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downing structured opportunities vct 1 plc - The Tax Shelter Report

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DOWNING STRUCTURED OPPORTUNITIES VCT 1 PLC<br />

Application Form<br />

Make your cheque or bankers' draft out to "Downing Structured Opportunities VCT 1 <strong>plc</strong> – D Share" and crossed "A/C<br />

Payee only" and return this form as soon as possible to Downing LLP, 10 Lower Grosvenor Place, London SW1W 0EN. <strong>The</strong> closing date for<br />

the 2011/12 Offer will be 3.00 p.m. on Thursday 5 April 2012 and, in respect of the 2012/13 Offer, 5.00 p.m. on Monday 30 April 2012<br />

(unless extended or fully subscribed earlier).<br />

1<br />

Title and name in full<br />

Permanent Address<br />

Existing Downing Managed VCT<br />

shareholder? Y/N<br />

Postcode<br />

Daytime tel<br />

Email<br />

address*<br />

Date of birth<br />

National Insurance No<br />

2<br />

I am applying for D Shares as follows:<br />

2011/12 tax year<br />

£ A<br />

2012/13 tax year<br />

£ B<br />

Total (A + B) £<br />

Min £5,000<br />

C<br />

Or such lesser sum for which this application may be accepted on the Terms and Conditions of Application set out in Part VII of this document.<br />

Please send me a certificate(s) confirming my entitlement to VCT tax reliefs.<br />

BY SIGNING THIS FORM I HEREBY DECLARE THAT: (i) I have had an opportunity to receive the Prospectus dated 31 August 2011 and to read the<br />

terms and conditions of application therein; (ii) I will be the beneficial owner of the D Shares in Downing Structured Opportunities VCT 1 <strong>plc</strong> issued<br />

to me pursuant to the Offers; (iii) to the best of my knowledge and belief, the particulars I have given to Downing Structured Opportunities VCT 1<br />

<strong>plc</strong> are correct; (iv) my subscription comprises the amount set out in box 2C above plus any commission waived or subscribed on my behalf for<br />

extra shares; and (iv) I acknowledge that my application for Shares will be allocated in the manner described under the heading "<strong>The</strong> Offers and<br />

minimum and maximum subscription" in Part I of this document.<br />

*Investors and their advisers are required to provide an email address if they require the receipt of the Application<br />

Form to be acknowledged.<br />

3<br />

HM Revenue and Customs may inspect this application form. It is a serious offence to make a false declaration.<br />

Signature Date / /<br />

Authorised intermediaries should stamp and complete this box<br />

Contact name<br />

Address<br />

Firm name<br />

FSA No.<br />

Email address*<br />

Postcode<br />

Tel.<br />

Due completion of the agent's box indicates that the agent is duly authorised to transact investments of this type under the Financial Services and Markets Act 2000.<br />

For Official Use Only<br />

Money laundering<br />

CHAPS

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