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BCS St George - Aanvraagformulier EN_tcm46-221479

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					      APPLICATION FORM FOR COMPENSATION UNDER THE INVESTOR
                      COMPENSATION SCHEME

                       ST. GEORGE PRIVATE FINANCE B.V

 ABOUT THIS APPLICATION FORM



Why this application form?
On 7 October 2005 the authorisation of St. George Private Finance B.V. in Rotterdam (SGPF) to
pursue the business of an investment firm was cancelled by the Stichting Autoriteit Financiële
Markten (AFM).
On 23 June 2009, the Rotterdam District Court pronounced the bankruptcy of SGPF and nominated a
receiver. In view of the bankruptcy of SGPF, the Beleggerscompensatiestelsel [Investor
Compensation Scheme, hereinafter: the Scheme] was activated for former investors with SGPF. The
class of investors concerned is defined in department 3.5.6 of the Wet op het financieel toezicht
[Financial Supervision Act, Wft] and the Besluit bijzondere prudentiële maatregelen,
beleggerscompensatie en deposito-garantie Wft [Decree providing Special Prudential Measures,
Investor Compensation and Deposit Guarantee pursuant to the Wft, ‘Decree’). The Scheme applies
only to claims of investors on SGPF that are associated with investment operations carried out prior
to 7 October 2005.
De Nederlandsche Bank NV (DNB) is the manager of the Scheme. In order to assess whether you
qualify for payment under the Scheme, DNB needs certain particulars concerning you and your claim.
Kindly use this application form to supply the required information. Note that if two or more
investors have a joint claim in respect of an investment operation, they must each submit a separate
application form.


Submission of application forms
If you are a former investors with SGPF and you think you are entitled to payment under the Scheme,
you should submit this application form, fully completed and signed, together with all the required
annexes, to DNB by post, using the enclosed addressed envelope (adequately stamped), taking care
that it is received by 6 January 2010 at the latest. Applications received by DNB after that date will
not be considered. Applications will be assessed pursuant to and with due regard to the Wft and the
Decree.




                                                                                                    1
DNB will, as soon as possible after it receives a duly completed and signed application form with all
the requisite annexes – i.e. in principle within three months – proceed to disburse the amount due to
the applicant under the Scheme. The maximum disbursement per investor is EUR 20,000.


To prevent misunderstandings, we point out that no rights may be derived from the present application
(form) or the appended explanatory notes.


Explanatory note
The appendix to this application form presents explanatory notes to each numbered section. You are
advised to read the explanation to each section carefully before completing it.


Further information
Kindly contact the DNB information desk to resolve any questions you may have with respect to the
application form.
Telephone: 0800 020 1068 (freephone), from abroad: +31 20 524 5765 or +31 20 524 2644
The information desk can be reached on weekdays between 9 and 17 hours CET.
E-mail: info@dnb.nl




                                                                                                  2
 1.         APPLICANT´S PARTICULARS



Applicant (Investor)

If the applicant / investor is a natural person:


 Name

 Initials
                                                                            M /     F
 Date of birth (dd-mm-yyyy)

 Burger Service Nummer (BSN) or
 similar foreign number

 Address

 Postal code and city

 Country

 Telephone number

 E-mail address

 No. of the bank account for
 payment under the Scheme

 Accountholder’s name

 Bank's name

 IBAN

 BIC

Please note: Every applicant for payment under the Scheme must enclose an authorised copy of his or
her valid identity document.




                                                                                              3
If you apply as an investor’s (legal) representative:

If you act on behalf of an applicant (e.g. as their authorised or legal representative), you must provide
your own particulars below.



 Name

 Initials
                                                                                         M / F
 Date of birth (dd-mm-yyyy)

 Address

 Postal code and city

 Country

 Telephone number

 E-mail address

 Power to act                     I am applying in my capacity as:

                                       - administrator

                                       - receiver

                                        - authorised representative

                                        - guardian; or

                                        - other (viz.:)




Please note: As the representative of the investor you must enclose:
-    an authorised copy of the valid identity document of the represented investor.
-    an authorised copy of the document showing the representative power, and
-    an authorised copy of your own identity document.




