Subscription Checklist:

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S E L L A R D E V E L O P M E N T F U N D M A N S A R D C A P I T A L / S E L L A R D E V E L O P M E N T S

Prospective applicants for Shares should inform themselves as to the legal requirements for acquiring, holding or disposing of Shares in the Sellar Development Fund (the “Sub-Fund”) within their countries of their nationality, residence, ordinary or permanent residence or domicile, and any applicable exchange control requirements and taxes in the countries of their nationality, residence, ordinary or permanent residence or domicile.

This document contains all the information required to invest in the Sellar Development Fund, a sub-fund of Mansard Capital SICAV Plc.

 Step 1: Complete the enclosed Subscription Agreement. PLEASE PRINT CLEARLY IN BLOCK CAPITALS THROUGHOUT. Then sign and date at the end of Section 5 and Section 8 (obligatory).

 Step 2: Obtain the documents required for Anti-Money Laundering and Client Verification purposes (Section 7), to be submitted with the Subscription Agreement (obligatory).

 Step 3: Send completed forms and the requested additional documents (Step 1 & 2) to the details below.

Completed subscription agreements may also be sent by email or fax with the originals to follow by post immediately thereafter. Subsequent subscriptions may be made in writing, email or by fax using the Additional Subscription Form available from the details below:

Email: Trades: [email protected]

Email: Queries: [email protected] Phone: +44 1624 630400

Fax: +44 1624 630401

All original documents should be forwarded to:

The Directors of Mansard Capital SICAV plc.

C/O Apex Fund Services (IOM) Ltd.

2^nd Floor Exchange House 54-58 Athol Street Douglas

Isle of Man IM1 1JD

Failure to provide the original subscription agreement along with the documentation required for Anti-Money Laundering purposes may result in a delay in the acceptance of the Subscriptionand/orpayment of a future transfer/redemption request.

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Please pay subscription monies to the following account(s)

GBP CHF

Bank Royal Bank of Scotland International Limited – Isle of Man Branch

SWIFT Code RBOSIMDX SWIFT Code RBOSIMDX

Account Name MANSARD CAP SICAV PLC T/A SELLAR CL SUB/RED AC

Account Number 58624346 Account Number 58624346

IBAN No: GB39RBOS16588058624346 IBAN No: GB39RBOS16588058624346 Reference: Please use shareholders name Reference: Please use shareholders name Correspondent

Bank

The Royal Bank of Scotland plc, London Correspondent Bank

UBS AG, Zurich

SWIFT Code RBOSGB2L SWIFT Code UBSWCHZH80A

USD EUR

Bank

Wells Fargo Bank NA, New York Correspondent Bank

The Royal Bank of Scotland plc, London

SWIFT Code PNBPUS3NNYC SWIFT Code RBOSGB2L

PLN ILS

Bank

Royal Bank of Scotland, London Correspondent Bank

Royal Bank of Scotland, London SWIFT Code RBOSGB2L via ING Bank Slaski SA, Slaskie

Poland INGBPLPW

SWIFT Code RBOSGB2L via Bank Hapoalim BM, Tel Aviv, Israel POALILIT

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1. S H A R E H O L D E R I N F O R M A T I O N

First Named Holder ________________________________________

Registered Address ________________________________________

________________________________________

Correspondence Address (if different) ________________________________________

________________________________________

_______________________________________

Telephone No: ________________________________________

Fax No: ________________________________________

Email Address: ________________________________________

Second Named Holder ________________________________________

Registered Address ________________________________________

________________________________________

Correspondence Address (if different) ________________________________________

________________________________________

Telephone No: ________________________________________

Fax No: ________________________________________

Email Address: ________________________________________

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2. S U B S C R I P T I O N I N S T R U C T I O N S

I/We wish to subscribe in the following Share Classes of the Sub-Fund, in the cash amounts indicated

Sub-Fund Name/Share Class ISIN Code Sales

Load (1-5%)*

Cash Amount Invested**

Sellar Development Fund - Class A USD Shares

(Institutional)

MT7000010989 N/A

Sellar Development Fund - Class B USD Shares

(Entry Class) MT7000011029

Sellar Development Fund - Class C USD Shares (Exit

Class) MT7000011060

N/A

Sellar Development Fund - Class D USD Shares (Exit

Class)

MT7000024485 N/A

Sellar Development Fund - Class A EURO Shares

(Institutional)

MT7000010963 N/A

Sellar Development Fund - Class B EURO Shares

(Entry Class) MT7000011003

Sellar Development Fund - Class C EURO Shares (Exit

Class)

MT7000011045 N/A

Sellar Development Fund - Class D EURO Shares

(Exit Class)

MT7000024527 N/A

Sellar Development Fund - Class A GBP Shares

(Institutional)

MT7000010971 N/A

Sellar Development Fund - Class B GBP Shares

(Entry Class) MT7000011011 Sellar Development Fund - Class C GBP Shares (Exit

Class)

MT7000011052 N/A

Sellar Development Fund - Class D GBP Shares (Exit

Class)

