Application Form

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

VP Capital Fund I (ABN: 65 866 722 565)
Unitholder Name

First NameLast Name
The party set out above (Unitholder) confirms that it is an existing unitholder in VP Capital Fund I (Fund), being a wholesale unit trust managed by VP Capital Pty Ltd ACN 620 372 741, holder of AFS licence 517199.

By completing and lodging this Change of Unitholder Details Form, the Unitholder hereby:

(a) agrees to be bound by the changes in details set out in this document;
(b) acknowledges that all details are correct and agrees to indemnify the Fund and VP Capital Pty Ltd from any errors, mistakes or omissions in the change of details in this document;
(c) authorises the directors of VP Capital Pty Ltd to complete or amend this Unitholder Change of Details 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
New Unitholder Contact Details (Contact Person)

Leave blank if no change
Name

First NameLast Name
Company/Trust/Account Name (if applicable)
Phone Number
Please enter a valid phone number.
Fax
Email
example@example.com
Postal Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
New Distribution Preferences

Leave blank if no change
I/we elect to receive distributions by:

Distribution reinvestmentPay to bank account (below)_________ % distribution reinvestment and _________ % payment to bank account (fill in below)
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.
New Bank Account Details (For Distributions and Redemptions)

Leave blank if no change. Please list below the bank account from which any electronic transfer of funds will be made. The bank account must be in the name of the investor. Distribution and redemption payments will be paid into this bank account.
BSB
Account Number
Account Name
Name of Bank
Branch Address
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.
New Taxation Details

Leave blank if no change
Are you a resident of Australia for taxation purposes?

Yes (complete below)No (please provide country of residence below)
Country of Residence
Tax file number (TFN) or Australian Business Number (ABN)
Exemption Number
Please indicate to whom the TFN or ABN belongs to:

CompanyTrust/Super FundIndividualOther - please specify below
Please fill if the "Other" option was selected above
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.
SIGNING
Account operating instructions (if no selection is made, all individuals to sign will be assumed)

Any individual to signAny two individuals to signAll individuals to signOther (please specify below)
Please fill if "Other" option selected above
Signatory 1
Name and Title
Signature

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Date

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Date
Signatory 2
Name and Title
Signature

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Signatory 3
Name and Title
Signature

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Signatory 4
Name and Title
Signature

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Should be Empty:

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

Change of Unitholder Details Form

New Unitholder Contact Details (Contact Person)

New Distribution Preferences

New Bank Account Details (For Distributions and Redemptions)

New Taxation Details

SIGNING

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