VP Capital Pty Ltd ACN 620 372 741
Level 1, 233 Exhibition Street, Melbourne, 3000
AFSL No. 517199

The party set out below (Applicant) hereby applies for units in the VP Capital Fund I (Fund), being a wholesale unit trust managed by VP Capital Pty Ltd (Company).

By completing and lodging this Application Form and amount the Applicant hereby:

(a) applies for units in the VP Capital Fund I;
(b) transfers the Application Amount to this Application Form;
(c) attaches the relevant completed Anti-Money Laundering Form (see Annexure B) together with any required supporting documentation referred to in that Anti-Money Laundering Form to this Application Form;
(d) agrees to be bound by the Information Memorandum and Trust Deed;
(e) confirms that any allotment of units to the Applicant will fully comply with the Corporations Act including the relevant provisions of section 708 and 761G (refer to Annexure A); and
(f) authorises the directors of the Company to complete or amend this Application Form where necessary to correct any errors or omissions.

Please then forward the completed sections and the required certified identification evidence from Annexure B

Apex Fund Services (Australia) Pty Ltd
Attn: Investor Services
Address: PO Box 189, Flinders Lane VIC 8009
Fax: +61 3 8648 6885
Email: investorregistry@apexfunds.com.au

If no election is made, distributions will be automatically reinvested in additional Units. If you wish to change your election, you must notify the Administrator in writing.

Banking information: Please note that in cases where the bank account is not in the same name as the investor as indicated above, documentary information must be provided detailing the reason for, and background to, such a “third party” payment request. Payments that do not originate from an account in the name of the investor, are subject to an approval process. Please note that supporting documentation on the relationship between the third party and investor should be provided. Should this not be to the satisfaction of the Administrator, the funds will be returned to the remitting party.

Note: You are not obliged to provide this information but if you do not provide either your TFN or ABN and unless you claim a TFN exemption, Trustee will be required to deduct tax at the highest marginal rate. The collection of this information is authorised and its use and disclosure is strictly regulated by the Australian tax laws and Privacy Act.Additionally, as part of our compliance with the AML Law, we required detailed verification of the investor’s identity and the source of the payment of the application money. We may ask your bank to confirm to us in writing that the funds were wired from a bank account held with them in the name of the investor. We reserve the right to request such information as is necessary to verify the identity of any investor.

as defined in the Income Tax Assessment Act 1997

NOTE: This Certificate is confidential and may only be provided to the individual, the company seeking to rely upon Section 708(8)(c) and/or 761G(7)(c), any employer of the individual and the Australian Securities & Investments Commission or their duly appointed agents

All documents must be scanned/ faxed to the Administrator before mailing the originals.

Certified copy means a document that has been certified as a true copy of an original document.

Certified extract means an extract that has been certified as a true copy of some of the information contained in a complete original document by one of the persons described in the sub-paragraphs below.
The certifier should sign the copy (printing his/her name underneath) and clearly indicate his/her position or capacity, and include a contact address and phone number. The certifier must indicate that the document is a true copy of the original document.

People who can certify documents or extracts are:

• A person who, under a law in force in a State or Territory, is currently licensed or registered to practice the following occupations:

o Chiropractor;
o Dentist;
o Legal practitioner;
o Medical practitioner;
o Nurse;
o Optometrist;
o Patent/Trademarks attorney;
o Pharmacist;
o Physiotherapist;
o Psychologist; and
o Veterinary surgeon.

• a lawyer - a person who is enrolled on the roll of the Supreme Court of a State or Territory, or High Court of Australia, as a legal practitioner (however described);

• a person listed in Part 2 of Schedule 2 of the Statutory Declarations Regulations 1993, which includes but is not limited to:

o a judge of a court;
o a magistrate;
o a chief executive officer of a Commonwealth court;
o a registrar or deputy registrar of a court;
o a Justice of the Peace;
o a notary public (for the purposes of the Statutory Declaration Regulations 1993);
o a police officer;
o a postal agent - an agent of the Australian Postal Corporation who is in charge of an office supplying postal services to the public;
o the post office - a permanent employee of The Australian Postal Corporation with 2 or more years of continuous service who is employed in an office supplying postal services to the public;
o an Australian consular officer or an Australian diplomatic officer (within the meaning of the Consular Fees Act 1955);
o an officer at a bank, building society, credit union or finance company with 2 or more continuous years of service with one or more financial institutions (for the purposes of the Statutory Declaration Regulations 1993);
o a member of the Institute of Chartered Accountants in Australia, the Australian Society of Certified Practising Accountants or the National Institute of Accountants; and
o a teacher employed on a full-time basis at a school or tertiary education institution.

• an officer or authorised representative of a holder of an Australian financial services licence, having 2 or more continuous years of service with one or more licensees.

The Foreign Account Tax Compliance Act (FATCA) generally requires financial institutions (FI) and certain other nonfinancial entities that are foreign to the United States to report on assets held by their US account holders.

*Controlling Persons refer to any holding of 25% or more in an entity and also includes positions of control including Directors and Company Secretaries. If either question above is answered YES, a FATCA form will be required to be completed (a copy is available by contacting William Buck Managed Funds).

The Common Reporting Standard (CRS) is the single global standard for the collection, reporting and exchange of financial account information on foreign tax residents.

Please provide details for all jurisdictions in which the Account Holder is resident for tax purposes.

If any Taxpayer Identification Number is unavailable, please provide an explanation.