MT7000024519 N/A

Sellar Development Fund - Class A CHF Shares

(Institutional)

MT7000010955 N/A

Sellar Development Fund - Class B CHF Shares (Entry Class

MT7000010997

Sellar Development Fund - Class C CHF Shares (Exit

Class)

MT7000011037 N/A

Sellar Development Fund - Class D CHF Shares (Exit

Class)

MT7000024535 N/A

Sellar Development Fund - Class A PLN Shares

(Institutional)

TBC N/A

Sellar Development Fund - Class B PLN Shares (Entry

Class) TBC

Sellar Development Fund - Class C PLN Shares (Exit

Class)

TBC N/A

Sellar Development Fund - Class D PLN Shares (Exit

Class)

MT7000024493 N/A

Sellar Development Fund - Class A ILS Shares

(Institutional)

MT7000024451 N/A

Sellar Development Fund - Class B ILS Shares (Entry

Class) MT7000024469

Sellar Development Fund - Class C ILS Shares (Exit

Class)

MT7000024477 N/A

Sellar Development Fund - Class D ILS Shares (Exit

Class)

MT7000024501 N/A

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* Please insert any additional Sales Load (1-5%) to be applied for investments in Class B Shares. This Sales Load is paid out of the Investment and results in a reduction of the Investment Amount. If no figure is inserted a default Sales Load of 0% will apply.

** Please separate thousands using a comma and to 2 decimal places maximum (e.g. Three Million $USD = 3,000,000.00)

3. S O U R C E O F S U B S C R I P T I O N M O N I E S

Registered Name of the Account/s from where Subscription Monies Emanated

Account Number

Name/Address of Bank with which Account/s are held

Name/Address of Correspondent Bank wiring Subscription Monies

Currency for which Subscription Monies being transferred * (Please tick)

USD ☐ GBP ☐ ILS ☐

EUR ☐ CHF ☐ PLN ☐

A Copy of the Swift Transfer/s Attached ☐ (please tick to indicate such)

Notes:

* Please refer to page 2 of this Initial Subscription Agreement which details the account details for payment of Subscription Monies

4. S O U R C E O F W E A L T H

Please provide information on the Source of Wealth* for this investment:

__________________________________________________________________________________

*Source of wealth is distinct from source of funds and describes the origins of a customer’s financial standing or total net worth i.e. those activities which have generated a customer’s funds and property. Vague or generic terms such as

"consultancy" or "investment" must be avoided, and details of the exact source of that wealth must be made clear.

Failure to provide sufficient information could delay your investment.

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5. D E C L A R A T I O N S B Y T H E I N V E S T O R

(i) I/We declare, represent and confirm that I/we make the undertakings, representations, warranties and acknowledgments set out below (where applicable), in the Offering Memorandum, in the Offering Supplement and in the Qualifying Investor Declaration Form. I/We acknowledge, understand and agree that the Company (and the Administrator and/or the Investment Manager, where appropriate) shall rely on all such undertakings, representations, warranties and acknowledgements, to the extent permitted by law.

(ii) I/We confirm that I/we have read, understood, acknowledge and confirm my/our agreement with the contents of the Offering Memorandum and the Offering Supplement thereto to which this Subscription Agreement was attached and I/we offer to subscribe and agree to accept the number of Shares in the Sub-Fund which may be allotted to me/us in accordance with the terms of the Offering Memorandum and the Offering Supplement thereto to which this Subscription Agreement was attached and subject to the provisions of the Memorandum and Articles of Association of the Company.

(iii) I/We understand and agree that, if I/we decide to redeem my/our holding, prior to receipt of any further documentation/information as may have been requested by the Company, from time to time, in accordance with the Company’s ongoing monitoring procedures, that redemption instruction will be executed, but the redemption proceeds will be retained in the Sub-Fund’s bank account, pending receipt of said information, and I/we shall bear all associated risks.

(iv) I/We hereby undertake to observe and be bound by the provisions of the Memorandum and Articles of Association of the Company and apply to be entered in the register of members as the holder / holders of the Shares in the Sub-Fund issued in relation to this application.

(v) I/We hereby confirm that this application is based solely on the Offering Memorandum and the Offering Supplement thereto to which this Subscription Agreement was attached together with (where applicable) the most recent annual reports of the Company.

(vi) I/We will not offer, sell or deliver any of such Shares in the Sub-Fund directly or indirectly to a person whosoever who is under any law or regulation of any jurisdiction whatsoever not allowed to hold Shares in the Sub-Fund.

(vii) I/We understand and acknowledge, in accordance with the Offering Memorandum, Offering Supplement and the Memorandum and Articles of the Company, should I/We wish to transfer any Shares, I/we shall obtain the prior written consent of the Directors of the Company. To the extent that any such request is granted, then I/we understand and acknowledge that the potential purchaser shall be required to make equivalent representations, warranties, undertakings and acknowledgments to those contained in this Subscription Agreement. Should the proposed transferee not make these representations and warranties or does not provide documentation that is deemed satisfactory by the Company, the Directors of the Company shall withhold its consent to the proposed transfer of the Shares.

