Præmium International Limited: T: +44(0)1534 765 450 F: +44(0)1534 765 459 E: W

Alexander Forbes Offshore WITHDRAWAL INSTRUCTION dps Select

Part 1 – Investor Account Details

Investor Account Number

Investor Account Name

Part 2 – My Adviser

Adviser Firm Name

Adviser Name

Part 3 – Withdrawal Details

Lump Sum Redemption

Please note that the remaining account balance must exceed the minimum investment size, as stated in the applicable mandate, or we reserve the right to redeem the whole of your investment and close your Account.

Withdrawal Amount - select currency - Or, if a full redemption please tick the box

Regular Withdrawal Instruction

Please note this Instruction will replace any existing Regular Withdrawal Scheme in place.

Regular Withdrawal Amount - select currency - Frequency Monthly

Part 4 – Investor Confirmation of Withdrawal Instruction

This Investor Confirmation of Withdrawal Instruction is dated: day of , 20

To: The Custodian (Præmium International Limited)

I [PRINT FULL NAMES BELOW]

Primary Client

declare that I would like to redeem the amounts stated above from my account as indicated at the top of this form.

By signing below, I also confirm my understanding that: -

 redemption amounts are payable when the underlying proceeds are received (some less liquid assets may take longer to redeem);  my instruction is irrevocable once the instruction has been processed; and  proceeds will be sent to the bank account included on the original application form, unless you have since instructed us of a change to account details via written instruction. Primary Investor/Authorised Signatory

Signature

This Withdrawal Instruction Form must be mailed to:

Præmium International Limited, 3rd Floor East Salisbury House 1-9 Union Street St Helier Jersey JE2 3RF

Præmium International Limited: T: +44(0)1534 765 450 F: +44(0)1534 765 459 E: [email protected] W:www.praemiuminternational.com Registered Office Address: Præmium International Limited, 3rd Floor East Salisbury House 1-9 Union Street St Helier Jersey JE2 3RF Company Registration No. 107624 (Jersey) Præmium International Limited is regulated by the Jersey Financial Services Commission under reference IB0271