                                                                                                    4
If the applicant is a legal person or partnership:


 Name

 Address

 Postcode

 City of registered office

 Country

 Legal form

 Registered with Chamber of
 Commerce in

 Trade Register number

 Please describe: activities, control
 structure and ultimate beneficial
 owner (UBO)

 E-mail address

 No. of applicant entity’s bank account
 for payment under the Scheme

 Accountholder’s name

 Bank's name

 IBAN

 BIC

Please note: The authorised representative of the legal person / partnership must enclose an authorised
copy of his or her valid identity document. Finally, an authorised copy of the ultimate beneficial
owner’s valid identity document must also be enclosed.

Please note: A legal entity / partnership registered with a Chamber of Commerce in the Netherlands
must enclose a recent, original extract from the Trade Register.
A legal entity or partnership registered with a foreign chamber of commerce must supply adequate
documentation proving the legal form, name, address and legal representatives’ particulars, such as
authorised copies of Articles of Association, other founding documents and/or registration documents.




                                                                                                 5
Legal representative 1 (name)

Title/function

Legal representative 2 (name)

Title/function




                                6
2.       TERMS OF THE INVESTOR COMPENSATION SCHEME


Pursuant to the Wft and the Decree, only certain categories of investors qualify for payment under the
Scheme. Before answering the statements in this Section, you should carefully read the relevant
explanatory notes. We point out that the statements below are intended only to help investors to
ascertain whether they fall inside the scope of the Scheme and as such may qualify for payment.


Note, moreover, that the Scheme is emphatically not intended to compensate losses ensuing from
portfolio investments or associated with claims relating to performance under asset management
agreements.
Kindly indicate, for each of the statements below, whether it is 'True' or 'False'.

     1   You are acting in a professional or institutional capacity, as on behalf of a        True / False
         bank, pension fund, investment firm or insurer, or acting for the account of a
         party who holds such a capacity.

     2   The funds and/or securities owed to you by SGPF are not registered in your           True / False
         name but in the name of someone else, or are not registered at all, and you
         do not represent the applicant.

     3   The balance in your account proceeds from a transaction which led to                 True / False
         your conviction for money laundering.

     4   You are acting on behalf of, for the account of or in the capacity of a              True / False
         government body.

     5   You were or are (i) a director of SGPF or one of SGPF’s group companies,             True / False
         or (ii) a shareholder holding a 5 per cent or larger share in SGPF or one of
         SGPF’s group companies.

     6   You are a close relative (naaste verwant) of a person or persons referred to         True / False
         under 5. above or you are acting for the account of such a close relative.
         Close relatives, for the present purpose, are defined as relatives in the first or
         second degree and their spouses or registered partners (geregistreerde
         partners).

     7   The legal person, partnership or other entity you represent satisfied at least       True / False
         two of the following criteria on two successive balance sheet dates: (i) a
         balance sheet total in excess of EUR 4.4 million; (ii) a net turnover in
         excess of EUR 8.8 million; or (iii) more than 50 employees, on average,
         across its financial year.




                                                                                                     7
If you answered 'True' to one or more of the statements above, you will in all probability be excluded
from payment under the Scheme. Should you require verification, please refer to Annex A to the
Decree (included in the appended explanatory notes) which lists investors excluded from the scope of
the Scheme.




                                                                                                 8
3.   CLAIMS UNDER THE INVESTOR COMPENSATION SCHEME
BELEGGINGSVERRICHTINGEN


SGPF may have acted as asset manager on your behalf. You should enclose the original client
agreement and asset management agreement between SGPF and yourself (applicant) with your
application.


Kindly state, in Tables (1) and (2) below, your claims on SGPF in respect of investment operations as
per 7 October 2005.


You must supply evidence of all such claims. Such evidence includes, among other things, original
documents received by you from SGPF or from the liquidator or receiver of SGPF. Enclosed
documents should be marked with sequential numbers, to which you may refer in the tables below.