(viii) I/We acknowledge that the Company may compulsorily redeem my/our Investor Shares in certain circumstances as laid down in the Offering Memorandum.

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5. D E C L A R A T I O N S B Y T H E I N V E S T O R continued

(ix) I/We warrant that I/we am/are a Qualifying Investor (as defined in the Offering Memorandum and the Offering Supplement thereto) and my/our investment in the Shares does not contravene any applicable law relating to the offering or distribution of securities in the jurisdiction in which I am/we are, or may be deemed to be, resident, and that I/we have the knowledge, expertise and experience in financial matters to evaluate the risks of investing in the Sub-Fund.

(x) I/we have read the risks as outlined in the Offering Memorandum and the Offering Supplement and I am/we are aware of the risks inherent in investing in the Sub-Fund.

(xi) I/We, warrant that I/we have the right and authority to make the investment pursuant to this Subscription Agreement, whether the investment is my/our own or is made on behalf of another person or corporate or an unincorporated entity, and that I/we am/are/will not be in breach of any laws or regulations of any competent jurisdiction and I/we hereby indemnify the Company for any loss suffered by it as a result of this warranty/representation not being true in every respect.

(xii) I/We, agree to provide the representations in this Subscription Agreement to the Company at such times as the Company may request and to provide on request such certificates, documents or other evidence as the Company may reasonably require to substantiate such representations and/or warranties.

(xiii) I/We, agree to notify the Company immediately if I/we become aware that any of the representations and/or warranties is/are no longer accurate and complete in all respects and agree immediately to sell or to tender to the Company for redemption a sufficient number of Shares to allow the representation to be made.

(xiv) I/We, hereby confirm that the Company is authorised and instructed to accept and execute any instructions in respect of the Shares in the Sub-Fund to which this Subscription Agreement relates given by me/us by facsimile.

(xv) If instructions are given by me/us by facsimile, I/we undertake to confirm them separately by means of a letter. I/

we hereby indemnify the Company and agree to keep it indemnified, against any loss of any nature whatsoever arising as a result of acting on facsimile instructions. The Company may rely conclusively upon and shall incur no liability in respect of any action taken upon any notice, consent, request, instructions or other instrument believed, in good faith, to be genuine or to be signed by properly authorised persons.

(xvi) I/We, agree to indemnify and hold harmless the Company, its Directors, officers and third parties delegated by it against any loss, liability, cost or expense (including without limitation attorneys’ fees, taxes and penalties) which may result directly or indirectly, from any misinterpretation or breach of any representation, warranty, condition, covenant or agreement set forth herein, in the Offering Memorandum, in the Offering Supplement or in the Qualifying Investor Declaration Form attached herewith or in any other document delivered by the undersigned to the Company.

(xvii) I/We acknowledge that all personal information supplied by me/us will be processed by the Company and/or its/their delegates and/or its service providers and/or duly authorised agents and/or any of their respective related, associated or affiliated companies (including, without limitation, the Investment Manager and/or the Administrator) (the “Fund Parties”) in accordance with their respective legal obligations, including under the General Data Protection Regulation 2016/679 (the ”Data Protection Legislation”) and as further detailed in the Offering Memorandum and Offering Supplement. I/We further acknowledge that, should it be necessary, either to

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5. D E C L A R A T I O N S B Y T H E I N V E S T O R continued

fulfil a legal requirement or to facilitate the efficient execution of the administrative functions, data supplied may be transferred, to the extent necessary and in compliance with Data Protection Legislation. I/We declare, represent and confirm that for the avoidance of doubt, the Company shall be considered to be a data controller in accordance with the Data Protection Legislation and each of the Fund Parties may act on behalf of and to the instruction of the Company as data processors, in accordance with Data Protection Legislation.

(xviii) If this form, or any other communication, is sent to the Company and/or the Administrator by fax, e -mail or verbally it will not be deemed to have been received by the Company or Administrator unless receipt is acknowledged in writing by the Administrator. Exceptions are made where the delivery of the communication has been acknowledged by a signed receipt.

(xix) I/we fully appreciate/s the Company's rights to accept or reject all applications for subscription in its sole discretion.

In order to induce the Company to accept this subscription, I/we agree/s, represent/s and warrant/s that the Shares hereby subscribed for are not being acquired for the account of any person who is, directly or indirectly:

(a) a US Person as defined in the Offering Memorandum;

(b) a citizen or resident of Malta.

(xx) The terms, conditions, representations and warranties in the Company's Offering Memorandum, Offering Supplement and Subscription Agreement and Application Form (together “the Documents”) cannot be amended.

If such amendments are made, they will not be binding unless and until they are agreed and approved in writing by the Board of the Company or by the Administrator, acting for and on behalf of the Board. If a Subscriber deems it necessary, for whatever reason, to amend the Documents, it must separately notify the Administrator of each requested amendment and the Administrator will take all necessary steps, including seeking approval by both the Investment Manager and the Board, to determine whether each requested amendment is to be allowed. Unless and until the Subscriber receives such confirmation of acceptance in writing, it is deemed that the existing unamended terms, conditions and warranties apply.

