Investor Self-Certification

HIGH NET WORTH INDIVIDUAL INVESTOR STATEMENT

If you meet condition A or B below, you may choose to be classified as a high net worth individual for the purposes of the Financial Services and Markets Act 2000 (Financial Promotion) Order 2005.

In the last financial year, did you have:

A) An annual income of £170,000 or more? Income does NOT include any one-off pension withdrawals.*

No
Yes

If yes, please specify your income (as defined above) to the nearest £10,000 in the last financial year

£

AND/OR

B) Net assets of £430,000 or more? Net assets do NOT include: your home (primary residence), any loan secured on it or any equity released from it; your pension (or any pension withdrawals) or any rights under insurance contracts. Net assets are total assets minus any debts you owe.*

No
Yes

If yes, please specify your net assets (as defined above) to the nearest £100,000 in the last financial year

£

AND/OR

C) None of these apply to me.

Yes

I declare that I have answered yes to A and/or B and wish to be treated as a high net worth individual.

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); and
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.

SELF-CERTIFIED SOPHISTICATED INVESTOR STATEMENT

If you meet condition A, B or C below, you may choose to be classified as a self-certified sophisticated

Have you:

A) 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?*

No
Yes

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

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

No
Yes

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

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

No
Yes

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

OR

D) 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); and
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.

Investor Self-Certification

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HIGH NET WORTH INDIVIDUAL INVESTOR STATEMENT

SELF-CERTIFIED SOPHISTICATED INVESTOR STATEMENT

Godwin Group