If you need more space to describe your relevant claims properly in either of the tables below, please
continue on a separate sheet of paper, maintaining the layout and order of the respective table.

(1)     Securities claims in respect of investment operations

 Reference        Investor’s name (and the names of any   Name and type of security   Number   Security’s
 number of        other investors holding claims in                                            value as per
 enclosed         respect of the same investment                                               1 July 2009
 document         operation)




                                                                                                        9
(2)        Cash claims in respect of investment operations

      Reference number of    Investor’s name (and the names of any other       Currency    Amount
      enclosed document      investors holding claims in respect of the same
                             investment operation)




In principle, all claims in respect of certain cash balances and financial instruments held on your behalf
by SGPF in connection with investment operations, after netting against any debts you owe to SGPF,
qualify for compensation under the Scheme to a maximum of EUR 20,000.


After the cancellation by the AFM of the licence held by SGPF, Mr Lori, solicitor in Milan
(hereinafter: the liquidator), was appointed by the AFM, under Section 19 of the Wet toezicht
effectenverkeer 1995 [Act on the Supervision of the Securities Trade 1995], to liquidate all current
agreements that SGPF had entered into up to the date the cancellation of SGPF’s licence was
announced by the AFM. Kindly state below the amounts received by you from the liquidator. With
respect to such payments you should also enclose the relevant original documents with your
application.


 Amounts received from the liquidator:


 Date:                                       Amount:




                                                                                                  10
In the space below, please add any comments you wish to make to your claims on SGPF in respect of
certain cash balances and financial instruments held on your behalf by SGPF in connection with
investment operations.




                                                                                             11
  4.        DEBTS OWED BY THE INVESTOR TO ST. GEORGE PRIVATE FINANCE B.V.


Pursuant to the Wft and the Decree, claims on SGPF stated by you in section 3 above must be netted
against, among other things, any debts you may owe to SGPF. Such debts might, for instance, be
denominated in cash or in securities. In the table below, please state any debts you owed to SGPF on 7
October 2005.


The list of debts you owe to SGPF may be corroborated by e.g. enclosure of original documents
which you have received from SGPF, or its liquidator or receiver, testifying to the debts you owe to
SGPF. Enclosed documents should be marked with sequential numbers, to which you may refer in the
table below.

Debts to SGPF may, of course, be owed jointly with others. In such cases, please state the entire
amount owed plus, the names of the other relevant debtors.


 Reference number   Description (including reference to the numbers of   Debt in cash or financial instruments
 of enclosed        relevant enclosed documents)
 document




                                                                                                             12
Below, please add any comment on the debt(s) you owe to SGPF.




                                                                13
5.      INVESTOR´S DECLARATION CONCERNING THE APPLICATION FOR
        COMPENSATION UNDER THE SCHEME



The investor hereby declares without restraint or reserve that:


1.      He does not fall into any of the categories of persons referred to in Annex A to the Decree (see
        the Annex) and that his claims on SGPF stated in Section 3 above are therefore not excluded
        from compensation under the Scheme.


2.      He had, as per 7 October 2005, the claim(s) on SGPF stated in Section 3 above.


3.      He has received the amounts stated in Section 3 above from the liquidator of SGPF.


4.      As per 7 October 2005, he owed the debts stated in Section 4 above to SGPF.


5.      He has taken due note, to the extent relevant, of the subrogation under Section 3:261(3) of the
        Wft, by virtue of which his claim(s) on SGPF – as apparent from the records of SGPF – will
        pass to DNB up to the amount disbursed to him by DNB under the Scheme.


6.      He agrees to transfer these claim(s) on SGPF, to the extent that the claims have not passed to
        DNB by virtue of subrogation, and up to the amount that will be disbursed to him by DNB
        under the Scheme, to DNB by means of assignment against payment by DNB to him of the
        said amount disbursed, under the express condition that, to the extent necessary, this payment
        by DNB shall not constitute full or partial discharge of his claim(s) on SGPF, but shall
        constitute the purchasing price in the sale by him of his claim(s) on SGPF to DNB.


