Self-Certification Sophisticated Individual.

SELF-CERTIFIED SOPHISTICATED INDIVIDUAL STATEMENT

If you meet conditions A, B or C below, you may choose to be classified as a self-certified sophisticated investor for the purposes of the Financial Services and Markets Act 2000 (Financial Promotions) Order 2005.

Have you:

Worked in a professional capacity in the private equity sector or in the provision of finance for small and medium enterprises in the last two years?

Yes No

B)If yes, what is/was the name of the business/organisation?

Been the director of a company with an annual turnover of at least £1.6 million in the last two years?

Yes No

If yes, what is/was the name of the company, and its Companies House number (or international equivalent)?

Been a member of a network or syndicate of business angels for more than six months, and are still a member?

Yes No

If yes, what is the name of the network or syndicate?

Or

None of these apply to me.

Yes

I declare that I have answered yes to A and/or B and/or C and wish to be treated as a self-certified sophisticated investor.

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.

Full Legal Name

Telephone Number

Date

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