners to make the following declaration which is in a format authorized by them, in order to receive payment without deduction of tax. It is important to note that this declaration if it is then still correct, shall apply in respect of any subsequent acquisitions of Shares. Terms used in this declaration are defined in the Prospectus.  

  • DECLARATION ON OWN BEHALF

    I/we* declare that I am/we are* applying for the shares on my own/our own behalf/on behalf of a company* and that I am/we are/the company is entitled to the shares in respect of which this declaration is made and that 

    • I am/we are/the company is* not currently Irish Resident or Ordinarily Resident in Ireland, and
    • Should I/we/the company* become Irish Resident I/we* will so inform the ICAV, in writing, accordingly.

    * Delete as appropriate

  • DECLARATION AS INTERMEDIARY

    I/we* declare that I am/we are* applying for shares on behalf of persons:

    • who will be beneficially entitled to the shares; and
    • who, to the best of my/our* knowledge and belief, is neither Irish Resident nor Ordinarily Resident in Ireland.

    I/we* also declare that:

    • unless I/we* specifically notify you to the contrary at the time of application, each application for shares made by me/us* from the date of this application will be made on behalf of such persons; and
    • I/we* will inform you in writing if I/we* become aware that any person on whose behalf I/we* hold(s) shares, becomes Irish Resident.

    * Delete as appropriate

  • IMPORTANT NOTES

    1. Declarations of Residence outside of Ireland are subject to inspection by the Irish Revenue Commissioners and it is a criminal offense to make a false declaration.
    2. To be valid, the Declaration of Residence outside of Ireland must be signed by the Applicant. Where there is more than one Applicant, each person must sign. If the Applicant is a company, it must be executed under seal or signed by duly authorized signatories
    3. If the Declaration of Residence outside of Ireland is signed under power of attorney, a copy of the power of attorney must be furnished in support of the signature.
    4. If the Applicant is an Exempt Irish Investor it should contact the Investment Manager who will provide it with the appropriate declaration which must be made to confirm its status[1].

    [1] Declaration referred to in Section 739D(6) Taxes Consolidation Act, 1997.

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  • FATCA & CRS CERTIFICATION

    I. FATCA & CRS CERTIFICATION

    If you are a US Entity or US individual please complete the underlying applicable Self-Certification(s) and provide a US Tax form (W-9) 

    For all Non-US Entities & Individuals please complete the underlying applicable Self-Certification(s) only 

    The latest W-9 form can be found on the IRS website at:

    www.irs.gov/uac/IRS-Accessible-PDF-Forms

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  •  Individual (including Controlling Persons) Self-Certification for FATCA and CRS 

    Instructions for completion and Data Protection Notice 

    We are obliged under Section 891E, Section 891F and Section 891G of the Taxes Consolidation Act 1997 (as amended) and regulations made pursuant to those sections to collect certain information about each account holder’s tax arrangements. Please complete the sections below as directed and provide any additional information that is requested. Please note that by completing this form you are providing personal information which may constitute personal data within the meaning of the General Data Protection Regulation (697/2016/EU) (the "GDPR") and applicable Irish data protection legislation (currently the Irish Data Protection Acts 1988 to 2018. Please note that in certain circumstances we may be legally obliged to share this information, and other financial information with respect to an account holder’s interests in the Fund, with the Irish tax authorities, the Revenue Commissioners. They may in turn exchange this information, and other financial information with foreign tax authorities, including tax authorities outside the EU. 

    If you have any questions about this form or defining the account holder’s tax residency status, please speak to a tax adviser or local tax authority. 

    For further information and guidance on FATCA or CRS please refer to the Irish Revenue or OECD websites at: http://www.revenue.ie/en/business/aeoi/index.html

    http://www.oecd.org/tax/automatic-exchange/common-reporting-standard/ in the case of CRS only. 

    If any of the information below about the account holder’s tax residence or FATCA/CRS classification changes in the future, please advise of these changes promptly. 

    Please note that where there are joint account holders each account holder is required to complete a separate Self-Certification form. 

    Section 1, 2, 3, and 5 must be completed by all Account holders or Controlling Persons. 

    Section 4 should only be completed by any individual who is a Controlling Person of an entity account holder which is a Passive Non-Financial Entity, or a Controlling Person of an Investment Entity located in a Non-Participating Jurisdiction and managed by another Financial Institution.

  • Section 1: Account Holder/Controlling Person Identification

  • PLACE AND DATE OF BIRTH

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  • Section 2: FATCA Declaration of U.S. Citizenship or U.S. Residence for Tax purposes

  • Section 3: Common Reporting Standard (CRS) Declaration of Tax Residency/Residencies (please confirm all Tax Residencies)

    Please indicate your country of tax residence (if resident in more than one country please detail all countries of tax residence and associated tax identification numbers (“TINs”)).

