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Compulsory fields I have read and understand the STANLIB Complaints Policy. 1. Please indicate by ticking the appropriate box the type of complaint The complaint must relate specifically to a financial service advice and or intermediary service rendered by STANLIB or any of its representatives. Client Complaint Form Please note the fais complaints regulations become active as at 30 September 2004 To STANLIB Wealth Management Limited / STANLIB Multi-Manager Limited / STANLIB Collective Investments / STANLIB Asset Management Limited The Head of Query Support P O Box 202 Melrose Arch 086 727 7501 for Unit Trust Accounts FAX TO From for Policies and Investment Plans Details of complainant. The complainant is a specific client who submits a specific complaint* Name ID number Postal address Telephone number Facsimile number Email if available Client account number / Investment reference number this detail must be filled in if you are unsure please call the STANLIB contact centre on 0860 123 003. 1. 1 STANLIB or its representative has contravened or failed to comply with any provision of the Financial Advisory Intermediary Service Act 2002 and that as a result thereof the complainant has suffered or is likely to suffer financial prejudice or damage has caused prejudice or damage to the complainant or which is likely to result in such prejudice or damage 2. Summary of complaint Please provide all relevant information* 3. Please attach copies of all relevant documentation No of pages attached 4. Other relevant information Signature of complainant Client Date Query Support reference number will be system generated on receipt of form*. This will then be used on all correspondence concerning this matter. Issued June 2010 17 Melrose Boulevard Melrose Arch 2176 www. 1. 1 STANLIB or its representative has contravened or failed to comply with any provision of the Financial Advisory Intermediary Service Act 2002 and that as a result thereof the complainant has suffered or is likely to suffer financial prejudice or damage has caused prejudice or damage to the complainant or which is likely to result in such prejudice or damage 2. Summary of complaint Please provide all relevant information* 3. Please attach copies of all relevant documentation No of pages attached 4. Summary of complaint Please provide all relevant information* 3. Please attach copies of all relevant documentation No of pages attached 4. Other relevant information Signature of complainant Client Date Query Support reference number will be system generated on receipt of form*. Other relevant information Signature of complainant Client Date Query Support reference number will be system generated on receipt of form*. This will then be used on all correspondence concerning this matter. Issued June 2010 17 Melrose Boulevard Melrose Arch 2176 www. 1. 1 STANLIB or its representative has contravened or failed to comply with any provision of the Financial Advisory Intermediary Service Act 2002 and that as a result thereof the complainant has suffered or is likely to suffer financial prejudice or damage has caused prejudice or damage to the complainant or which is likely to result in such prejudice or damage 2. Summary of complaint Please provide all relevant information* 3. Please attach copies of all relevant documentation No of pages attached 4. Other relevant information Signature of complainant Client Date Query Support reference number will be system generated on receipt of form*.

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