AUGUST2014

ADDITION & AMENDMENT FORM

MPORTANT INFORMATION

1. Please complete all the relevant sections and sign sections 5 and 7.
2. The completed form and supporting documentation (see below) can be scanned and emailed to uttransactions@[Link],
faxed to +27 (0) 21 509 7100 or handed in at any Old Mutual branch. Illegible and incomplete forms may lead to delays. Contact
our Service Centre at (061) 239 513/522 for any queries.
3. Your investment will be made once we have received the completed form and supporting documentation and your money reflects in the
correct bank account.
4. Once your account has been opened, you can register via [Link] to view your portfolio.
5. Old Mutual Unit Trust Management Company Namibia Limited will henceforth be referred to as Old Mutual Unit Trust.
6. Please take into account daylight savings time during winter.
SUPPORTING DOCUMENTS (REQUIRED)

1. Account Holder Documentation

Namibian ID or Passport Holders Foreign ID or Passport Holders
• Copy of Namibian ID document or Namibian Passport • Copy of Foreign ID document or Passport
• Proof of Residential address (not older than 3 months)
(e.g. Utility bill in the account holder’s name, Cell phone
contract or Fixed line account, Formal lease agreement)
Contributions exceeding N$ 250,000.00 or monthly contributions exceeding N$ 6,000.00 p/m (per Investor)

• Payslip or Proof of Income (e.g. proof of incorporation of own business)

2. Documentation for person acting on behalf of Investor

Namibian ID or Passport Holders Foreign ID or Passport Holders

• Proof of authority to act • Proof of Authority to Act
(e.g. power of attorney, full birth certificate for minors) (e.g. power of attorney, full birth certificate for minors)
• Copy of Namibian ID document or Namibian Passport • Copy of Foreign ID document or Passport
• Proof of Residential address (not older than 3 months)

PROCESSING TIMES

If all the requirements are met by 15h00 (13h00 for all transactions involving money market unit trusts), you will receive the same day’s price.
Otherwise the first working day’s price will apply once all requirements have been met, with the same cut-off times applying.

Please complete this form using block letters and tick ( ) where appropriate.

Fax your completed form to +27 (0)21 509 7100 and contact our Service Centre at (061) 239 513/522 to obtain your account number. Then use this
account number as the reference when making a direct deposit or Electronic Fund Transfer. Selecting the incorrect bank account or not including an account
number as reference may cause delays.

1. INVESTOR DETAILS

INDIVIDUAL IN WHOSE NAME INVESTMENT IS HELD

Surname and initials:

Previous names, if any:

Title and first names:

Gender: Male Female Marital status: Married Single Widowed Divorced

ID/Passport number: Date of birth:

Income tax number: Tax Residence:

1
 ADDITION & AMENDMENT FORM

3. BANK DETAILS

Deductions cannot be made from credit cards. Debit orders can only be raised from your own account (except in the case of legal guardians investing on
behalf of minors, or spouses investing on each other’s behalf). Payments can only be made to your own bank account (except in the case of minors).

BANK DETAILS FOR DEDUCTIONS (We will deduct the stated amount as well as all future payments from this account. Please provide proof of banking
details and resolution authorising deductions)

Surname of account holder: Initials:

Bank and Branch:

Branch code: Account number:

Account type: Current Savings Cheque

BANK DETAILS FOR PAYOUTS IF DIFFERENT FROM ABOVE

(We will pay dividends, proceeds of sales and regular withdrawals, into this account.) Please provide proof of banking details.

Surname of account holder: Initials:

Bank and Branch:

Branch code: Account number:

Account type: Current Savings Cheque

4. AUTOMATED REGULAR WITHDRAWALS

Please sell units to the value of N$ from my Fund,

every month/quarter/six months/year (circle payment frequency). Starting D D M M C C Y Y (Date).

3
 ADDITION & AMENDMENT FORM

5. DECLARATION

I agree to accept the number of units sold to me by virtue of this application and I warrant that I have full power and authority to enter into and conclude this
transaction, with the necessary assistance where such assistance is a legal requirement. I am aware that this product offers no cooling-off rights. I know that the
cost of buying units includes an initial charge and that there are no guarantees on my capital. I acknowledge that there are further allowable deductions from
the fund (e.g. an annual service fee) that impact on the value of my investment. I am satisfied that the facts provided are accurate and complete. I am aware of
the fund’s/funds’ objectives, risk factors, the charges and income distributions, as set out in the fund fact sheet/s. I acknowledge that Old Mutual Unit Trust may
borrow up to 10% of the portfolio to bridge insufficient liquidity. I have read and fully understood all pages of this application form. I hereby authorise Old
Mutual Unit Trust to debit the account mentioned above in Section 3 with the monthly amount/ lump sum specified. I hereby consent to Old Mutual Unit Trust
transmitting the information or documentation provided by me in so far as may be needed to facilitate its day-to-day business, including sharing the information
provided by me with national and international regulatory authorities and further consent to Old Mutual Unit Trust transmitting information required to discharge
local or international regulatory obligations without further notice to me. I further authorise Old Mutual Unit Trust to accept instructions from me via facsimile.