(xxi) I/We by executing this Subscription Agreement hereby appoint the Directors who accept such an appointment, with full power of substitution, as my/our true and lawful representative and attorney-in-fact and agent to execute, acknowledge, verify, swear to, deliver, record and file, in my/our name, place and stead any agreement or instrument which may be deemed necessary to request the Company to redeem all of my/our Investor Shares, free of any encumbrances, in the event that I/we become a defaulting shareholder (as stipulated within the Offering Memorandum and Offering Supplement) or where it is otherwise deemed necessary or desirable by the Directors.

(xxii) To the fullest extent permitted by law, this power of attorney is coupled with an interest, is irrevocable and shall survive, and shall not be affected by, the subsequent death, disability, incapacity, incompetence, termination, bankruptcy, insolvency or dissolution of me/us. I/we, hereby waive any and all defences which may be available to contest, negate or disaffirm any action of the agent and/or attorney-in-fact taken in good faith under the said power of attorney.

(xxiii) I/We confirm that the funds which I/we are using to honour the commitment are (i) not the direct or indirect proceeds of illegal activities including, but not limited to, corruption, fraud, money laundering or terrorist financing activities, and (ii) the distribution proceeds from my/our commitment of the Shares in the Sub-Fund will not be

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5. D E C L A R A T I O N S B Y T H E I N V E S T O R continued

used to finance any legal or terrorist activities and that I/We will produce such documents as required by the Company and/or the Administrator to comply with regulations in Malta and other applicable jurisdiction preventing money laundering and terrorist financing (as further stipulated within this Subscription Agreement).

(xxiv) I/We hereby agree that this Subscription Agreement (in its entirety), the Offering Memorandum, Offering Supplement and Qualifying Investor Declaration Form are governed by, and shall be construed in accordance with, the laws of Malta and any claims brought are subject to the exclusive jurisdiction of the Courts of Malta.

(xxv) All payments in respect of redemptions will be made by wire transfer only to the account of the registered Shareholder at the Remitting Bank/Financial Institution from which the original subscription was made.

I/We agree to be bound by the Declarations, Representations, Consents and Indemnities set out in this Initial Subscription Form.

Signature (1): Signature (2):

Name of Authorised Signatory (1):

Name of Authorised Signatory (2):

Capacity of Authorised Signatory (1):

Capacity of Authorised Signatory (2):

Date: (dd/mm/yyyy) Date: (dd/mm/yyyy)

6. S I G N I N G I N S T R U C T I O N S

☐ All to sign

☐ Any to sign

☐ Authorised Signatory List Attached

7. I N T E R M E D I A R Y D E T A I L S (if applicable)

Intermediary Name: ________________________________________

Intermediary Address: ________________________________________

Representative Name: ________________________________________

Unique Mansard ID: ________________________________________

Telephone No: ________________________________________

Fax No: ________________________________________

Email Address: ________________________________________

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8. C L I E N T V E R I F I C A T I O N R E Q U I R E M E N T S

Please note that the Administrator is required to, and applies, a risk based approach in reviewing Anti-Money Laundering (AML) documentation for applicants; as such it reserves the right to request further information should the documents provided not be complete/provide the level of comfort that is required in order to on-board a client as per applicable laws and regulations.

At the time of a new subscription, the administrator will require the following:

• Completed original subscription document. This must include bank details and source of wealth declaration, amongst all other relevant declarations. Additional documents/information may be requested in certain circumstances.

• Full AML documentation. Please ensure that the investor signs in accordance with their passport. In the case of entities, please ensure that the investor signs in accordance with the authorised signatory list of the entity.

Individuals

We require a certified* copy of one of the following for proof of identity:

• A valid passport

• A valid driving licence which contains a photograph

• A valid national identity card Corporates - Private/Unlisted Companies

We require either an original or a certified* copy of one of the following for proof of residential address (no more than 6 months old):

• A utility bill for a fixed service (not a mobile/cell phone bill)

• A bank or credit card statement

• A tax bill

• Driving licence or national identity card containing the current residential address (only if the document has not already been used to verify identity) Corporates - Private/Unlisted Companies

We require certified* copies of the following:

• Organisation Structure Chart

• Certificate of Incorporation/Registration

• Memorandum and Articles/Bye-Laws of Association

• Register of Directors

• Register of Members/Shareholders

• Authorised signatory List

• Latest report and accounts (audited if available)

• AML documentation on minimum of two Directors as per individual requirements (All directors if you have been risk assessed as High Risk.)

• AML documentation on minimum of two authorised signatories (if different to the above Directors) as per individual requirements

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8. C L I E N T V E R I F I C A T I O N R E Q U I R E M E N T S continued

• AML documentation as per individual requirements for any shareholders holding 25% or more of the issued shares (All if you have been risk assessed as High Risk. The Administrator will advised you if this is applicable to your investment)

Corporates – Public Listed Companies (Plc)

A ‘Plc’ is defined as a company whose securities are listed or traded on a recognised stock exchange. Details of recognised stock exchanges are available from the hr Administrator.

