Get PH PhilEquity Investment Application Form

INVESTMENT APPLICATION FORM DATE mm/dd/yyyy 2004-A East Tower Philippine Stock Exchange Centre Exchange Rd. Investment Application Form and validated deposit slip copy of check issued should be i. Submitted directly to PhilEquity Management Inc. 2004-A East Tower Philippine Stock Exchange Centre Exchange Rd. Pasig City Philippines 1605 632 689 8080 632 706 0795 sales philequity. net www. philequity. net IAF NO. INSTRUCTIONS Please type all information in CAPITAL LETTERS* Fill-out this form completely. Write N/A on fields that are not applicable and do not leave any blank spaces. TRANSACTION DETAILS Account Name Fund Name Investment Type Amount Amount in Words Initial Additional Reinvestment from Currency Peso Dollar PAYMENT DETAILS / OPTIONS Mode of Payment Check No* Reference No* Check Telegraphic Transfer Direct Deposit Bills Payment s Post Dated Check Others IF CHECK PAYMENT Checks should be payable to Fund Name For investment of Investors Account Name Bank/Branch Date IF DIRECT DEPOSIT / BILLS PAYMENT DETAILS Subject to receipt of good funds DECLARATION I/We hereby declare that all information disclosed is correct complete and truly stated* I/We hereby declare that I/We am/are authorized to make this investment and that the amount invested in the Fund/s is through legitimate sources only. I/We am/are fully aware that only upon submission of complete information and documentary requirements will the transaction be processed* I/We have understood and have relied solely upon the General Terms and Conditions and the Fund s Prospectus. RIFIE V RE E Authorized Signatory Signature over Printed Name TU NA IG DS IMPORTANT REMINDERS As proof of your investment a Confirmation Notice will be sent to you not later than 7 banking days with the number of shares purchased and the Net Asset Value Per Share NAVPS booked* Documents and transactions received before the 12 noon cut-off will be processed within the same business day using the NAVPS for the day. Anything received past cut-off shall be processed the next business day applying the corresponding NAVPS for that day. Pasig City ii. If enrolled to Facsimile and Electronic Mail Instructions Fax to 632 706 0795 or email to sales philequity. net. The document will be processed based on the time when the faxed / email document was received by PEMI. DISTRIBUTOR / AGENT ACKNOWLEDGEMENT Date Received Received by Distributor / Branch PHILEQUITY USE ONLY Value Date Processor Date Processed Copy Distribution Sales Load Rate Authorizer Date Authorized Original - Philequity 2nd copy blue - Transfer Agent 3rd copy yellow - Investor / Client PEMI Website. Pasig City Philippines 1605 632 689 8080 632 706 0795 sales philequity. net www. philequity. net IAF NO. INSTRUCTIONS Please type all information in CAPITAL LETTERS* Fill-out this form completely. Write N/A on fields that are not applicable and do not leave any blank spaces. INSTRUCTIONS Please type all information in CAPITAL LETTERS* Fill-out this form completely. Write N/A on fields that are not applicable and do not leave any blank spaces. TRANSACTION DETAILS Account Name Fund Name Investment Type Amount Amount in Words Initial Additional Reinvestment from Currency Peso Dollar PAYMENT DETAILS / OPTIONS Mode of Payment Check No* Reference No* Check Telegraphic Transfer Direct Deposit Bills Payment s Post Dated Check Others IF CHECK PAYMENT Checks should be payable to Fund Name For investment of Investors Account Name Bank/Branch Date IF DIRECT DEPOSIT / BILLS PAYMENT DETAILS Subject to receipt of good funds DECLARATION I/We hereby declare that all information disclosed is correct complete and truly stated* I/We hereby declare that I/We am/are authorized to make this investment and that the amount invested in the Fund/s is through legitimate sources only. .