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APPLICATION FORM FOR INVESTMENT MANAGEMENT SERVICES FOR UNREGISTERED GROUPS

This form should be completed with the assistance of your investment adviser. NOTE: Please complete in BLOCK LETTERS Tick applicable block(s)

Step 1 of 4

25%

PART A: INVESTMENT MANDATE

This refers to the classes of investment assets dealt with by Bridgepath Capital Limited. Please indicate the Service(s) in which you wish to invest as discussed between you and your investment adviser. The principal investment objectives, particularly any specific exclusions or requirements, should be clearly detailed below. As the account will be managed to the client’s specific requirements, it is possible that the portfolio construction will be different to Bridgepath Capital’s investment portfolios
Asset Class
I/we confirm that I/we have received professional advice from a qualified investment adviser and agreed the following investment profile (please tick the relevant boxes):
Primary Investment Objective:
Investment Horizon:

ATTITUDE TO RISK

When investing capital, my/our primary goal is:
Low Risk (Defensive)
Low to Moderate Risk (Cautious)
Moderate Risk (Balanced)
Moderate to High Risk (Growth)
High Risk
Payment of Income

Base Currency and Reporting Currency

Kindly note that the funds will be managed in Malawi Kwacha and funds received in other denominations will be converted to Malawi Kwacha equivalent using prevailing market rates.

PART B: GROUP DETAILS

PART C: GROUP MEMBERS (use separate sheet if necessary)

PART C: GROUP MEMBERS (use separate sheet if necessary)
FULL NAME
RESIDENTIAL ADDRESS
ID TYPE AND ID NO
 

PART D: AUTHORISED PERSONS

Max. file size: 1 GB.
Max. file size: 1 GB.
Max. file size: 1 GB.

First Authorised Personnel

MM slash DD slash YYYY
Max. file size: 1 GB.

Second Authorised Personnel

MM slash DD slash YYYY
Max. file size: 1 GB.

Third Authorised Personnel

MM slash DD slash YYYY
Max. file size: 1 GB.

PART E: POTENTIALLY EXPOSED PERSON AND POTENTIALLY AFFILIATED PERSON

We undertake to indemnify and hold harmless Bridgepath Capital Limited (and its directors, officers, affiliates, agents, successors and assigns) from and against any and all losses, liabilities, deficiencies, costs, damages and expenses (including, without limitation, reasonable attorney’s fees, charges and disbursements) incurred by Bridgepath Capital Limited as a result of any inaccuracy in or breach of the representations, warranties or covenants in this form
Is a member of group, or any party connected to a member of the group, a Potentially Exposed Person or Potentially Affiliated Person (PEP)?

PART F: BENEFICIAL OWNERS* (If applicable)

Name

PART G: ACCOUNT DETAILS

Please provide details of the bank from which the funds are being sent.

PART C: FEES AND CHARGES

Fees will be communicated and agreed seperately between the counterparties) Note: No fees will be charged on nominee client fund(s) invested on the money market.

SETTLEMENT BANK DETAILS (IF DIFFERENT FROM BANK ACCOUNT DETAILS ABOVE)

Please provide bank details through which we will be making payments to you.

PART I: ADMINISTRATION DETAILS

Please advise us whose instruction we are authorized to act upon for this account. Kindly select one option from the following list:
Signing Arrangement

PART J: THE INVESTMENT ADVISER

i About the adviser (to be completed by the adviser)

Name

ADVISER DECLARATION

I/we confirm that I/we have conducted a comprehensive analysis of the Investor’s financial circumstances, financial product experience, investment and financial objectives and have advised and agreed with the Investor(s) the suitability of the Mandate specified in Part A of this Agreement.
Max. file size: 1 GB.
Please Attach Signature
MM slash DD slash YYYY

FOR: THE INVESTOR

Applicant(s) must read this Agreement in its entirety, complete Parts B-E in full, provide signatures and ensure that all appropriate additional documentation is attached. NB Applications signed under a Power of Attorney may not be accepted. Please refer to the Investment Manager.

THE INVESTMENT MANAGER

We hereby accept our appointment as Investment Manager of the Investments under the terms of this Agreement.
MM slash DD slash YYYY
NAME
Max. file size: 1 GB.
Please Attach signature here

FOR: BRIDGEPATH CAPITAL LIMITED

KYC CHECKLIST Please provide the following documents:
Documents
Drop files here or
Max. file size: 1 GB.

    IMPORTANT INFORMATION

    Direct deposits and electronic transfers can be made to the following bank account: Bank: Standard Bank Branch: Blantyre Account Type: Current Sort Code: 101002 Account Name: Bridgepath Capital - Nominees Account Number: 9100003191157 * Please make sure to send proof of payment after the transaction has been done.
    This field is for validation purposes and should be left unchanged.

    About Us

    Bridgepath Capital is a company that provides Investment Management and Financial Advisory services to individual and institutional investors.

    Contact Us

    • info@bridgepathcapitalmw.com
    • +265 (0) 111 828 355
    • www.bridgepathcapitalmw.com

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    EVENTS

    We are a licenced portfolio/investment manager under the Financial Services Act 2010 with licence no PM001/20. We are regulated by the Registrar of Financial Institutions (Reserve Bank of Malawi)

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