    For further guidance on Tax Residence and TINs, please refer to the OECD CRS Information Portal http://www.oecd.org/tax/automatic-exchange/crs-implementation-and-assistance/tax-identification-numbers/#d.en.347759

    NOTE: Under the Irish legislation implementing the CRS, provision of a Tax ID number (TIN) is required to be provided unless:

    (a) You are tax resident in a Jurisdiction that does not issue a TIN; or

    (b) You are tax resident only in a non-reportable Jurisdiction (i.e. Ireland or the USA)

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  • Section 4 – Type of Controlling Person
    *ONLY COMPLETE IF YOU ARE AN INVESTOR ADVISOR OR PART OF AN ENTITY*

    (ONLY to be completed by an individual who is a Controlling Person of an entity which is a Passive Non-Financial Entity or an Investment Entity located in a Non-Participating Jurisdiction and managed by another Financial Institution).

    For Joint or multiple Controlling Person(s) please complete a separate “Individual (Including Controlling Persons) Self-Certification for FATCA and CRS form for each Controlling Person.

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  • Section 5: Declaration and Undertakings

    I declare that the information provided in this form is, to the best of my knowledge and belief, accurate and complete. 

    I acknowledge and consent to the fact that the information contained in this form and information regarding the Account Holder may be reported to the tax authorities of the country in which this account(s) is/are maintained and exchanged with tax authorities of another country or countries in which the Account Holder may be tax resident where those countries (or tax authorities in those countries) have entered into Agreements to exchange financial account information. 

    I undertake to advise the recipient promptly and provide an updated Self-Certification form within 30 days where any change in circumstances occurs which causes any of the information contained in this form to be incorrect. 

    Data Protection - Customer Information Notice:

    The Common Reporting Standard (CRS), formally referred to as the Standard for Automatic Exchange of Financial Account Information, is an information standard for the automatic exchange of information (AEoI), developed in the context of the Organisation for Economic Co-operation and Development (OECD). 

    The standard requires that Financial Institutions in participating jurisdictions gather certain information from account holders(and, in particular situations, also collect information in relation to relevant Controlling Persons of such account holders). 

    Under CRS account holder information (and, in particular situations, information in relation to relevant Controlling Persons of such account holders) is to be reported to the relevant tax authority where the account is held, which, if a different country to that in which the account holder resides, will be shared with the relevant tax authority of the account holder’s resident country, if that is a CRS-participating jurisdiction. 

    Information that may be reported includes name, address, date of birth, place of birth, account balance, any payments including redemption and dividend/interest payments, Tax Residency(ies) and TIN(s). 

    Further information is available on the OECD website: http://oecd.org/tax/automatic-exchange/

    And on the Irish Revenue website - https://www.revenue.ie/en/companies-and-charities/international-tax/aeoi/index.aspx

     

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    Entity Self-Certification for FATCA and CRS

    Instructions for completion and Data Protection notice.

    We are obliged under Section 891E, Section 891F, and Section 891G of the Taxes Consolidation Act 1997 (as amended) and regulations made pursuant to those sections to collect certain information about each account holder’s tax arrangements. Please complete the sections below as directed and provide any additional information that is requested. Please note that by completing this application form you are providing personal information, which may constitute personal data within the meaning of the General Data Protection Regulation (697/2016/EU) (the “GDPR”) and applicable Irish data protection legislation (currently the Irish Data Protection Acts 1988 to 2018). Please note that in certain circumstances we may be legally obliged to share this information, and other financial information with respect to an account holder’s interests in the Fund, with the Irish tax authorities, the Revenue Commissioners. They in turn may exchange this information, and other financial information with foreign tax authorities, including tax authorities located outside the EU. 

    If you have any questions about this form or defining the account holder’s tax residency status, please speak to a tax adviser or local tax authority. 

    For further information and guidance on FATCA or CRS, please refer to the Irish Revenue or the OECD website at:  http://www.revenue.ie/en/business/aeoi/index.html

    http://www.oecd.org/tax/automatic-exchange/common-reporting-standard/ in the case of CRS only.  

    If any of the information below about the account holder’s tax residence or FATCA/CRS classification changes in the future, please ensure that we are advised of these changes promptly. 

    Account-holders that are Individuals or Controlling Persons should not complete this form and should complete the form entitled “Individual (including Controlling Persons) Self-Certification for FATCA and CRS”. 

    (Mandatory fields are marked with an *)

  • Section 1: Account Holder Identification

  • Section 2: FATCA Declaration

  • Section 3: Entity’s FATCA Classification

    (the information provided in this section is for FATCA, please note your FATCA classification may differ from your CRS classification in Section 5): 

    3.1 Financial Institutions under FATCA:

    If the Entity is a Financial Institution, please tick one of the below categories and provide the Entity's GIIN at 3.2 or indicate at 3.3 the reason why you are unable to provide a GIIN.