• Organisation Structure Chart

• Audited annual report and accounts

• Documentation as evidence to show that the company has been admitted to trading on a regulated main market

• List of Directors

• List of authorised signatories Wholly or majority owned subsidiary of a Plc

As above, but with a letter from the company secretary or other validated evidence confirming the ownership by the Plc.

Corporates regulated in an equivalent country

For registered named investors regulated in countries with equivalent AML/CFT controls to Malta, the Administrator will require the following:

• Original or certified AML comfort letter from the registered named investor; and

• Original or certified ‘Wolfsberg’ AML Questionnaire from the registered named investor.

A list of these countries is available from the Administrator.

Trusts/Foundations

• Trust/Foundation Deed (or relevant extracts of the trust/ foundation deed) and any subsequent deeds of appointment and retirement (or equivalent)

• Copy of Letter of wishes, or other relevant documents of the trust, in order to assist in confirming the beneficiaries / potential beneficiaries to the trust, if applicable

• List of names and addresses of all Trustees/Counsel Members

• Authorised signatory List

• AML documentation on a minimum of two of the Trustees/Counsel Members of the Trust/Foundation, as per individual requirements

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8. C L I E N T V E R I F I C A T I O N R E Q U I R E M E N T S continued

• AML documentation on the Settlor(s), Protector/Enforcer(s) and any named Beneficiaries as per individual requirements

• AML documentation on minimum of two authorised signatories (if different to the Trustees/Counsel Members) as per individual requirements

Partnerships, Funds and Charites

Please contact the Administrator if you are a partnership, fund or charity and they will advise you of the AML documentation we require for these entities.

Ultimate Beneficial Owner (“UBO”)

If you are investing on behalf of an underlying client, we will require AML documentation on the underlying client, as per the appropriate requirements listed above.

All Investors

For all investors, we will require details of your Source of Funds (i.e. details of where the investment monies have been sent from) and Source of Wealth (i.e. how the investment monies were originally acquired). This information is provided on the subscription document. Please ensure that generic descriptions are not used and include appropriate reference were applicable.

Where the investor is High Risk or the investment is above GBP100,000 or currency equivalent, we require

documentary evidence of Source of Wealth, which must be certified*. High Risk investors include, but are not limited to the following: investors not located in a country listed in a high risk country, complex legal structures, PEPs and certain non-profit organisations. The Administrator will advise you if you have been risk assessed as High Risk.

Please contact the Administrator for sample details for when Source of Wealth evidence is required.

*Certification requirements

Please ensure that photographic identification is certified using the following or similar wording:

‘I certify this to be a true copy of the original document which I have seen and that the photograph is a true likeness of the individual concerned’

Please ensure all other documents are certified using the following or similar wording:

‘I certify this to be a true copy of the original document which I have seen’

The certifier should sign and date the copy document and provide adequate information so that contact can be made with the certifier in the event of a query. Adequate information means:

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8. C L I E N T V E R I F I C A T I O N R E Q U I R E M E N T S continued

• The full name of the certifier (i.e. not just their signature):

• The professional position/capacity held by the certifier; and

• Contact details such as a postal address, telephone number or e-mail address at which the certifier can be contacted.

This information may be provided either on the certified document or attached to that document by way of email, file note or other record. Certification should be completed by one of the following suitable people:

a) An Embassy, Consulate or High Commission of the country of issue of the documentary evidence;

b) A member of the Judiciary, a senior Civil Servant or a serving Police or Customs Officer based in an equivalent jurisdiction country:

c) A Lawyer or Notary Public who is a member of a recognised professional body;

d) An Actuary who is a member of a recognised professional body;

e) An Accountant who is a member of a recognised professional body;

f) A Tax Advisor who is a member of a recognised professional body;

g) A Director, Officer or Manager of a regulated financial services business operating in an equivalent jurisdiction country; or h) A Bank Manager of a major bank whose headquarters/head office are based in an equivalent jurisdiction country.

Please note that we are unable to accept a certified copy of a certified copy.

9. E N T I T Y S E L F – C E R T I F I C A T I O N F O R F A T C A / C R S D E C L A R A T I O N F O R M

Entity Self-Certification for FATCA and CRS

Investors that are individuals should not complete this form and should complete Section 10 “Individual Self-Certification for FATCA and CRS”.

We are obliged under the Foreign Account Tax Compliance Act (FATCA), related intergovernmental agreements (“IGAs”) and regulations based on the OECD Common Reporting Standard (“CRS”) to collect certain information about each investor’s tax arrangements. Please complete the sections below as directed and provide any additional

information that is requested. Please note that in certain circumstances we may be legally obliged to share this information, and other financial information with respect to an investor’s interests in the Fund with relevant tax authorities .This form is intended to request information only where such request is not prohibited by local law.

If you have any questions about this form or defining the investor’s tax residency status, please refer to the OECD CRS Portal or speak to a tax adviser.

For further information on FATCA or CRS please refer to the US Department of the Treasury’s website at

http://www.irs.gov/Businesses/Corporations/Foreign-Account-Tax-Compliance-Act-FATCA or the following link to the OECD CRS Information Portal at: http://www.oecd.org/tax/automatic-exchange/ in the case of CRS only.