D D M M C C Y Y
Date Signature of Investor

6. ACCEPTANCE OF ADVICE

I am solely responsible for my investment choices and their associated outcomes, and acknowledge that I have entered into this transaction without
A
obtaining financial advice as that is my preference. As a result no initial charge will be levied on any investment of R300 (the general unit trust
minimum) or more.

OR

I hereby confirm that, where applicable, the relevant intermediary (adviser or broker) has satisfied me that he/she is authorised to render financial
B
services in respect of this product.

Do you want to appoint this intermediary as your Preferred Servicing Intermediary (PSI) for all your future Old Mutual financial services needs?

YES
YES, I appoint and give the PSI access to information on all my existing Old Mutual financial services products.

NO NO, I will complete an Intermediary Appointment Note (IAN) selecting my Service intermediaries of preference per category of business.

4
 ADDITION & AMENDMENT FORM

7. INSTRUCTION FOR PAYMENT OF ADVISER FEES (If applicable)

AN INITIAL ADVISER FEE has been agreed as follows (subject to the maximums for each Unit Trust, stipulated on the Unit Trust fund fact sheet). The applicable
amount will be deducted prior to the purchase of units.

% N$
for equity/asset allocation Unit Trusts (max. 3.00%) which is

% N$
for fixed income Unit Trusts (max. 0.60%) which is (Note: If % and N$ amount differ, the % holds.)

ANNUAL ADVISER FEE

In addition, you may elect to pay an ongoing annual adviser fee. This fee is negotiated between yourself and your adviser or broker, and is over and above the
initial adviser fee stipulated above.

YES NO

%
If yes, specify percentage (max. 1.00% p.a.) of your discretionary Unit Trust portfolio. Note that this instruction
overrides all existing annual adviser fee agreements.

A UT
from Fund (one Unit Trust only) (Unit Trust account number)
OR
B
Proportionally across all my Unit Trusts.

This annual fee is calculated as a percentage of the value of your discretionary unit trust portfolio. The annual adviser fee is deducted monthly, through the sale
of units from the nominated unit trust/s. If this fee is being paid from a single unit trust and there is at any time an insufficient number of units in the unit trust,
the fee will automatically be deducted from your Money Market Fund, failing which, the largest unit trust in your portfolio. Where investments are held in more
than one class in the same unit trust, the fee will be deducted from the class open to new business (unless the closed unit trust class is stipulated above). You will
receive confirmation of the implementation of this fee, any adjustments made to the annual percentage or to the unit trust, as well as the cancellation thereof.
This fee is based on an agreement between the client and the intermediary. Old Mutual Unit Trust is not a party to the agreement and will cancel the fee on the
written instruction of either party. The fee will further be cancelled by a change in servicing intermediary. Old Mutual Unit Trust will change any erroneous
instructions received, but will not rectify prior payments based on erroneous instructions.

D D M M C C Y Y
Date Signature of Investor

8. DECLARATION OF ADVISER/BROKER

I, the undersigned, hereby declare and warrant that I am duly authorised to render financial services in respect of this product. All parties concerned have been
identified and verified and all relevant documentation has been obtained and appropriate procedures have been applied in accordance with the Financial
Intelligence Act, Act 13 of 2012.

Name of Introducer Branch Intermediary/Broker code Tel. no.

Introducer’s e-mail address Signature of Introducer

FOR OFFICE USE:

Name of Reviewer: Signature of Reviewer

Staff code:

SPECIAL INSTRUCTIONS

5
 ADDITION & AMENDMENT FORM

PLEASE NOTE

• Buying and selling requests

For requests to be processed on the same day as submitted, all requirements must be met by 15h00 (13h00 for the Old Mutual Nedbank Namibia Money
Market and Old Mutual Nedbank Namibia Corporate Funds). Such investments will be valued on the day after processing.
Direct Deposits/EFTs: Fax the application form to +27 (0) 21 509 7100 and then contact the Service Centre to obtain your account number. This account
number must appear on the electronic fund transfer or Standard Bank deposit slip. To obtain the same day’s value, fax confirmation of transfer or direct deposit
to +27 (0) 21 509 7100 before 15h00 (13h00 for Old Mutual Nedbank Namibia Money Market and Old Mutual Nedbank Namibia Corporate Funds).
• Monthly and lump sum debit orders
No debit order payments will be allowed on behalf of another person - except where parents/grandparents are investing on behalf of a minor, or where an
investment is made on behalf of a spouse. The amount/s you specify will be deducted from your bank account automatically by debit order (please note that
credit cards are not accepted). Old Mutual Unit Trust is under no obligation to accept debit orders below the stipulated minimums. Old Mutual Unit Trust
reserves the right to cease debiting your account under certain circumstances.
• Distributions
Historical income distributions are available on each fund fact sheet.
• Annual Adviser Fee
This annual fee is calculated as a percentage of the value of your entire unit trust portfolio. The fee is deducted monthly, through the sale of units from the
nominated fund/funds. If this fee is being paid from a single fund and there is at any time an insufficient number of units in the fund, the fee will automatically
be deducted from the largest fund in your Namibia portfolio.
You will receive confirmation of the implementation of this fee, any adjustments made to the annual percentage or to the fund, as well as the cancellation thereof.
This fee is based on an agreement between the client and the intermediary. Old Mutual Unit Trust is not a party to the agreement and will cancel the fee on
the written instruction of either party. The fee will further be cancelled by a change in servicing intermediary. Old Mutual Unit Trust will change any erroneous
instructions received, but will not rectify prior payments based on erroneous instructions.