  • Section 4. Common Reporting Standard (“CRS”) Declaration of Tax Residency (Note that Entities may have more than one country of Tax Residence)

    Please indicate the Entity’s country of tax residence for CRS purposes, (if resident in more than one country please detail all countries of tax residence and associated tax identification numbers (“TIN”)). Please refer to the OECD CRS Web Portal for AEOI for more information on Tax Residence and TIN’s. http://www.oecd.org/tax/automatic-exchange/crs-implementation-and-assistance/tax-identification-numbers/#d.en.347759 

    If the Entity is not tax resident in any jurisdiction (e.g., because it is fiscally transparent), please indicate that below and provide its place of effective management or country in which its principal office is located. 

    NOTE: Under the Irish legislation implementing the CRS, provision of a Tax ID number (TIN) is required to be provided unless:

    (a)    You are tax resident in a Jurisdiction that does not issue a TIN; or

    (b)    You are tax resident only in a non-reportable Jurisdiction (i.e. Ireland or the USA)

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  • Section 5: Entity’s CRS Classification

    (The information provided in this section is for CRS. Please note an Entity's CRS classification may differ from its FATCA classification in Section 3 above). In addition, please note that the information that the Entity has to provide may differ depending on whether they are residents in a participating or non-participating CRS Jurisdiction. For more information, please see the OECD CRS Standard and associated commentary. http://www.oecd.org/tax/automatic-exchange/common-reporting-standard/

    5.1 Financial Institutions under CRS: 

    If the Entity is a Financial Institution, Resident in either a Participating or Non-Participating CRS Jurisdiction please review and tick one of the below categories that apply and specify the type of Financial Institution below. 

    Note: Please check the Irish Revenue AEOI portal at the time of completion of this form to confirm whether your country of Tax Jurisdiction is considered Participating or Non-Participating for the purposes of CRS Due-Diligence in Ireland. https://www.revenue.ie/en/companies-and-charities/documents/aeoi/participating-jurisdictions.pdf

  • 5.2 Non Financial Institution (“NFE”) under CRS:

    If the Entity is a not defined as a Financial Institution under CRS then, please tick one of the below categories confirming if you are an Active NFE or Passive NFE.

  • Section 6: Controlling Persons

    NB: Please note that each Controlling Person must complete a separate “Individual (including Controlling Persons) FATCA and CRS Self-Certification” form. 

    If there are no natural person(s) who exercise control of the Entity then the Controlling Person will be the natural person(s) who hold the position of senior managing official of the Entity. 

    For further information on Identification requirements under CRS for Controlling Persons, see the Commentary to Section VIII of the CRS Standard. http://www.oecd.org/tax/automatic-exchange/common-reporting-standard/ 

    6.1 Controlling Person(s) of the Account Holder: 

    If you have ticked a Passive NFE with Controlling Persons in either the FATCA or CRS Classification sections above, then please also complete this section for each of the Controlling Person(s) of the account holder and provide a separate “Individual (including Controlling Persons) FATCA and CRS Self-Certification” form for each Controlling person as per 6.2 below:

  • Note: In case of a trust, Controlling Persons means the settlor(s), the trustee(s), the protector(s) (if any), the beneficiary(ies) or class(es) of beneficiary(ies), AND any other natural person(s) exercising ultimate effective control over the trust. With respect to an Entity that is a legal person, if there are no natural person(s) who exercise control over the Entity, then the Controlling Person will be the natural person who holds the position of senior managing official of the Entity.

  • Section 7: Declarations and Undertakings 

    I/We declare (as an authorised signatory of the Entity) that the information provided in this form is, to the best of my/our knowledge and belief, accurate and complete. 

    I/We acknowledge and consent to the fact that the information contained in this form and information regarding the Account Holder may be reported to the tax authorities of the country in which this account(s) is/are maintained and exchanged with tax authorities of another country or countries in which the Account Holder may be tax resident where those countries (or tax authorities in those countries) have entered into Agreements to exchange financial account information. 

    I/We on behalf of the Entity undertake to advise the recipient promptly and provide an updated Self-Certification form within 30 days where any change in circumstance (for guidance refer to Irish Revenue or OECD website) occurs which causes any of the information contained in this form to be incorrect.

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  • KEY INVESTOR INFORMATION DOCUMENT DECLARATION
     

    I/We* hereby acknowledge that I/we* have been offered the choice of receiving the Prospectus and Key Investor Information Document (“KIID”) on paper or in electronic form by means of a website and hereby specifically consent to receiving the KIID in electronic form by way of accessing the latest version of the document online at www.mayarcapital.com (or such other website address as may be notified to me/us from time to time). 

     I/We* hereby represent that I/we* have regular access to the internet. The KIID will be available on www.mayarcapital.comand I/we* hereby confirm that I/we* have also been notified electronically of this website address and the place on the website where the KIID can be accessed.                                                                      

    I/We* hereby acknowledge that I/we* have received or accessed by electronic means the KIID. I/We* hereby also confirm that I/we* will access the relevant KIID by electronic means before making any subsequent and/or future subscriptions for Shares in any share class and/or Fund. 