7.      He hereby assigns to DNB his claim(s) on SGPF, up to the amount which he will have
        received from DNB in payment for such claim(s) under the Scheme, to the extent that such
        claim(s) has (have) not already been passed to DNB by virtue of the aforementioned
        subrogation, which assignment DNB hereby accepts and undertakes to bring to the notice of
        SGPF or, respectively, the receiver in the bankruptcy of SGPF, on behalf of both DNB and the
        investor, and whose legal basis is the agreement stated in paragraph 6. above of this
        declaration.




                                                                                                   14
8.      He has been notified of the fact that if he applies for compensation under the Scheme
        after the receiver in the bankruptcy of SGPF has determined or paid a percentage on the
        claims, DNB reserves the right to reduce and if necessary to reclaim the compensation
        under the Scheme by an amount equal to the advantage he has vis-à-vis the accountholder
        who receives compensation from DNB prior to the determination or payment of (a
        percentage of) claims by order of the receiver in the bankruptcy of SGPF.


9.      That the subrogation and assignment referred to above shall be subject to Dutch law and that
        any disputes regarding the passing of claims will be put before a competent court of law in
        Amsterdam. If the validity and enforceability of the said subrogation or assignment in any
        foreign jurisdiction requires the investor to fulfil additional formalities or perform additional
        acts, the investor hereby states his preparedness to do so at the first request of DNB.


10.     He will not invoke any claims, or avail himself of any rights or reservations related thereto, vis-
        à-vis SGPF or any third party, to the extent that these have been transferred to DNB under the
        aforementioned subrogation or assignment.


11.     His claim(s) on SGPF does/do not ensue from a transaction or transactions that are associated
        in any way with money laundering or terrorist financing or in connection with which he has
        been found guilty of money laundering or terrorist financing.


12.     That he has completed this form fully and truthfully and is aware that failure to do so will lead
        to his disqualification for payment under the Scheme or to reclamation of any sum or sums
        thus paid.


13.     That he will, without delay, report to DNB any and all facts and/or circumstances which shall
        cause any statement in paragraphs 1 to 12 above of this declaration to be no longer true.



On the basis of this application form, the investor hereby requests DNB to be designated as eligible for
payment under the Scheme in respect of SGPF, and for such payment to be remitted to the account
number given above.




                                                                                                   15
In the case of a natural person:


 Signed at:                                                             , on (date as dd-mm-yyyy):




 Applicant’s name



 Signature




In the case of (legal) representation or legal entities/partnerships:


 Signed at:                                                             , on (date as dd-mm-yyyy):




 Name of authorised representative # 1



 Signature




 Name of authorised representative # 2



 Signature




                                                                                             16
Submitting the application form
Please sign the complete application form (i.e. pages 1–17) and send it, along with the requisite
annexes, by post alone (i.e. not by e-mail or fax) using the enclosed return envelope (fully to
be paid by you) to DNB.


You are advised that enclosed statements of account or other documents evidencing your claims and
debts should be originals. Please take care to keep copies for your own administration.
DNB will not return original documents, regardless of whether or not payment under the Scheme is
effected.




                                                                                                    17
EXPLANATORY NOTES TO THE APPLICATION FORM
 FOR COMPENSATION TO CLIENTS OF ST. GEORGE
  PRIVATE FINANCE B.V. UNDER THE INVESTOR
           COMPENSATION SCHEME




                                             18
 EXPLANATORY NOTES PER SECTION OF THE APPLICATION FORM
 AANVRAAGFORMULIER
These notes provide a section-by-section explanation of the application form for compensation to
clients of St. George Private Finance B.V under the Investor Compensation Scheme. Should you have
any questions after reading the explanatory notes, please contact DNB’s Information Desk via
telephone number 0800 020 1068 (freephone), from abroad: + 31 20 524 5765 or +31 20 524 2644 or
by e-mail: info@dnb.nl.


