ARIE Tech EIS Fund 3

Application Form

To apply, please take the time to fill out the information below.

All terms and conditions of the Offer set out in the Information Memorandum (available here) are incorporated into this Application Form and terms defined in the Memorandum shall have the same meaning in this Application Form.

Paying your Subscription

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Please pay by bank transfer if possible. Use the details below to make payment:

Bank Name: Lloyds Bank, Godalming

Sort Code: 30-93-49

Account Number: 39603068

Account Name: Roffe Swayne re Client Prosper (Arie)

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To pay by cheque: please make your cheque payable to “Roffe Swayne re client ARIE Tech EIS fund” and enclose with your application.

NOTES:

1. This Application Form and payment must arrive no later than 1pm on the Closing Date (26th March 2021), or such later date as Prosper may at its sole discretion decide to close the Offer. 

2. The Fund reserves the right to reject an Application Form if it has reasonable cause to do so, for example, if relevant information is not included.

3. Due to anti-money laundering regulations, you will need to provide two different forms of identification, one to prove your identity (passport or driving licence) and one to confirm where you live (utility bill or bank statement less than three months old). Copies must be certified.

4. If you are a lawyer or an accountant or other professional person who is subject to professional rules preventing you from making investments in particular EIS-qualifying companies, please advise the Fund.

NB: We can only accept cheques drawn on an account in your own name. Third party cheques cannot be accepted. 

SUITABILITY QUESTIONNAIRE

1. INTRODUCTION

1.1.        In order for us to accept your application, we will need to undertake an assessment to determine whether this product is appropriate for you. In order for us to do this we need to consider:

• Your knowledge and experience of investing in similar investments;

• Your financial situation so that we can assess whether you are able financially to bear the risk of your investment in the Fund; and

• Your investment objectives so that we can assess whether the Fund meets these objectives.

1.2.       In addition, we want to satisfy ourselves that you understand the Fund and the risks associated with it. We would therefore appreciate it if you could answer the following questions. If you do not answer these additional questions we will not be able to determine whether your investment in the Fund is appropriate for you which may result in your application being rejected. You must ensure that any information which you give us about your circumstances must be true and not misleading in any material respect and you must notify the Fund immediately if there is any material change in the information which you have provided.

2. KNOWLEDGE AND EXPERIENCE

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2.1. During the last 5 years, in which of the following investments have you invested?

TYPE OF INVESTMENT

If yes, please state the average numbers and volumes per annum

2.2 KNOWLEDGE

Is investing in shares similar to depositing money with a bank?

When can I withdraw my investment?

What is the nature of the investment and how is it managed?

What is the nature of EIS relief?

3. FINANCIAL SITUATION

4. INVESTMENT OBJECTIVES

5. DECLARATION

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I, the Investor, confirm that:

1. I have truthfully answered this questionnaire;

2. I wish to seek EIS relief for my investment in the Fund;

3. I am applying on my own behalf;

4. I will notify the Fund if I am connected to any company in the Fund within the meaning of sections 166-7, 170-1 of the Income Tax Act 2007;

5. I will notify the Fund if, within the period of three years from the date of issue of my Shares, I become connected with any company in the Fund;

6. I have read the ARIE Technology EIS Fund 3 Information Memorandum and understood the section headed Risk Factors;

7. I acknowledge that neither the Fund nor Prosper Capital are providing investment, legal, financial, tax or other advice and that any tax information provided is only a generic summary of EIS;

8. I am a person to whom the Memorandum may lawfully be distributed without contravention of the Financial Services and Markets Act 2000;

9. I agree to be bound by the terms of the Investment Management Agreement (a copy of the agreement is available here);

10. I have advised the Fund if I am a solicitor or accountant or other professional person who is subject to professional rules preventing me from making investments, in particular in the Fund;

11. I have supplied the correct anti-money laundering documents as requested in this Application Form;

12. I recognise that the Fund is a speculative venture and has no history of operations or earnings;

13. I recognise that there is no established market for shares in the Fund, that it is not expected that there will be such a market at any time and that I may have difficulty in selling my shares or in obtaining reliable information about their value;

14. I have the financial ability to bear the economic risk of my investment, have adequate means for providing for any current needs and possible contingencies and no need for liquidity of my investment in the Fund;

15. I have provided the Fund with a valid sophisticated investor certificate, self-certified sophisticated investor certificate, certificate of high net worth or such other proof that I am an Applicable Investor as the Fund may require.

Please upload the following TWO documents:

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* Copy of the picture page of you passport (including name and other details)

* Copy of a proof of address (for example, a driver's license or utility bill not more than three months old)

Passport

Proof of Address

Should you encounter any issues or have any further questions, please contact Martin Taylor at martin@arietech.co.uk.