    GENERAL DECLARATIONS
     

    I/We* confirm that I am/we are* 18 years of age or over (natural persons only). I/we* have the capacity and authority to make the investment pursuant to this Application Form whether this investment is in my/our* name or is made on behalf of another person or institution. I/We* am/are* duly organised, validly existing and in good standing under the laws of the jurisdiction in which I am/we are* organised and I/we* have the power and authority to enter into and perform my/our* obligations under this Application Form. 

    I/We* hereby acknowledge that I/we* have received and read the current Prospectus relating to the ICAV, the Supplement relating to the relevant Fund, the KIID relating to the relevant Share Class and that this application is made on the terms of the Prospectus, the Supplement, the KIID and subject to the Instrument of Incorporation of the ICAV. I/We* acknowledge that the ICAV reserves the right to reject any application in whole or in part. 

    I/We* irrevocably apply for such number of Shares (including fractions) at a price determined in accordance with the Prospectus as may be purchased with the amount subscribed. I/We hereby undertake and agree to accept any number of Shares in respect of which this application may be accepted. I/We acknowledge that the ICAV reserves the right to reject any application in whole or in part and to restrict or prevent the ownership of shares by any person, firm or corporation in the circumstances outlined in the Prospectus. 

    I/We* agree that the issue and allotment to me/us* of the Shares is subject to the provisions of the Prospectus, the Supplement and the KIID, that subscription for Shares will be governed and construed in accordance with Irish law and I/we* confirm that by subscribing for Shares, I/we* are not relying on any information or representation other than such as may be contained in the Prospectus, the Supplement, the KIID and the most recent annual or semi annual report (if available) thereto. 

    I/We* hereby certify that I/we* am/are* not a US Person and that the Shares hereby applied for are not being acquired directly or indirectly by or on behalf of, or for the account of, a US Person[1]. I/We* further confirm that I/we* will notify the Administrator in the event that I/we* become a US Person or hold the Shares on behalf of, or for the account or benefit of, a US Person. 

    I/We* confirm that I/we* am/are not a “benefit plan investor”[2] and am/are* not investing on behalf of a “benefit plan investor”.*(Benefit plan investors should contact the Investment Manager.) 

    I/We* hereby declare that I/we* am/are* not an Exempt Irish Investor (If you are an Exempt Irish Investor, you should request the relevant Exempt Irish Investor declaration from the Investment Manager). 

    /We* acknowledge that the ICAV intends to take such steps as may be required to satisfy any obligations imposed by (i) the Foreign Account Tax Compliance Act (“FATCA”)  or (ii) any provisions imposed under Irish law arising from the inter-governmental agreement between the Government of the United States of America and the Government of Ireland (“IGA”) so as to ensure compliance or deemed compliance (as the case may be) with FATCA or the IGA from 1 July 2014. 

    Furthermore, I/We* hereby acknowledge that the ICAV intends to take such steps as may be required to satisfy any obligations imposed by (i) the OECD’s Standard for Automatic Exchange of Financial Account Information in Tax Matters (“the Standard”), which therein contains the  Common Reporting Standard, as applied in Ireland by means of the relevant international legal framework and Irish tax legislation and (ii) EU Council Directive 2014/107/EU, amending Directive 2011/16/EU as regards mandatory automatic exchange information in the field of taxation (“DAC2”), as applied in Ireland by means of the relevant Irish tax legislation, so as to ensure compliance or deemed compliance (as the case may be) with the Standard/CRS and the DAC2 from 1 January 2016 (hereafter collectively referred to as “CRS”). 

    In order for the ICAV to comply with the above FATCA and CRS obligations, I/We* agree to provide to the ICAV or its authorised FATCA & CRS agents/delegates (“FATCA & CRS Agent(s)”) necessary declarations, confirmations and/or classifications at such times as each of them may request and furthermore provide any supporting certificates or documents as each of them may reasonably require in connection with this investment by reason of FATCA or CRS, as described above, or otherwise.  Should any information furnished to any of them become inaccurate or incomplete in any way, I/we* hereby agree to notify the ICAV and the FATCA & CRS Agent(s) immediately of any such change and further agree to immediately take such action as the ICAV may direct, including where appropriate, redemption of our Shares in respect of which such confirmations have become incomplete or inaccurate where requested to do so by the ICAV or its authorised agents/delegates (as applicable).  If relevant, I/we* agree to notify the ICAV and FATCA & CRS Agent(s) of any change to my/our tax residency status. I/We* hereby also agree to indemnify and keep indemnified the ICAV, the Manager, the Directors, the Investment Manager, the Administrator, European Depositary Bank SA, Dublin Branch and their authorised agents or delegates against any loss, liability, cost or expense (including without limitation legal fees, taxes and penalties) which may result directly or indirectly as a result of a failure to meet our obligations pursuant to this section or failure to provide such information which has been requested by the ICAV or the FATCA & CRS Agent(s) and has not been provided by me/us, and from any misrepresentation or breach of any warranty, condition, covenant or agreement set forth herein or in any document delivered by me/us to the ICAV or the FATCA & CRS Agent(s). I/We* further acknowledge that a failure to comply with the foregoing obligations or failure to provide the necessary information required may result in the compulsory redemption of our entire holding in the ICAV, and that the ICAV is authorized to hold back from redemption proceeds or other distributions to me/us such amount as is sufficient after the deduction of any redemption charges to discharge any such liability and I/we* shall indemnify and keep indemnified the ICAV, the Manager, the Directors, the Investment Manager, the Administrator, European Depositary Bank SA, Dublin Branch and their authorised agents or delegates against any loss suffered by them or other Shareholders in the ICAV in connection with any obligation or liability to so deduct, withhold or account. 

