Online application form:

Individual Application:

Title: *

Date of Birth: *//

First Name: *

Surname: *

Address: *

Address Line 1

City

State / Province / Region

Postal Code

Country

Joint Application: Applicant 2 (Fill in above as applicant 1)

Title:

Date of Birth://

First Name:

Surname:

Address:

Address Line 1

City

State / Province / Region

Postal Code

Country

Company Application:

Company Name:

Name of Director(s):

Company Number:

Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Contact Details:

Email Address: *

Contact Tel/Mob Number: *

MINIMUM INVESTMENT

TOTAL $50,000 – Lower investments are subject to discretion

Investment Amount:

Please confirm your investment amount: *

*(Payment instructions are sent to yourself within a confirmation statement upon approval of a returned completed application form. Payments are to be made via bank transfer. Please remember that bank transfers must come from the account of the named Fund applicant.)

Customer Agreement: *

I confirm that I have read and understood the Prospectus document for the QPT Watch Fund, including the sections entitled ‘Risk Factors’ and ‘Terms & Conditions’.
I agree to the Privacy and Terms of Use statement.

You must agree to this statement.

Applicant Signature *

Date *//

Applicant Signature

(Corporate application First signatory/Joint application)

Date//

Applicant Signature

(Corporate application Second signatory)

Date//

Please only complete and return one relevant Investor Statement:

We are required to find out what type of investor you are, to check that you understand the nature of the investment you are considering and the risks involved. The investor types have been split into the four categories listed below. Please select one relevant investor type and return a completed Investor Statement and signed declaration with your application. We can only process your application if the relevant Investor Statement has been completed.

Restricted Investor
Sophisticated Investor
High-Net Worth Investor
Self-Certified Sophisticated Investor

Declaration: *

I accept that the investments to which the promotions will relate may expose me to a significant risk of losing all of the money or other property invested.
I am aware that it is open to me to seek advice from an authorised person who specialises in advising on non-readily realizable securities.
I agree to QPT WATCHES LTD keeping a record of these declarations and providing it if requested.

* You must agree to this statement.

Applicant Signature *

Date *//

Applicant Signature

(Corporate application First signatory/Joint application)

Date//

Applicant Signature

(Corporate application Second signatory)

Date//

Please ensure that you have completed and gathered all the relevant documents before sending us your application.

(Tick the boxes below to ensure that you have correctly filled in this application form.)

Individuals

Application Form
Copy of ID (driving licence or passport)
Proof of address*(bill or bank statement from the last three months)*

Company

Application Form
Copy of ID for each Director
Certificate of Incorporation
Copy of ID (driving licence or passport)
Proof of address*(bill or bank statement from the last three months)*

Number of files you want to upload *

File upload (max. 5gb): *

**Copy of ID (driving licence or passport), Proof of address / Copy of ID for each Director, Certificate of Incorporation

Privacy and Terms of Use:

In the case of trust or company I/we are in a domicile in which the trust or company is not prevented by the laws of its governing jurisdiction or place of incorporation from applying for or holding the holdings in QPTwatchfund02. 2. I will comply with requests made by QPT Watches Ltd (the ‘Company’) to verify our identity in accordance with the Money Laundering Regulations 2007 (as amended). 3. I consent to the Company communicating with, and sending or supplying documents or information to us in electronic form or by mail to the address given in Step 1. 4. In the event that my application to subscribe to QPTwatchfund02 is not successful, I consent to the Company communicating with, and sending or supplying documents or information to me in electronic form or by mail to the address given in Step 1. 5. In making this Application, I confirm that the Application for the issue of holdings in QPTwatchfund02 (if any) issued are subject to the Terms and Conditions contained in this Application Form, the Information Memorandum and the Terms & Conditions document. In making this Application for holdings in QPTwatchfund02, I confirm that any decision to accept the Application (in whole or in part) is at the sole discretion of the company.

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