These explanatory notes are a constituent part of the application form. The application form and the
explanatory notes are meant to be read in conjunction. The application form and the explanatory notes
to it do not confer any rights. Applications will be assessed pursuant to and with due regard to the Wft
and the Decree.


You are advised that any payment to you under the Investors Compensation Scheme (hereinafter: the
Scheme) will be deducted from the claim you may lodge with the receivers in the bankruptcy of St.
George Private Finance B.V. (SGPF), Rotterdam.



 EXPLANATORY NOTE TO SECTION 1


The applicant should enclose an authorised copy of his or her identity document (passport, driving
licence issued in a Member State of the European Union or identity card issued in a Member State of
the European Union) with the application. In the Netherlands you may have a copy authorised at your
local town or city hall or by a public notary (notaris). Outside of the Netherlands you can have a copy
authorised by a notary or by the authority which issued the identity document.
Please note: Applications arriving without an authorised copy of the applicant's proof of identity cannot
be considered by DNB.


The following is important if the investor is a legal entity or partnership.
A legal entity or partnership registered with a Chamber of Commerce in the Netherlands must
enclose a recent, original extract from the Trade Register. A legal entity or partnership registered
with a foreign chamber of commerce must supply adequate documentation proving the legal
form, name, address and legal representatives’ particulars, such as authorised copies of Articles of
Association, other founding documents and registration documents. In addition, the application
from a legal entity should be accompanied by an authorised copy of the identity document of the




                                                                                                  19
ultimate beneficial owner. In this context, the ultimate beneficial owner should be understood to
mean: a natural person holding more than 25 per cent of the equity capital, or carrying more than
25 per cent of the voting rights at the shareholders meeting, or the beneficiary of 25 per cent or
more of the assets of a foundation or a trust as referred to in the Convention on the Law
Applicable to Trusts and on their Recognition (Trb. 1985, 141).


In the case of a claim arising from an investment transaction for the account of two or more persons,
each investor must submit a separate application form. If more than one person lays claim to
compensation in respect of a claim arising from an investment transaction for the account of two or
more persons, this should be evidenced by the client agreement or the asset management agreement,
the original copy of which should be enclosed with the application form.


If you apply for payment on behalf of someone else, you must provide your own personal data, in
addition to the personal data on the investor you represent. You may represent an investor in the
capacity of, for instance, a guardian or an administrator. You must also provide an authorised copy of
the document proving that you have authority to represent the investor. Furthermore, authorised
representatives must enclose an authorised copy of their identity document with the application form, in
addition to the authorised copy of the investor's proof of identity. In the Netherlands you may have a
copy authorised at your local town or city hall or by a public notary (notaris). Outside of the
Netherlands you can have a copy authorised by a notary or by the authority which issued the identity
document.


Please note: Payment under the Scheme may only be remitted to a current account with a bank
established within the European Union or the European branch of a bank established outside the
European Union. Along with your account number and the name of the account holder, you must state
the IBAN number and the BIC code on the form. These can be found on your bank statement.




                                                                                                     20
 EXPLANATORY NOTE TO SECTION 2



Only certain categories of investors are eligible for compensation under the Scheme. Briefly put, they
include certain private persons, foundations or associations and small enterprises. Compensation under
the Scheme relates to the funds or financial instruments held for them by SGPF itself in relation to
investment services. The Scheme is expressly not intended for losses on portfolio investments or for
losses on shares in SGPF. Nor is the Scheme intended for compensation of claims relating to
performance under asset management agreements.


Annex A to the Decree sets out which categories of investors are in any case not eligible for
compensation under the Scheme. Examples of such excluded classes are professional or institutional
investors such as banks, pension funds, insurance companies and investment firms, but also persons
(formerly) involved in SGPF such as directors, certain shareholders, and their close relatives.
Enterprises that do not qualify for publication of an abridged balance sheet are also excluded from
payment under the Scheme. To qualify for publication of an abridged balance sheet, enterprises must
meet two or more of the following conditions on two successive balance sheet dates: (i) the value of
the assets according to the balance sheet with notes amounts, on the basis of the acquisition price and
the manufacturing price, to no more than EUR 4.4 million; (ii) the net turnover over its financial year
amounts to no more than EUR 8.8 million; (iii) the average number of employees over its financial
year is less than 50.


