Vitabeam Limited

EIS Investment Application Form

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

Paying your Subscription

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


Bank name: Barclays Bank

Account name: Vitabeam Limited

Account No: 63485021

Sort Code: 20-42-73

To pay by cheque: please make your cheque payable to Vitabeam Limited and enclose with your application.



  1. This Application Form and payment must arrive no later than 1pm on the Closing Date (3rd April 2022), or such later date as Vitabeam Limited may at its sole discretion decide to close the Offer. 

  2. Vitabeam Limited 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 Vitabeam Limited.


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





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 Vitabeam Limited; and

  • Your investment objectives so that we can assess whether Vitabeam Limited meets these objectives.


1.2.       In addition, we want to satisfy ourselves that you understand Vitabeam Limited 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 Vitabeam Limited 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 Vitabeam Limited immediately if there is any material change in the information which you have provided.




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


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

Shares listed on a recognised stock exchange
Shares not listed on a recognised stock exchange
Shares in a startup fund or venture capital opportunities
Shares under management in an EIS-managed portfolio
Unit Trust / Investment Companies
Stock and shares component of an Individual Savings Plan (ISA) / Personal Equity Plan (PEP)
An index tracker
A product where the return is dependent upon another financial instrument
Are you employed in the financial services industry?
Are you an FCA-approved person?


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

My investment is used to purchase unlisted shares in new startup companies and there is a risk that they will not make a profit and may even fail. This is not like depositing money in a bank account as the return of my money is not guaranteed.
Having been approved by HMRC means that the company is lower risk than other startup companies.
Investments in unlisted companies are not covered by the Financial Services Compensation Scheme and I may not get all my capital back if Vitabeam Limited fails.

When can I withdraw my investment?

I can sell my shares at any point on the market and get my money back.
Shares in Vitabeam Limited are not listed on any market. It may be possible to sell my shares, but this isn’t guaranteed.
There may not be a market for the shares at the end of the anticipated term end and I may need to hold my investment for longer than planned.

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

I will be able to pick and choose which company to invest in.

What is the nature of EIS relief?

Once a company has been granted EIS status this cannot be taken away.
Tax relief will only be granted on amounts invested in EIS qualifying companies
If I sell my shares before the end of three years I will lose my entitlement to EIS tax relief.


What is your current annual income?
What is your net worth?
Of your net worth, what percentage is held in liquid assets?


Over what period are you willing to remain invested?
Do you understand that the nature of this investment is higher risk?
How do you view the purpose of this investment?


I, the Investor, confirm that:


  1. I have truthfully answered this questionnaire;

  2. I wish to seek EIS relief for my investment in Vitabeam Limited;

  3. I am applying on my own behalf;

  4. I acknowledge that Vitabeam Limited is not providing investment, legal, financial, tax or other advice and that any tax information provided is only a generic summary of EIS;

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

  6. I agree to be bound by the terms of the Investor Agreement;

  7. I have advised Vitabeam Limited 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 Vitabeam Limited;

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

  9. I recognise that Vitabeam Limited is a speculative venture;

  10. I recognise that there is no established market for shares in Vitabeam Limited, 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;

  11. 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 Vitabeam Limited;

  12. I have provided Vitabeam Limited 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 Vitabeam Limited may require.

Please upload the following TWO documents:

* 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)


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Proof of Address

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Should you encounter any issues or have any further questions, please contact Martin Taylor at