DEposit pLAN AppLiCAtioN FoRM.

LEGAL & GENERAL 6 Year Growth Deposit Bond 19
DEPOSIT PLAN APPLICATION FORM.
Applications must be received by 26 April 2013.
FOR OFFICE USE
Client Number
Launch Fund
23L
FOR ADVISER USE
L&G Agent Number
Adviser Name
FSA Number
Adviser Company and Address
5326921
If you would like to sacrifice commission, please confirm how much
%
NOTES FOR ADVISERS – VERIFICATION OF IDENTITY
he verification of identity declaration can only be used if you have fully verified the customer(s). You cannot use the declaration if the
T
customer falls into one of the following categories:
• Those who are exempt from verification as being an existing client of the introducing firm prior to the introduction of the requirement
for such verification;
• Those who have been subject to Simplified Due Diligence under Money Laundering Regulations; or
• Those whose identity has been verified using the source of funds as evidence.
For verification of third party donors, please use the Confirmation of Verification of Identity certificate on our Adviser Centre.
Before signing this application form, please ensure you have copies of the Terms and Conditions and the Key Features document.
Please read this document as soon as possible as it explains your Bond in detail. The Terms and Conditions form the basis of our
agreement with you.
1a
PERSONAL DETAILS – PLEASE COMPLETE IN BLOCK CAPITALS
Title
Mr
Mrs
Miss
Surname
Ms
Other
Male
Female
Full forename(s)
/
Date of birth (DD/MM/YYYY)
/
Do you have a National
Insurance number?
Do you have an existing
Legal & General account?
Yes
No
If Yes, please enter it here
Yes
No
If Yes, please enter client number
Please tick if applicable
Legal & General employee
Legal & General shareholder
Relative of Legal & General
employee/shareholder*
*If you have ticked this box, please write the name of the Legal & General employee/shareholder below.
Email address
Daytime
phone number
continues
1a
PERSONAL DETAILS CONTINUED
Permanent residential
address
Postcode
If you have lived at this address for less than three months, please provide your previous address details here.
Previous address
Postcode
1b
JOINT INVESTMENT
Investments can be held in joint names. If you wish to hold an investment with another person please
complete their details here.
Title
Mr
Mrs
Miss
Ms
Surname
Male
Female
Full forename(s)
Date of Birth
(DD/MM/YYYY)
Do you have a National
Insurance number?
Permanent residential
address
Other
/
Yes
/
No
If Yes, please enter it here
Postcode
Email address
Daytime
phone number
If you have lived at this address for less than three months, please provide your previous address details here.
Previous address
Postcode
All correspondence will be sent to the address given in SECTION 1A.
1c
ADD A PERSONAL REFERENCE
Please complete if you wish to add a personal reference to your investment.
Account holding
designation
2
BANK/BUILDING SOCIETY DETAILS – PLEASE COMPLETE THIS SECTION
Please provide details of your bank/building society account in order that we can make any payments, either
on your request or at the payment date as stated in the Terms and Conditions at the end of the fixed term.
Name of bank/
building society
Address
Postcode
Name of account holder
Sort code
Account number
Roll number (if applicable)
3
YOUR INVESTMENT
I wish to open an account for
£
(Minimum £500, no maximum) in the Legal & General 6 Year Growth Deposit Bond 19.
Legal & General 6 Year Growth Deposit Bond 19
Page 2
4
PAYING FOR YOUR INVESTMENT
You can pay for your investment by cheque. Please make your cheque for the total amount payable to Legal & General. Cheques should
be drawn on your personal account. For banker’s drafts/building society cheques, please ask the bank/building society to print your
name as the account holder. Please remember to attach your cheque to this application.
5
DECLARATION
I declare that:
• I am 18 years of age or over.
• I am not a US person.
• the information given in this declaration is true and correct to the best of my knowledge and belief and I will inform Legal & General
without delay of any change to my circumstances affecting any information in this form.
I authorise Legal & General:
• to hold my cash subscription, direct investments, interest and any other rights or proceeds in respect of those investments and any
other cash.
I declare that Legal & General (Portfolio Management Services Limited) shall act as Bare Trustee for the cash investments which will
be placed in deposit with the Deposit Taker.
IMPORTANT, PLEASE READ: Data Protection
Use of your information:
Legal & General takes your privacy very seriously. We use the personal information collected via this form and any other information
that you provide to us (‘your information’) for the purposes of:
1. providing you with our products and services and dealing with your enquiries and requests,
2. administering your investment,
3. carrying out market research, statistical analysis and customer profiling, and
4. sending you marketing information (by post, telephone, email and SMS) about products and services of companies in the
Legal & General group and of third parties whose products and services we offer to our customers.
By signing overleaf, you agree to receive the information as described in 4 above, unless you tell us otherwise by ticking this box
Given the global nature of our business, we may need to transfer your information to countries outside the European Economic Area
in order to provide our services to you.
Disclosures:
We will disclose your information to other companies within the Legal & General group of companies, regulatory bodies, law
enforcement agencies, future owners of our business and suppliers we engage to process data on our behalf. If you have been
dealing with a financial adviser, we will give them information about your product and, where appropriate, provide them with other
information about your dealings with us to enable them to give you informed advice.
Where you have been introduced to us by a bank or a building society, we will share your information with them to enable them to:
(a) carry out market research, statistical analysis and customer profiling, and
(b) send you marketing information about their products and services and products and services of companies in the Legal & General
group and of third parties whose products and services we offer to our customers.
By signing overleaf, you agree to receive the information as described in (b) above by post or telephone, unless you tell us otherwise
by writing to Legal & General Investments, PO Box 6080, Wolverhampton WV1 9RB.
continues
Legal & General 6 Year Growth Deposit Bond 19
Page 3
5
DECLARATION CONTINUED
Access:
You have the right to ask for a copy of your information in return for payment of a small fee (currently £10.00). To obtain a copy of
your information, please write to us at the address overleaf.
I agree to the use of my information as set out in this declaration.
I understand that a copy of the Terms and Conditions and completed application form is available on request.
I have read the declaration and received the Legal & General 6 Year Growth Deposit Bond 19 Key Features and Terms and Conditions.
I agree that the Terms and Conditions form the basis of my agreement with Legal & General.
PLEASE SIGN AND DATE BELOW
First Applicant
Signature
Date (DD/MM/YYYY)
Second Applicant
Signature
/
/
/
Date (DD/MM/YYYY)
/
In the case of a joint application, all applicants must sign.
All applicants must be at least 18 years of age.
Please send to your financial adviser or to:
Legal & General Investments,
PO Box 6080,
Wolverhampton WV1 9RB.
FOR ADVISER USE ONLY – VERIFICATION OF IDENTITY
This is not applicable to Legal & General appointed representatives or employees.
I confirm the personal details listed in Section 1 were obtained by me. I have seen evidence to verify the identity of all applicants that
meets or exceeds the standards set out within JMLSG guidance. Details of any evidence exceeding the guidance are attached.
Name
Job title
Signature
Date (DD/MM/YYYY)
/
/
www.legalandgeneral.com
Legal & General (Portfolio Management Services) Limited
Registered in England No. 2457525
Registered office: One Coleman Street, London EC2R 5AA
Authorised and regulated by the Financial Services Authority.
Q32930 print date: 02/13 approval number: NON ASD
expiry date: 26/04/13
*LGCAA390*
LGCAA390