Please note: Section 2 is exclusively intended to help investors to ascertain whether they come within
the scope of the Scheme and thus possibly qualify for compensation under the Scheme. If you
answered 'True' to any of the statements in Section 2, you will in all probability be excluded from
payment under the Scheme. However, it is up to investors themselves to ascertain whether they fall
outside the classes listed in Annex A to the Decree. Annex A is included as an annex to these
explanatory notes.




                                                                                                  21
 EXPLANATORY NOTE TO SECTION 3


Under the Scheme, former investors of SGPF may submit claims arising from funds or financial
instruments held for them by SGPF in relation to investment services. Section 3 deals with the
investors’ claims.


Investors and SGPF
SGPF may have been acting for you as asset manager. The signed client agreement and asset
management agreement concluded between you and SGPF should be enclosed with the application
form.
Investors who entrusted SGPF with the management of their assets may be owed funds or certain
securities (such as shares or bonds) by SGPF itself.
The Scheme does not cover claims arising from funds or securities administered by SGPF, but which
you are or were owed from an organisation other than SGPF because the funds or securities were or are
held by you at that other institution.


What claims from investors arising from investment services do come within the scope of the Scheme?
Which investors’ claims actually do come within the scope of the Scheme? Claims from investors
arising from certain funds or securities held for them in connection with investment services fall into
two categories:
(1)     claims in respect of obligations of SGPF to repay funds belonging to investors and held on
        their behalf in connection with investment services. These could, for example, be funds
        transferred to an account with the clear purpose of buying securities in the securities markets or
        dividends received by SGPF but not yet passed on to you;
(2)     claims relating to an obligation by SGPF to return securities which are held by SGPF itself for
        an investor in connection with investment services. If the obligation on SGPF concerns the
        return of securities, it should be clear that DNB will not be able to make a payment in the form
        of securities. Instead, any payment under the Scheme in respect of such obligations will be
        based on such securities' market value as per 1 July 1009.


For the sake of brevity, the claims described under (1) and (2) above will hereinafter be referred to as
'claims arising from investment services'. A condition for a (partial) payment of these claims under the
Scheme is obviously that SGPF itself was bound to fulfil these obligations under the applicable legal
and contractual conditions and that this fulfilment has for the moment became impossible because of




                                                                                                  22
its bankruptcy. The maximum amount that DNB pays out to investors under the Scheme on the basis
of claims arising from investment services is EUR 20.000.


What you should fill in under Section 3
In the Section 4 tables you are asked to give an overview of all that the investor is owed in claims
arising from investment services by SGPF. Due care should be taken to ensure that the listing
represents the situation at the moment SGPF's licence was withdrawn on 7 October 2005.


The investor should submit as much evidence of possible of his existing claims on SGPF arising from
investment services. Such evidence may include a statement of net assets, securities account
statements, broker's contract notes or remittance orders, or an original listing - as may be sent to
investors by the liquidator or receiver of SGPF - of your claims and liabilities, including claims ensuing
from funds and certain securities held for you in connection with investment services and claims in
respect of certain securities. If you have been sent such a listing by the liquidator or receiver, you
should enclose it with the application form. Should you receive such a listing after submission of this
application form, we request that you send it on to DNB immediately upon receipt.


Pursuant to the Wft and the Decree, DNB values securities at their value on the day on which SGPF’s
inability to pay was established (1 July 2009). You must enclose original documents showing the value
of the relevant securities as on 1 July 2009.


You must also list the amounts you have received from the liquidator, enclosing as much original
documentary evidence as possible.


Statements or other documents evidencing claims arising from investment services and the amounts
received from the liquidator must be originals. Please keep copies for your own administration. DNB
will not return original documents, regardless of whether or not payment under the Scheme is effected.