If any of the information below about the investor’s tax residence or FATCA/CRS classification changes in the future, please ensure that we are advised of these changes promptly.

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9. E N T I T Y S E L F – C E R T I F I C A T I O N F O R F A T C A / C R S D E C L A R A T I O N F O R M continued.

(Mandatory fields are marked with an *) Section 1: Investor Identification

Investor Name*:________________________________________________________ (the "Entity”) Country of Incorporation or Organisation:_____________________________________________

Current Registered Address*:

Number: _____________ Street: ____________________________________________________

City, town, State, Province or County: ________________________________________________

Postal/ZIP Code: _____________ Country: ____________________________________________

Mailing address (if different from above):

Number: _____________ Street: _____________________________________________________________

City, town, State, Province or County: _________________________________________________________

Postal/ZIP Code: _____________ Country: __________________________________

Section 2:

FATCA Declaration Specified U.S. Person:

Please tick either (a), (b) or (c) below and complete as appropriate.

Section 3:

Entity’s FATCA

Classification* (the information provided in this section is for FATCA, please note your classification may differ from your CRS classification in Section 5):

a) The Entity is a Specified U.S. Person and the Entity’s U.S. Federal Taxpayer Identifying number (U.S. TIN) is as follows: U.S

TIN:_____________________________________________________

☐

b) The Entity is not a Specified U.S. Person (please also complete Sections 3, 4 and 5 ☐ c) The Entity is a US person but not a Specified U.S. Person (please also complete Sections

3, 4 and 5)

☐

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9. E N T I T Y S E L F – C E R T I F I C A T I O N F O R F A T C A / C R S D E C L A R A T I O N F O R M continued.

3.1 Financial Institutions under FATCA:

If the Entity is a Financial Institution, please tick one of the below categories and provide the Entity’s GIIN at 3.2

I. Partner Jurisdiction Financial Institution ☐

II. Registered Deemed Compliant Foreign Financial Institution ☐

III. Participating Foreign Financial Institution ☐

3.2 Please provide the Entity’s Global Intermediary Identification number (GIIN) _______________________________________

3.3 If the Entity is a Financial Institution but unable to provide a GIIN, please tick one of the below reasons:

I. The Entity has not yet obtained a GIIN but is sponsored by another entity which does have

a GIIN

Please provide the sponsor’s name and sponsor’s GIIN : Sponsor’s Name: Sponsor’s GIIN:

☐

II. Exempt Beneficial Owner ☐

III. Certified Deemed Compliant Foreign Financial Institution (including a deemed compliant

Financial Institution under Annex II of the Agreement)

☐

IV. Non-Participating Foreign Financial Institution ☐

V. Excepted Foreign Financial Institution ☐

3.4 Non-Financial Institutions under FATCA:

If the Entity is not a Financial Institution, please tick one of the below categories

I. Active Non-Financial Foreign Entity ☐

II. Passive Non-Financial Foreign Entity

(If this box is ticked, please include self-certification forms for each of your Controlling Persons)

☐

III. Excepted Non-Financial Foreign Entity ☐

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9. E N T I T Y S E L F – C E R T I F I C A T I O N F O R F A T C A / C R S D E C L A R A T I O N F O R M continued.

Section 4:

CRS Declaration of Tax Residency (please note that you may choose more than one country)*

Please indicate the Entity’s country of tax residence for CRS purposes, (if resident in more than one country please detail all countries of tax residence and associated tax identification numbers (“TIN”)).

NOTE: Provision of a Tax ID number (TIN) is required unless you are tax resident in a Jurisdiction that does not issue a (TIN).

If the Entity is not tax resident in any jurisdiction (e.g., because it is fiscally transparent), please indicate that below and provide its place of effective management or country in which its principal office is located.

Country of Tax Residency Tax ID Number

Section 5:

Entity’s CRS Classification*(The information provided in this section is for CRS. Please note an Entity's CRS classification may differ from its FATCA classification in Section 3):

For more information please see the CRS Standard and associated commentary.

http://www.oecd.org/tax/automatic-exchange/common-reporting-standard/common-reporting-standard-and- related-commentaries/#d.en.345314

5.1 Financial Institutions under CRS:

If the Entity is a Financial Institution, please tick one of the below categories

I. Financial Institution under CRS(other than (II) below) ☐

II. An Investment Entity located in a Non-Participating Jurisdiction and managed by another Financial Institution (If this box is ticked, please indicate the name of any Controlling Person(s) of the Entity and complete a separate individual self-certification forms for each of your Controlling Persons **)

☐

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9. E N T I T Y S E L F – C E R T I F I C A T I O N F O R F A T C A / C R S D E C L A R A T I O N F O R M continued.

