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Application Form
This Application Form (including the Direct Debit Request and the Adviser Electronic Transaction Authority Form) accompanies and forms part of the Product Disclosure Statement (PDS) issued by KeyInvest Ltd ABN 74 087 649 474 AFSL 240667 (KeyInvest) ('we', 'us', 'our' in this Application Form) for the Funeral Bond dated 11th November 2022.
The PDS (and any Supplementary PDS issued) contain important information about the Funeral Bond which you should consider before making an application.
The PDS is available via our website at keyinvest.com.au or you may request a copy from your financial adviser or funeral director.
An application to invest in the KeyInvest Funeral Bond can only be made using this form. Completed Application Forms can be posted to KeyInvest, Reply Paid 3340,
RUNDLE MALL SA 5000 (no stamp required) or emailed to: info@keyinvest.com.au Please use CAPITAL letters to complete the Application form
1. Investor details
Investor
(All correspondence will be sent to this person)
Title
Mr
Mrs
Miss
Other
Surname
Given name
Date Of Birth
Gender
Male
Female
Other
Residential Address
(must not be a PO Box, RMB or Locked Bag)
Unit Number
Street No.
Street Name
Suburb
State
NSW
ACT
NT
QLD
SA
TAS
VIS
WA
Postcode
Country
Mailing Address
(if different to above address)
Unit Number
Street No.
Street Name
Suburb
State
NSW
ACT
NT
QLD
SA
TAS
VIS
WA
Postcode
Country
Contact Details
Daytime Telephone
Mobile
Email Address
If the application is being completed under a Power of Attorney (POA), please include the attorney’s contact details under the Mailing Address and Contact Details sections
2. Contribution Details
Initial Contribution
Contribution Amount
$
Please select how the initial contribution will be paid.
EFT
Banking details will be provided on a seperate invoice
3. Service fee payment instruction
Initial Service Fee
Where agreement has been reached to pay a financial adviser or service provider a one-off service fee, please insert the fee as either a fixed dollar amount or percentage of the initial contribution
Fixed Dollar Amount
$
please note service fees will be deducted from the Initial Contribution amount with the lower net amount invested. The lower net amount is the amount assessed under the Exempt Funeral Bond Threshold.
4. Application
Before signing this Application Form, investors should read the PDS to which this application is attached. This Application Form must not be distributed unless attached to the PDS. Investors aged between 10 and 16 years of age require the written consent of a parent or guardian.
Declaration:
I/We agree and acknowledge:
— I/We have read and understood this Application Form and the PDS attached and to which this Application Form relates;
— To be bound by the terms and conditions of the PDS, this Application Form and the Constitution of KeyInvest (as amended from time to time);
— I/We have not relied on statements or representations made by any person, other than those made in the PDS to which this Application Form relates;
— The information I/We have provided in this Application Form is true and correct;
— The KeyInvest Funeral Bond does not mature until my/our death and that no withdrawals under the KeyInvest Funeral Bond are possible (other than where the KeyInvest Funeral Bond is ‘cooled-off’ in accordance with the terms of this PDS);
— The amount of my/our contributions to the KeyInvest Funeral Bond do not exceed my/ our anticipated total amount of funeral expenses;
— Except for in respect of the repayment of capital of the ‘Capital Guaranteed Fund’, KeyInvest does not guarantee the performance of any other ‘Investment Option’ of the KeyInvest Funeral Bond;
— In the event KeyInvest is wound up and unable to meet its liabilities, I/We will contribute to the sum of $1.00 only, towards the meeting of KeyInvest’s liabilities;
— I/We shall be responsible for any Stamp Duty payable on the issue of my/our KeyInvest Funeral Bond or any subsequent assignment of my/our KeyInvest Funeral Bond to a funeral director in consideration of a pre-arranged funeral contract;
— My/Our financial adviser (where applicable), may process an application under the KeyInvest Funeral Bond using KeyInvest’s online application portal and agree to this electronic form of application unless specifically requested not to;
— That my/our personal information will be collected, used and disclosed by KeyInvest in accordance with its Privacy Policy which can be accessed at
keyinvest.com.au/privacy-policy/
and otherwise in accordance with the law
If you do not wish to receive newsletters or information in relation to our other products and services, please mark this box
If you do not wish to receive newsletters or information about goods or services from other suppliers which KeyInvest reasonably consider may be of interest to you, please mark this box.
5. Nominate a funeral director to perform the funeral
This section should only be completed and signed if the Funeral Bond is being ‘NOMINATED’ and by the investor(s) only.
The funeral director’s signature is not required. I/We in accordance with the Constitution of KeyInvest and as outlined in the Product Disclosure Statement, wish to nominate this Funeral Bond to:
Nominated to:
Name of Funeral Director
Phone
Signature of Investor
Clear Signature
Date
Submit
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