    I/We* confirm that we have accurately and correctly completed the relevant FATCA & CRS self-certification form(s) included within this Application Form.  I/We* further confirm that if any information included in the self-certification form(s) subsequently becomes inaccurate or incorrect we will notify the ICAV and the FATCA & CRS Agent(s) immediately of any such change and  agree to immediately take such action as the ICAV may direct, including where appropriate, redemption of our Shares/ 

    I/We* agree to waive any provision of any privacy, banking secrecy or other law or regulation of any jurisdiction and/or the terms of any confidentiality agreement, arrangement or understanding that would, absent such a waiver, prevent the ICAV’s compliance with FATCA and CRS requirements. 

    I/We* acknowledge that the ICAV intends to take such steps as may be required to satisfy any obligations imposed by Council Directive (EU) 2018/822 (amending Directive 2011/16/EU), as applied in Ireland by means of the relevant Irish tax legislation (“DAC6”).  I/We* further acknowledge that this may, in specific circumstances, require the ICAV or any party that falls to be considered an “intermediary” for the purposes of DAC6 to exchange certain of my/our information (including details of my/our investment in the ICAV) to the Irish Revenue Commissioners and/or other relevant tax authorities.  I/We* hereby agree to the transmission of such data by the relevant party to the Irish Revenue Commissioners and/or other relevant tax authorities, as is required to comply with DAC6. 

    I/We* hereby acknowledge that I/we* should consult our own tax advisers about the applicability of FATCA, CRS, DAC6 and any other reporting requirements with respect to our own situation. 

    I/We* hereby warrant that I/we* have the knowledge, expertise and experience in financial matters to evaluate the risks of investing in the ICAV, am/are* aware of the risks inherent in investing in the assets in which the ICAV will invest and the method by which these assets will be held and/or traded, and can bear the loss of my/our* entire investment in the ICAV. 

    I/We* hereby declare that the Shares are not being acquired and will not be held in violation of any applicable laws. 

    I/We* agree not to duplicate or to furnish particulars of the Prospectus, or to divulge any of its contents, to any person other than my/our* investment, legal or tax advisors (who may use the information contained in the Prospectus solely for purposes relating to my/our* investment in the ICAV).

    I/We* hereby confirm that I/we* shall be deemed to make, on a continuing basis, each of the statements contained herein unless I/we* notify you to the contrary in relation to any Shares I/we* may hold or obtain at any time. 

    I/We* hereby agree to indemnify and hold harmless the ICAV, the Manager, the Directors, the Investment Manager, the Administrator, European Depositary Bank SA, Dublin Branch (the “Depositary”) or their authorised agents or delegates and the Shareholders against any loss, liability, cost or expense (including without limitation legal fees, taxes and penalties) which may result, directly or indirectly, from any misrepresentation or breach of any warranty, condition, covenant or agreement contained herein or in any other document delivered by the undersigned to the ICAV. 

    I/We* am/are able to bear the economic risk of an investment in the Shares, including, without limitation, the risk of loss of all or a part of my/our investment and the potential difficulties in selling or transferring my/our Shares for an indefinite period of time. I/We* do not have an overall commitment to investments which are not readily marketable that is disproportionate to my/our net worth, and my/our investment in the Shares will not cause such overall commitment to be excessive. 

    I/We* hereby undertake to pay cleared monies in respect of my/our Shares on or before the Subscription Settlement Cut-Off, as outlined in the Prospectus, unless otherwise agreed by the Directors. I/We* acknowledge that my/our application is irrevocable on receipt regardless of the timing of receipt of cleared monies. I/We* agree to indemnify each of the Administrator, the Depositary, the Investment Manager and the Manager and agree to keep each of them indemnified against any loss of any nature whatsoever arising to any of them owing to the late or non-receipt of cleared monies. I/We* hereby acknowledge that my/our Shares may be cancelled or that interest may be charged to me/us in accordance with the Prospectus and Instrument of Incorporation if cleared monies are not received within the above timeframes. 

    In respect of joint applicants only, I/we* direct that on the death of one of us the Shares for which we hereby apply be held in the name of and to the order of the survivor or survivors of us or the executor or administrator of the last of such survivor or survivors. 