                                                                                                    23
 EXPLANATORY NOTES TO SECTION 4



Any compensation of an investor will be calculated on the basis of his claims settled with any
liabilities that the investor still owes to SGPF. In section 4, the investor must list his liabilities to
SGPF as at 7 October 2005. Such liabilities may be debts based on loans allowed or granted by
SGOF, debts arising from specific financial instruments described in the Wft or fees due for asset
management services already performed by SGPF.
You are requested to elucidate the listing of your liabilities to SGPF with explanatory notes and with as
much documentation as possible. Such evidence might include account statements or an original listing
of claims and liabilities as may be sent to investors by the receiver of SGPF. If you have received such
a listing from the liquidator or receiver, you are requested to enclose it with the completed application
form to be submitted by you to DNB. Should you receive such a listing from the receiver after
submitting this application form, you are requested to send this listing to DNB immediately upon
receipt.
In determining the compensation under the Scheme, DNB will deduct the applicant's claims on
SGPF from any remaining liabilities of the applicant to SGPF.
This means that in determining the compensation under the Scheme, DNB will assume that, to the
extent applicable, the applicant will, for all his claims on SGPF’s estate, use all available legal
options of appeal to settlement thereof with all of his eligible liabilities. Only the net claim
remaining on (the estate of) SGPF upon that settlement will be eligible as basis for determining
compensation under the Scheme. To leave no doubt: despite the settlement principle observed by
DNB for application of the Scheme, the applicant himself must appeal to (the receiver of) SFPF
for settlement, if necessary.




                                                                                                        24
 EXPLANATORY NOTES TO SECTION 5


In Section 5 of the application form you are requested to sign the application. You thus also sign the
statements entered in Section 5. These statements have regard to the answers to the questions asked in
Section 1 - 4 and the following explanatory notes.


Subrogation and assignment
The statements serve a number of objectives. Under the Wft, DNB subrogates to the rights of the
claimant vis-à-vis SGPF (maximally) up to the amount of the compensation to be paid by DNB under
the scheme. The payment and the related transfer to DNB of (part of) your claim(s) on SGPF, up to the
amount paid under the Scheme, is called subrogation (subrogatie). Upon assuming these claims, DNB
will attempt to receive payment of the amounts from (the receiver of) SGPF. By means of the
statement in subsection 5 of section 5 of the application form, you acknowledge, insofar as necessary,
that you are aware of the subrogation described above. To put it plainly, you will not be able to lodge
another claim (with the receiver of) SGPF in respect of the amount paid under the Scheme. The amount
to be paid out under the Scheme will be deducted from the claim which you must lodge with SGPF or
the receiver in the bankruptcy of SGPF.


To be certain, the application form also provides for the transfer of your claim(s) on SGPF to DNB.
This means that you assign to DNB the part of your claims on SGPF equal to the amount paid by DNB
under the Scheme, to the extent that such claim(s) have not already been transferred by virtue of the
subrogation referred to above, in exchange for the said payment to you by DNB. Thus DNB secures its
power to recover the amount paid to account holders under the Scheme. This transfer of claims is
called assignment. The application form therefore also serves as a deed of assignment.


Concurrence with the bankruptcy proceedings
In addition to the appeal on the Scheme, the investor with SGPF will also lodge a claim with the
receiver of SGPF, if applicable. In such a case, the receiver may pay a percentage of the claim.
The order in which the receiver and DNB pay an investor must have no consequences for the total
amount received by the investor. It should be avoided that an investor benefits financially by
delaying the submission of a request for compensation under the Scheme until after he has
received a percentage of his total claim from the receiver, and, subsequently, by submitting an
application for the remainder. Besides, DNB would be disadvantaged as a result, as it would
subrogate to a claim from which the percentage already paid would be deducted. DNB therefore




                                                                                                   25
reserves the right to curtail the compensation under the Scheme to be paid to investors after the
receiver has determined or paid a percentage of the claims submitted by them within the scope of
the bankruptcy. DNB also reserves the right to proceed to recover the excess amount received, if
necessary. The amount by which compensations to investors are cut or that is recovered will
equal the financial advantages that the investors concerned have vis-à-vis investors who received
compensations from DNB before the receiver in the bankruptcy determined or paid the claims.