5.2 Non Financial Institutions under CRS:

If the Entity is a Non Financial Institution, please tick one of the below categories:

I. Active Non-Financial Entity – a corporation the stock of which is regularly traded on an established securities market or a corporation which is a related entity of such a corporation

☐

II. Active Non-Financial Entity – a Government Entity or Central Bank ☐ III. Active Non-Financial Entity – an International Organisation ☐ IV. Active Non-Financial Entity – other than (I)-(III) (for example a start-up NFE or a

non-profit NFE)

☐ V. Passive Non-Financial Entity (If this box is ticked, please complete a separate Individual

Self-Certification Form for each of your Controlling Person(s) )

☐

**Controlling Person’s:

NB: Please note that each Controlling Person must complete a Separate Individual Self-Certification form.

If there are no natural person(s) who exercise control of the Entity then the Controlling Person will be the natural person(s) who hold the position of senior managing official of the Entity.

For further information on Identification requirements under CRS for Controlling Persons, see the Commentary to Section VIII of the CRS Standard.

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9. E N T I T Y S E L F – C E R T I F I C A T I O N F O R F A T C A / C R S D E C L A R A T I O N F O R M continued.

Section 6:

Declarations and Undertakings

I/We declare (as an authorised signatory of the Entity) that the information provided in this form is, to the best of my/our knowledge and belief, accurate and complete.

I acknowledge that the information contained in this form and information regarding the Account Holder may be reported to the tax authorities of the country in which this account(s) is/are maintained and exchanged with tax authorities of another country or countries in which the Account Holder may be tax resident where those countries (or tax authorities in those countries) have entered into Agreements to exchange financial account information.

I/We undertake to advise the recipient promptly and provide an updated Self-Certification where any change in circumstance occurs which causes any of the information contained in this form to be incorrect.

Authorised Signature(s)*:

_______________________________ _______________________________

Print Name(s)*:

_______________________________ _______________________________

Capacity in which declaration is made*:

_______________________________ _______________________________

Date: (dd/mm/yyyy):* _ _ / _ _ / _ _ _ _

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10. I N D I V I D U A L S E L F – C E R T I F I C A T I O N F O R F A T C A / C R S D E C L A R A T I O N F O R M

Individual (Controlling Person’s) Self-Certification for FATCA and CRS

We are obliged under the Foreign Account Tax Compliance Act (FATCA), related intergovernmental agreements (“IGAs”) and regulations based on the OECD Common Reporting Standard (“CRS”) to collect certain information about each investor’s tax arrangements. Please complete the sections below as directed and provide any additional

information that is requested. Please note that in certain circumstances we may be legally obliged to share this information, and other financial information with respect to an investor’s interests in the Fund with relevant tax authorities .This form is intended to request information only where such request is not prohibited by local law.

If you have any questions about this form or defining the investor’s tax residency status, please refer to the OECD CRS Portal or speak to a tax adviser.

For further information on FATCA or CRS please refer to the US Department of the Treasury’s website at

http://www.irs.gov/Businesses/Corporations/Foreign-Account-Tax-Compliance-Act-FATCA or the following link to the OECD CRS Information Portal at: http://www.oecd.org/tax/automatic-exchange/ in the case of CRS only.

If any of the information below about the investor’s tax residence or FATCA/CRS classification changes in the future, please ensure that we are advised of these changes promptly.

Please note that where there are joint or multiple account holders each investor is required to complete a separate Self-Certification form.

Sections 1, 2, 3 and 5 must be completed by all investors.

Section 4 should only be completed by any individual who is a Controlling Person of an entity investor which is a Passive Non-Financial Entity. For further guidance see

(Mandatory fields are marked with an *) Section 1: Investor Identification

Investor Name*:________________________________________________________________

Current Residential Address*:

Number: _____________ Street: ___________________________________________________

City, town, State, Province or County: ________________________________________________

Postal/ZIP Code: _____________ Country: ____________________________________________

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10. I N D I V I D U A L S E L F – C E R T I F I C A T I O N F O R F A T C A / C R S D E C L A R A T I O N F O R M continued.

Mailing address (if different from above):

Number: _____________

Street: ___________________________________________________________________________

City, town, State, Province or County:___________________________________________________

Postal/ZIP Code: _________________________ Country: ___________________________________

Place of Birth* _____________________________________________________________________

Town or City of Birth*: ____________________ Country of Birth*: __________________________

Date of Birth*(dd/mm/yyyy): _ _/_ _/_ _ _ _ Section 2:

FATCA Declaration of U.S. Citizenship or U.S. Residence for Tax purposes*:

Please tick either (a) or (b) and complete as appropriate.

(a) ☐ I confirm that [I am]/[the investor is] a U.S. citizen and/or resident in the U.S. for tax purposes and [my]/[its] U.S. federal taxpayer identifying number (U.S. TIN) is as follows:

________________________________________

OR

(b) ☐ I confirm that [I am not]/[the investor is not] a U.S. citizen or resident in the U.S. for tax purposes.

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10. I N D I V I D U A L S E L F – C E R T I F I C A T I O N F O R F A T C A / C R S D E C L A R A T I O N F O R M continued.

Section 3:

CRS Declaration of Tax Residency (please note that you may choose more than one country)*

Please indicate your / the investor’s country of tax residence, (if resident in more than one country please detail all countries of tax residence and associated tax identification numbers (“TIN”) Please see the CRS Portal for more information on Tax Residency.