    I/We* hereby agree to indemnify the ICAV, the Manager and the Administrator and agree to keep each of them indemnified against any loss of any nature whatsoever arising to each of them as a result of any of them acting on electronic instructions. The ICAV, the Manager, the Directors and the Administrator may rely conclusively upon and shall incur no liability in respect of any action taken upon any notice, consent, request, instructions or other instrument believed, in good faith, to be genuine or to be signed by properly authorised persons. 

    In accordance with the provisions of the Data Protection Acts 1988 to 2018 (as may be amended or supplemented from time to time) and the EU’s General Data Protection Regulations 2016/679 (the “GDPR” (together the “Data Protection Legislation”), I/We hereby acknowledge and are informed that personal data given in this Application Form (or otherwise provided in connection with an application to subscribe for Shares in the ICAV, on application or at any other time, including without limitation my/our name, age, contact details, bank account details, transactions and the invested amount, and any information regarding the dealing in Shares (subscription, conversion, redemption and transfer) (the “Personal Data”), will be collected, recorded, stored, adapted, transferred and processed, by electronic means or otherwise, by the ICAV as a “data controller” under the Data Protection Legislation, and as further described in the ICAV’s data privacy statement, which is set out in this Application Form. 

    I/We hereby undertake to provide information to the ICAV or the Administrator as may be required for the establishment and maintenance of the ICAV’s beneficial ownership register in accordance with the European Union (Anti- Money Laundering Beneficial Ownership of Corporate Entities) Regulations 2019 as may be amended from time to time (the “Beneficial Ownership Regulations”). I/We hereby consent to the publication of such information in accordance with the requirements of the Beneficial Ownership Regulations. 

    I/We hereby acknowledge that it is our responsibility to check the accuracy of information provided in any confirmation of ownership, any valuation statements and other reports (collectively “contract notes”) issued by the Administrator on behalf of the relevant Fund. It will be assumed that we have received contract notes and that the details contained therein are correct unless we contact the Administrator within 24 hours of the date of issue. The ICAV’s liability and the Administrator's ability to change contract notes will be restricted after this time, however, the Administrator, the ICAV and the Manager reserve the right to correct errors at any time and will endeavour to ensure errors are corrected. 

    This Application Form and any or all non-contractual obligations arising in connection with it shall be governed by and construed in accordance with Irish Law. Each party hereto submits to the jurisdiction of the Irish courts; and to the fullest extent permissible all disputes will be governed by Irish law. With respect to any suit, action or proceedings relating to any dispute arising out of or in connection with this Application Form (including any non-contractual obligations arising out of or in connection with it) (“Proceedings”), each party and the irrevocably: (a) submits to the jurisdiction of the Irish courts; (b) waives any objection which it may have at any time to the laying of venue of any Proceedings brought in any such court, waives any claim that such Proceedings have been brought in an inconvenient forum and further waives the right to object, with respect to such Proceedings, that such court does not have any jurisdiction over such party; and (c) agrees, to the extent permitted by Irish law, that the bringing of Proceedings in any one or more jurisdictions will not preclude the bringing of Proceedings in any other jurisdiction.

    DATA PRIVACY STATEMENT
     

    In accordance with the General Data Protection Regulation (697/2016/EU) (the “GDPR”) and applicable Irish data protection legislation (currently the Data Protection Act 2018) (collectively, “Data Protection Legislation”) the ICAV being a data controller, must provide you with information on how the personal data that you provide as part of your subscription to shares in the ICAV will be processed by the ICAV, its service providers and delegates and their duly authorised agents and any of their respective related, associated or affiliated companies. 

    As a consequence of your investment, the ICAV acting as a data controller may itself (or through third parties including but not limited to the Manager and, the Administrator, together with any distributors that may be appointed from time to time (collectively the “Distributor”), local paying agents and mailing firms appointed by any of the foregoing (together the “Service Providers”) process your personal information or, to the extent that you are a non-natural person, that of your directors, officers, employees, intermediaries and/or beneficial owners. Save where otherwise expressly provided, any reference in this Data Privacy Statement to “you” or “your” in the context of processing personal data of data subjects shall be understood to mean and relate to the personal data of your directors, officers, employees, intermediaries and/or beneficial owners as the context may require. 

    The Administrator may use your personal data where this is necessary for compliance with a legal obligation to which it is directly subject (i.e. to comply with applicable law in the area of anti-money laundering and counter-terrorist

    financing or where mandated by a court order or regulatory sanction). The Administrator, in respect of this specific use of personal data, acts as a data controller. In circumstances where the Administrator acts as a data controller in respect of the information that has been provided to it by you, all rights afforded to you as a data subject under GDPR shall be exercisable by you solely against the Administrator. 

    The Depositary may use your personal data where this is necessary for compliance with a legal obligation to which it is directly subject (i.e. to comply with applicable law in the area of anti-money laundering and counter-terrorist financing or where mandated by a court order or regulatory sanction). The Depositary, in respect of this specific use of personal data, acts as a data controller. In circumstances where the Depositary acts as a data controller in respect of the information that has been provided to it by you, all rights afforded to you as a data subject under GDPR shall be exercisable by you solely against the Depositary. 

