Individual / Joint Application Form

Which Investment are you applying for?*

Applicant 1*

First NameLast Name

Address (PO Box Not Accepted)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Postal Address (if different)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email *

example@example.com

Phone Number*

Area CodePhone Number

Date of Birth*

MonthDayYear

Quotation of TFN

Quotation of your Tax File Number (TFN) is not compulsory and will not affect your application. However, if you do not provide this information we will be required to deduct tax from your distributions at the highest marginal rate. If exempt, please supply supporting documentation.

Tax File Number or Exemption Code*

Applicant 2

First NameLast Name

Address (PO Box Not Accepted)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Postal Address (if different)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email

example@example.com

Phone Number

Area CodePhone Number

Date of Birth

MonthDayYear

Tax File Number or Exemption Code

Politically Exposed Person

"politically exposed person" means an individual who holds a prominent public position or function in a government body or international organisation in Australia or overseas.

Are you a politically Exposed Person?*

YesNo

If "Yes" please provide details

Investment Amount - (Must meet minimum investment subscription amount)*

BANKING DETAILS FOR DISTRIBUTIONS / REDEMPTIONS (IF APPLICABLE)

Bank:

Account Name:

BSB:

Account Number:

DISTRIBUTION REINVESTMENT PLAN

Please consider the disclosure document regarding whether or not your investment will receive a cash distribution or if your distribution will be reinvested.

You can change your election at any time by contacting:

registry@primarysecurities.com.au

Please tick the box for your preference*

I confirm I wish to have my distributions reinvested.I confirm I wish to receive a cash distribution.

INDIVIDUAL PROOF OF IDENTIFICATION

Please upload certified proof of identification documents to fulfil the requirements of the Anti Money Laundering and Counter Terrorism Financing Legislation.

For a list of require identification documents Click Here

Upload Identification Documents*

Browse Files

ADVISER DETAILS (Optional)

I / We agree that information relating to my investment be supplied to my / our adviser. If this Section is not completed, information will not be provided to the adviser.

Advisory Name

Dealer Group

AFSL Number

Postal Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Area CodePhone Number

Adviser Email

ADVISER PROFESSIONAL FEE FOR SERVICE DETAILS (Optional)

(Please consider the disclosure document if this is applicable to your application)

If you have negotiated a professional fee for servce with your financial adviser, you need to complete this section.

PROFESSIONAL FEE FOR SERVICE AUTHORITY

I request until further notice from me, that the Responsible Entity/Trustee deduct a professional fee for service from my Application Amount and/or an ongoing professional fee for service from my distribution payments as set out below. I acknowledge that these fees will be paid to my financial adviser as specified in the Adviser Details section above which forms part of this Application Form and that the balance of my Application Amount will be invested in the Fund and/or the balance of my distribution payments will be paid to me.

I AGREE TO THE PROFESSIONAL FEE FOR SERVICE AUTHORITY ABOVE (Please leave blank if not applicable)

Upfront professional fee for service. Either a percentage of your Application Amount or a fixed amount.

Ongoing professional fee for service. Either a percentage or fixed amount from your distributions up to a maximum of 1% per annum (excluding GST) of your net Application Amount after deduction of any upfront professional fee for service.

Enter % amount or $ amount above

ANNUAL REPORTS

We will send you an email when the annual report is available on our website.

If you would like us to send you a copy of the annual report for the Fund, please indicate below how you would like to receive it:

EmailMail

Email

FOREIGN ACCOUNT TAX COMPLIANCE ACT (FATCA) AND COMMON REPORTING STANDARD (CRS) SELF CERTIFICATION

Tax authorities require Primary Securities Ltd to collect and report certain information about an investor's tax residency status.

If you are unable to answer any of the following questions, please seek appropriate advice relating to the tax information required (as set out in the Automatic Exchange of Information Guidance published by the Australian Taxation Office www.ato.gov.au).

Are you a tax resident of any other country outside of Australia?*

YesNo

If you answered Yes, please provde the following information.

Date, Town and Country of Birth

Are you a US Citizen or resident of the US for tax purposes?

YesNo

If Yes, please provide your US Taxpayer Identification Number (TIN)

Please indicate your jurisdiction of tax residence (other thant the US identified above). If you are a tax resident in more than one jurisdiction please include details for all jurisdictions.

Please provide any relevant Jurisdiction of Tax Residence (Country); Tax Identification Number (TIN) or equivalent and Reason Code if no TIN provided.

Reason A: the jurisdiction of the tax residence does not issue TIN's to its residents

Reason B: the individual is otherwise unable to obtain a TIN or equivalent number, (please explain why in the section below)

Reason C: No TIN is required (only select this reason if the domestic law of the relevant jurisdiction does not require the TIN to be disclosed)

Please explain why the individual is unable to obtain a TIN (per Reason B)

DECLARATION AND SIGNATURE

I declare and agree that:

1. The details given in this application are true and correct;

2. I am over 18 years of age;

3. My information will be collected and used in accordance with Primary Securities Ltd's privacy policy;

4. The information provided in the FATCA / CRS section may be disclosed to the Australian Taxation Office or any other government bodies, including bodies located overseas, to enable it to be reported and used in compliance with any FATCA or CRS regulations;

5. I will notify Primary Securities Ltd with any changes to the information provided by me and provide any futher information reasonably required by Primary Securities Ltd to comply with any obligation under the FATCA / CRS regulations within 30 days of such change in circumstances.

6. I have read and understood the current Information Memorandum or Product Disclosure Statement to which this application relates and agree to be bound by the Constitution governing the Trust;

7. I am not aware of and have no reason to suspect that the moneys used to fund our investment have been or will be derived from or realted to any money laundering, terrorism financing or similar illegal activities and that I will continue to comply with Australian anti money laundering and counter terrorism financing laws.

8. We acknowledge that the Trust is subject to investment risks, which could include delays in repayment, and loss of income and capital invested and that no member of Primary Securities Ltd, or any of its agents guarantees the performance of the Trust or any particular rate of return;

9. If signed under power of attorney, the attorney encloses a certified copy of the power of attorney and declares that he/she has not received notice of revocation of that power.

10.By typing my signature and sending it via the Internet, I acknowledge that I have read the Information Memorandum or Product Disclosure Statement and understand all information provided during the application process; that I intend Primary Securities Ltd to rely upon it; that I intend to be bound thereby; and that I understand and agree that my electronic signature is the equivalent of a manual written signature.

Signature - Applicant 1

Signature - Applicant 2 (if applicable)

Once your application has been received and reviewed you will receive an email confirming receipt of your application and advising you of the bank account details for the funds to be deposited.