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Company Registration Form
Insert Passport Photo
Insert Passport Photo
Insert Passport Photo
Type of Fund
Income & Growth Fund
Income Fund
Income Plus Plan
Investment Plans
A. COMPANY/TRUST/GROUPS & ASSOCIATIONS INFORMATION
Entity Name:
Contact Person:
Designation:
Registration No:
Tax Identification No:
Postal Address:
Email:
Telephone No:
Fax No:
B. PURCHASE OF UNITS
Fund
Investment Plans
Number of Units
Value of Units [$]
Income & Growth Fund
n/a
Income Fund
Children Investment Plan
Income Plus Plan
Source of Funds:
Annual Income (Optional):
Minimum initial application amount
Income & Growth Fund: 100 units
Income Fund:
Children Investment Plan
20 units ($20.00)
Income Plus Plan
50 units ($50.00)
Reinvestment Plan: (Please Tick)
Yes
No
Bank Direct Credit
Bank Name:
Account No:
Branch:
Cheque Payment: (applicable to Income & Growth Fund only with investment in excess of 1,000 units)(Please Tick)
Yes
No
D. DECLARATION AND SIGNATURE
I/We declare that I/We have seen and agree with the Declaration and Conditions that are outlined in on page 32 of this Prospectus.
TRUSTEE SIGNATURE[S]
Name
Name:
Name
Signature
Signature:
Signature
Date:
Date:
Date:
Please affix Company seal here
E. REFERRAL[S]
FDB
POST FIJI
REPRESENTATIVE/AGENT
F. Official Use Only Checklist
No:
Documents
1
Photo I-D (Valid FNPF Card, Drivers License and Passport)
2
Birth Certificate
3
Passport Photo(s)
4
Statutory Declaration (in the absence of a formal identification) with photo(s)
5
Passport for overseas based investors (compulsory)
6
Consent letter from Parents/guardians/custodians (applicable to Children Investment Plan)
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