    Please note the following: 

    Purposes of Processing and Legal Basis for Processing

    The personal data collected from you or provided by you or on your behalf in connection with your application for Shares in the ICAV will be collected, stored, disclosed, used and otherwise processed by the Service Providers for the purposes outlined in the table below. 

     

     

    Processing Activity by or on behalf of the ICAV Legal Basis for Processing
    Where you are a natural person, opening your account with the ICAV and managing and administering your holdings in the ICAV and any related account on an ongoing basis. Performance of the contract between the ICAV and you
    Where you are a natural person, disclosures to third parties such as auditors, regulatory authorities, tax authorities and technology providers in the context of the day-to-day operations of the ICAV. Performance of the contract between the ICAV and you
    Where you as an investor are a non-natural person, disclosures to third parties such as auditors, regulatory bodies, tax authorities and technology providers in the context of the day to day operations of the ICAV. Pursuing the legitimate interests of the ICAV in managing and administering the holdings of the non-natural persons in the ICAV and any related account on an ongoing basis.
    Complying with any applicable legal, tax or regulatory obligations imposed on the ICAV including legal obligations under Fund law, the UCITS Regulations, the Central Bank Regulations, under tax law and under anti-money laundering / counter terrorist financing legislation. Compliance with a legal obligation to which the ICAV is subject
    Recording, maintaining, storing and using recordings of telephone calls and electronic communications that you make to and receive from the ICAV, the Service Providers and their delegates or duly appointed agents and any of their respective related, associated or affiliated companies for any matters related to investment in the ICAV, dispute resolution, record keeping, security and/or training purposes. Pursuing the legitimate interests of the ICAV.

    Further information relating to the balancing test undertaken by the ICAV in respect of such processing is available upon request.

    Please note that where personal data is processed for purposes of legitimate interests, you have a right to object to such processing and the ICAV and its appointed Service Providers will no longer process the personal data unless it can be demonstrated that there are compelling legitimate grounds for the processing which override your interests, rights and freedoms or for the establishment, exercise or defence of legal claims.

    Profiling and Screening

    The ICAV and its appointed Service Providers may engage in PEP screening and financial sanctions screening programs defined by the European Union (“EU”), the United Nations (“UN”), Her Majesty’s Treasury (“HMT”) and the Office of Foreign Assets Control (“OFAC”) for the purposes of complying with for the purposes of complying with the Criminal Justice (Money Laundering and Terrorist Financing) Act 2010 as may be amended or replaced from time to time and with UN, EU and other applicable sanctions regimes. Such processing, which may reveal your political opinion, is considered lawful on the grounds of substantial public interest permitted under Article 9(2)(g) of the GDPR. Further information is available in the prospectus for the ICAV.

    Undertaking in connection with other parties

    By agreeing to provide personal data to the ICAV, you undertake to be authorised to disclose to the ICAV relevant information applicable to the beneficial owner of the investment, to your directors and authorised signatories and to persons that own, directly or indirectly, an interest in the ICAV. In this respect you confirm that you have provided these persons with all the information required under applicable data protection law, notably regarding their data protection rights, and received from these persons their authorisation for the processing and transfer of their personal data to us.

    Disclosures to Service Providers and / or Third Parties

    Personal data relating to you which is collected from you or provided by you or on your behalf may be handled by Service Providers appointed by the ICAV and its or their duly appointed agents and any of related, associated or affiliated companies where required for the purposes specified above.

    These Service Providers will be obliged to adhere to the data protection laws of the countries in which they operate.

    The ICAV may disclose your personal data to other third parties where required by law or for legitimate business interests. This may include disclosure to third parties such as auditors and the Central Bank of Ireland, regulatory bodies, taxation authorities and technology providers.

    Transfers Abroad

    Personal data collected from you or provided by you or on your behalf may be transferred outside of Ireland including to companies situated in countries outside of the European Economic Area (“EEA”) that may not have the same data protection laws as in Ireland.

    Where data transfers outside of the EEA take place, the ICAV has taken the necessary steps to ensure that appropriate safeguards have been put in place to protect the privacy and integrity of such personal data, in particular the implementation of binding corporate rules and/or ensuring the implementation of model contracts by the Service Providers and their affiliates.

    Data Retention Period

    The ICAV and its appointed Service Providers will retain all information and documentation provided by you in relation to your investment in the ICAV for such period of time as may be required by Irish legal and regulatory requirements, being at least six years after the period of your investment has ended or the date on which you had your last transaction with us.

    Your data protection rights

    Please note that you have the following rights under the GDPR. In each case, the exercise of these rights is subject to the provisions of the GDPR:

    (i) You have a right of access to and the right to amend and rectify your personal data.

    (ii) You have the right to have any incomplete personal data completed.

    (iii) You have a right to lodge a complaint with a supervisory authority, in particular in the Member State of your habitual residence, place of work or place of the alleged infringement if you consider that the processing of personal data relating to you carried out by the ICAV infringes the GDPR.