Country of Tax Residency Tax ID Number

NOTE: Provision of a Tax ID number (TIN) is required unless you are tax resident in a Jurisdiction that does not issue a (TIN).

Section 4:

Type of Controlling Person

(ONLY to be completed by any individual who is a Controlling Person of an entity investor which is a

Passive Non-Financial Entity or an Investment Entity located in a Non-Participating Jurisdiction and managed by another Financial Institution).

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10. I N D I V I D U A L S E L F – C E R T I F I C A T I O N F O R F A T C A / C R S D E C L A R A T I O N F O R M continued.

For joint or multiple Controlling Persons please complete a separate Self-Certification form for each Controlling Person

Please Confirm what type of Controlling Person applicable under CRS that applies to you/the investor by ticking the appropriate box.

Please Tick

Entity Name

Controlling Person of a legal person – control by ownership ☐ Controlling Person of a legal person – control by other means ☐ Controlling Person of a legal person – senior managing

official

☐

Controlling Person of a trust - settlor ☐

Controlling Person of a trust – trustee ☐

Controlling Person of a trust – protector ☐ Controlling Person of a trust – beneficiary ☐

Controlling Person of a trust – other ☐

Controlling Person of a legal arrangement (non-trust) – settlor-equivalent

☐ Controlling Person of a legal arrangement (non-trust) –

trustee-equivalent

protector-equivalent

beneficiary-equivalent

other-equivalent

☐

Section 5:

Declaration and Undertakings:

I declare that the information provided in this form is, to the best of my knowledge and belief, accurate and complete.

I acknowledge that the information contained in this form and information regarding the Account Holder may be reported to the tax authorities of the country in which this account(s) is/are maintained and exchanged with tax authorities of another country or countries in which the Account Holder may be tax resident where those countries (or tax authorities in those countries) have entered into Agreements to exchange financial account information.

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I undertake to advise the recipient promptly and provide an updated Self-Certification form where any change in circumstances occurs which causes any of the information contained in this form to be incorrect.

Authorised Signature*: ______________________________

Print Name*: ______________________________

Date: (dd/mm/yyyy)*: _ _ / _ _ / _ _ _ _

Capacity*: _________________________________

11. Q U A L I Y F Y I N G I N V E S T O R D E C L A R A T I O N F O R M

Scheme: Mansard Capital SICAV plc Sub-Fund: Sellar Development Fund Section I:

This section should be completed by the Qualifying Investor or his/ her duly authorised agent [as appropriate]

If the investment is not being made directly by the investor but through a duly authorized agent:

Name of Investor / duly authorised agent:

____________________________________________________________________________

I hereby confirm that I have been properly appointed as a duly authorised agent of a prospective investor in the Scheme described above. I certify that my principal is eligible to be treated as a “Qualifying Investor” since my

principal satisfies the definition thereof in light of the positive response(s) that I have given to the question(s) below in respect of my principal. I certify that my principal has read and understood the Offering Document including the mandatory risk warnings.

I qualify / My principal qualifies [delete as applicable] as an “Qualifying Investor”, as I/ he/ she possess(es) the

necessary expertise, experience and knowledge to be in a position to make my/ his/ her own investment decisions and understand the risks involved as:

If the investment is being made directly by the investor (not through a duly authorized agent):

I hereby confirm that I am eligible to be treated as a “Qualifying Investor”, since I satisfy the definition thereof in light of the positive response(s) that I have given to the question(s) below. I certify that I have read and understood the Offering Document including the mandatory risk warnings.

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11. Q U A L I Y F Y I N G I N V E S T O R D E C L A R A T I O N F O R M continued

I am/ (s)he is Yes No

a body corporate which has net assets in excess of

EUR750,000 or which is part of a group which has net assets in excess of EUR750,000; or

☐ ☐

an unincorporated body of persons or association which has net assets in excess of EUR750,000

☐ ☐

a trust where the net value of the trust’s assets is in excess of EUR750,000;

☐ ☐

an individual, or in the case of a body corporate, the majority of its Board of Directors or in the case of a partnership its General Partner, who has reasonable experience in the acquisition and/or disposal of funds of a similar nature or risk profile; or property of the same kind as the property, or a substantial part of the property, to which the Scheme in question relates;

☐ ☐

an individual whose net worth or joint net worth with that

person’s spouse, exceeds EUR750,000;

☐ ☐

a senior employee or director of service providers to the

Scheme;

☐ ☐

a relation or a close friend of the promoters; ☐ ☐

an entity with (or which are part of a group with) EUR3.75 million or more under discretionary management investing on

its own account;

☐ ☐

a PIF promoted to Qualifying or Extraordinary Investors; ☐ ☐

an entity (body corporate or partnership) wholly owned by persons or entities satisfying any of the criteria listed above which is used as an investment vehicle by such persons or entities.

☐ ☐

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NAME OF INVESTOR / DULY AUTHORISED AGENT SIGNATURE

TITLE/CAPACITY IN WHICH SIGNED

DATE