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Appendix A

STATEMENT FOR CERTIFIED HIGH NET WORTH INDIVIDUAL

I make this statement so that I can receive promotional communications which are exempt from the restriction on promotion of speculative illiquid securities. The exemption relates to high net worth investors and I declare that I qualify as such because at least one of the following applies to me:

If you meet condition A or B below, you may choose to be classified as a high net worth individual for the purposes of the Financial Services and Markets Act 2000 (Financial Promotions) Order 2005.

In the last financial year, did you have:

Annual Income of £170,000 or more? Income does NOT include any one-off pension withdrawals.

Yes No

If yes, please specify your income (as defined above) to the nearest £10,000 in the last financial year

AND/OR
B. NET assets of £430,000 or more? Net assets do NOT include your home (primary residence), any loan secured on it or any equity released from it, your pension (or any pension withdrawals) or any rights under insurance contracts. Net assets are total assets minus any debts you owe.

Yes No

If yes, please specify your net assets (as defined above) to the nearest £100,000 in the last financial year

I declare that I have answered yes to A and/or B and wish to be treated as a high net worth individual.

I understand that this means:

a. I can receive financial promotions where the contents may not comply with rules made by the Financial Conduct Authority (FCA).

b. I can expect no protection from the FCA, the Financial Ombudsman Service or the Financial Services Compensation Scheme.

I am aware that it is open to me to seek advice from someone who specialises in advising on investments.

I accept that I could lose all of the money I invest.

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

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December 5, 2017 3:37 pm GMT

Appendix A Uploaded by Jamie Johnson - jamie@fjpinvestment.co.uk IP 81.37.47.6