    (iv) You have a right to be forgotten (right of erasure of personal data).

    (v) You have a right to restrict processing.

    (vi) You have a right to data portability.

    (vii) You also have the right to object to processing where the ICAV is processing personal data for legitimate interests.

    Where you wish to exercise any of your data protection rights against the ICAV, please contact us via the details provided below under “Contact Us”.

    The ICAV or its Service Provider will respond to your request to exercise any of your rights under the GDPR in writing, as soon as practicable and in any event within one month of receipt of your request, subject to the provisions of the GDPR. The ICAV or its Service Provider may request proof of identification to verify your request

    Failure to provide personal data

    Please see the prospectus for the ICAV for further information on failure to provide personal data.

    Contact us

    If you have any questions about our use of your personal information, please contact the Administrator at cosecfunds@apexfs.com.

  • IMPORTANT

    To be valid Application Forms must be signed by each Applicant and received by the Administrator. In the case of a legal entity, Applications Forms should be executed under seal or signed by duly authorised signatories provided that a copy of the authorised signatories list together with sample signatures and details of any signing protocol accompanies the Application Form. If this Application Form is signed under power of attorney such power of attorney or a copy thereof must accompany it. The right is reserved to reject any Application Form in whole or in part or to seek such further information as the ICAV may require to satisfy itself in regard to the identity and legal capacity of any Applicant.

  • APPENDIX 1 - Anti-Money Laundering Supplement
    ("AML Supplement")

    We refer you to the Administrator’s AML Supplement (attached separately) listing the documentation to be provided by investors and outlining the simplified and standard due diligence requirements. 

    We require detailed verification of each Applicant’s and investor’s identity for anti-money laundering purposes, in accordance with the Criminal Justice (Money Laundering & Terrorist Financing) Act 2010. 

    The information in the Administrator’s AML Supplement will provide you with the minimum requirements for different types of Applicants, for example, individuals and corporate entities. 

    The ICAV reserves the right to request any further documentation it requires to satisfy its obligations under anti-money laundering procedures or legislation.

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  • INVESTOR IDENTIFICATION

    PASSPORT

    Please see the template page below and download it in order to properly re-upload your passport for the verification process.

    It is important that both the picture page AND the signature page are verified.

    If you are unsure which documents require certification, please feel free to contact ir@mayarcapital.com.

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  • SOURCE OF FUNDS/WEALTH DECLARATION

    In order to comply with our regulatory obligations, we are obliged to obtain information about our customer’s source of funds and source of wealth. In certain circumstances, we will also require documentary evidence (see Appendix 1). Please avoid generic responses such as “employment” or ”inheritance.”

  • SECTION A: SOURCE OF FUNDS

  • SECTION B: SOURCE OF WEALTH

    Your source of wealth can be described as the activities which have generated your overall wealth and are distinct from your source of funds. Your overall wealth may have been accumulated from a number of different sources over a period of time and full details must be provided to avoid any delay in processing your application. 

    For Example: Family Inheritance: Provide names, relationships, dates, the jurisdiction of probate, and amount.
      Entrepreneurial: Provide full details of companies, business activities, place(s) of business, website addresses and details of return on investment
      Employment: Provide details of employer, positions held, details of salary and bonuses

  • SECTION C: *DOCUMENTARY EVIDENCE OF SOURCE OF FUNDS/SOURCE OF WEALTH

    In certain circumstances, to meet our regulatory obligations, we are required to obtain documentary evidence to verify the source of funds and source of wealth. It is not possible to describe all situations where we will require documentary evidence, however, we are able to indicate those situations where documentary evidence will definitely be required, and have provided details below:-

    1. If you are a Politically Exposed Person (“PEP”) (or a close family member to a PEP) and/or
    2. If you are resident in a country, have a passport issued by a country or your source of funds or wealth arises from a country detailed in Appendix 2, then documentary evidence must be provided.

    Examples of documentary evidence likely to be accepted are provided in Appendix 1. However, we reserve the right to request additional information upon review of the documentation provided.

  • Should you wish to confirm prior to submission of your completed Declaration, if documentary evidence of source of funds/source of wealth is required, please contact your Account Manager.

    If you are unable to provide documentary evidence please contact us prior to sending in the completed Declaration.

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  • SECTION D: ADDITIONAL TRANSACTIONS

    For additional transactions, further information will generally not be required, unless the source of funds is different from that previously stated.

  • SECTION E: CERTIFIED DOCUMENTATION

    Please note that copy documentation provided to support source of funds and source of wealth must be properly certified in accordance with our certification requirements. Improperly certified documentation could lead to delays.

  • SECTION F: THIRD PARTY COMPLETION

    Please confirm the name and capacity of the person who completed this form on your behalf (if applicable):

  • DECLARATION

    I declare that the information provided is, to the best of my knowledge and belief, accurate and complete.

    If I did not complete this form, I hereby confirm that the individual who completed the form on my behalf was in possession of sufficient information to allow for its proper completion.

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