STATUTORY INFORMATION
Unit trusts are generally medium to long term investments. Past performance is no indication of future growth. It is important that you are prepared for some
shorter term fluctuations as your investment moves in line with the markets. Fluctuations or movements in exchange rates may cause the value of underlying
international investments to go up or down. An initial charge (from 0,25% to maximum 5% of the investment amount) is included in the buying price of units.
This charge may include commission (up to 3% of the investment amount). An annual service fee (from 0,6% to 1,5%) is calculated on the market value of the
fund’s assets (excluding income and permissible deductions) and deducted from the portfolio on a monthly basis. Further fees that may be deducted from the
fund’s portfolio are compulsory and bank charges, brokerage, marketable securities tax, other taxes and levies, custodian and trustee fees and audit fees. A
schedule of fees and charges and maximum commissions is available from the company/intermediary. The daily price is based on the current value of the fund’s
assets plus income (minus expenses) divided by the number of units in issue. You can easily sell your investment at the ruling price of the day (calculated at 15h00
on a forward pricing basis). The Old Mutual Nedbank Namibia Money Market and Old Mutual Nedbank Namibia Corporate Funds unit prices are static and
interest is declared daily at 13h00. The Namibia Enhanced Income Fund and Namibia Dynamic Floor Fund may be capped in order to be managed in accord-
ance with their mandates.

CONTACT DETAILS

Old Mutual Unit Trust Management Company Namibia Limited Old Mutual Investment Administrators (Pty) Ltd
(Registration no. 94/288) (Registration no. 1988/003478/07)
PO Box 165, Windhoek, Namibia Mutualpark, Jan Smuts Drive, Pinelands 7405, South Africa
PO Box 5408, Cape Town 8000, South Africa
Telephone: 061 239 513/522 Telephone: +27 (0)21 503 1770
Facsimile: +27 (0) 21 509 7100 Fax: +27 (0)21 509 7100
Compliance Department: 061 299 8000 Compliance Department: +27 (0)21 503 1770
[Link]
Email: unittrusts@[Link]

Professional indemnity and fidelity insurance cover is in place.

6
 ADDITION & AMENDMENT FORM

INVESTOR DETAILS (continued)

SOURCE OF INCOME

Employer Name/Name of own business:

Occupation/Nature of own business:

Employer/Business Address:

2. HOW TO INVEST

Old Mutual Unit Trust is under no obligation to accept below minimum investments and reserves the right not to debit or to cease debiting your account
under certain circumstances. If no selection is made, distributions are automatically reinvested.

Lump sum investment

A N$ D D M M C C Y Y
Please debit my bank account with on the

B N$
I have transferred into Old Mutual Unit Trust’s bank account.
Bank details for the Old Mutual Unit Trusts Namibia’s bank account:

Bank Account Number Branch Branch Code Account type

Standard Bank 04 3195 636 Windhoek 08 23 72 Current

Fax your completed form to +27 (0)21 509 7100 and contact our Service Centre at (061) 239 513/522 to obtain your account number. Then use this
account number as the reference when making a direct deposit or EFT. Selecting the incorrect bank account or not including an account number as reference
may cause delays.

Recurring Monthly (debit order) Investments

PLEASE ALLOW AT LEAST 10 DAYS’ NOTICE
1 3 7 15 20 27 D D M M C C Y Y
Debit order dates (select one): Commencing month:

To help ensure my investment amount keeps pace with inflation, please increase my debit order investment amount every year on the anniversary date by:

N$
5* % or % or on all Unit Trusts or (specify Unit Trust)
* Delete if not applicable. If you don’t indicate your choice, the increased amount will be applied to all Unit Trusts in your portfolio that are affected by this application.

Select your Unit Trusts

Fund (lump sum/monthly minimums) Lump Sum Monthly Annual debit Distributions**
order increase* (to action)
(% or N$ value) Payout Reinvest

OM Nedbank Namibia Corporate Fund (N$25 000) N$ N/A N/A N/A

OM Nedbank Namibia Money Market Fund (N$5 000/N$500) N$ N$ N/A N/A
Namibia Income Fund (N$1 000/N$300) N$ N$
Namibia Enhanced Income Fund (N$1 000/N$300) N$ N$
Namibia Real Income Fund (N$1 000/N$300) N$ N$
Namibia Dynamic Floor Fund (N$1 000/N$300) N$ N$
Namibia Managed Fund (N$1 000/N$300) N$ N$
Namibia Growth Fund (N$1 000/N$300) N$ N$
TOTAL N$ N$