Signature
The application form must be signed by either the investor or by his or her authorised representative. It
is prohibited to submit more than one completed application form for compensation under the Scheme.
If several investors are involved in a claim arising from a portfolio investment transaction, they must
each complete an application form. If the investor is a legal person or partnership, the application must
be duly signed according to its official signing powers as recorded in the Trade Register of the
Chamber of Commerce.
Please note: DNB may withhold or recover payment from any investor that submits an incorrect
application, whether intentionally or unintentionally.


Compensation under the Scheme
After DNB receives a duly completed and signed application, every claim in it will be verified against
the administration of SGPF and assessed against the provisions of the Wft and the Decree. DNB will
proceed with due despatch - in principle within three months after receiving the application - to pay out
to the amount due under the Scheme. The maximum disbursement per investor is EUR 20,000.
The three-month term will, of course, be extended with a period equal to the period during which the
investor defaults on providing the supplementary information or evidence requested by DNB.
Applications for compensation received by DNB after 6 January 2010 will not be considered.




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Questions?
For questions or further information you may contact DNB’s Information Desk via telephone number
0800 020 1068 (freephone) or, if you telephone from abroad, + 31 20 524 5765 or +31 20 524 2644 on
business days from 9 to 17 hrs CET, or by e-mail (info@dnb.nl).


A copy of the Decree (including Annex A) is available on DNB’s website (www.dnb.nl) or from
DNB’s Information Desk upon a request in writing or by e-mail.


Submitting the application form
Please sign the completed application form (i.e. pp. 1-17) and send it, along with the requisite annexes,
by post alone (i.e. not by e-mail or fax) using the enclosed return envelope (fully to be paid by you)
to DNB.


Only original copies and other documents of evidence enclosed with the application form will be taken
into consideration. Please take care to keep copies for your own administration. DNB will not return
original documents, regardless of whether or not payment under the Scheme is effected. Submission by
post will be at sender's risk. DNB suggests that you consider sending the application form and the
corresponding annexes by registered post (with acknowledgement for receipt).


Recording of personal data
Personal data furnished by the investor to DNB will be processed within the scope of the execution of
the compensation scheme.



No rights
The application form and the corresponding explanatory notes do not confer any rights.




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ANNEX A, PERTAINING TO SECTION 9 OF THE DECREE ON SPECIAL
PRUDENTIAL MEASURES, INVESTOR COMPENSATION AND DEPOSIT
GUARANTEES UNDER THE WFT




Categories of persons whose claims fall beyond the scope of this decree


1. Any investor whose claim ensues from a transaction in respect of which a criminal
    sentence for money laundering has been passed;
2. Professional investors and professional market parties.
3. Persons who:
       a. are also a director, administrator, or jointly and severally liable partner of the
            financial undertaking that is unable to pay;
        b. hold at least a five percent share in the capital of the financial undertaking that is
            unable to pay; or
        c. have control comparable with (b) in other enterprises in the same group as the
            financial undertaking that is unable to pay.
4. Close relatives of the persons referred to under (3) above and third parties acting for the
    account of all such persons. Close relatives, for the present purpose, are defined as
    relatives in the first degree, as well as their spouses or registered partners (geregistreerde
    partners). With regard to partners, their status as partner of a person as referred to here is
    subject to corroboration by (a) notarial instrument(s), unless they are registered partners;
5. Legal persons that are part of the same group as referred to in Section 24a of Book 2 of
    the Civil Code as the financial undertaking that is unable to pay.
6. Persons that in part caused, or that have benefited from, the financial undertaking’s
    inability to pay..
7. Legal persons that are a financial undertaking of such magnitude that they may not draw
    up an abridged balance sheet in accordance with Article 11 of the Fourth Council
    Directive 78/660/EEC of the Council of the European Communities of 25 July 1978
    based on Article 54(3)(g) of the Treaty on the annual accounts of certain types of
    companies (OJEC L 222).




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