FOR FINANCIAL ADVISERS ONLY

FOR FINANCIAL ADVISERS ONLY

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Collective Investment Account - Appointment for advisory discretionary asset managers

This form is for use by policyholders of a International Portfolio Bond or Collective Bond where:
- the underlying investment choice for the Bond is to be
 a Collective Investment Account on Charge Basis 3 provided by Old Mutual Wealth's platform; and
- the policyholder's financial adviser has been appointed as a Discretionary Asset Manager on an advisory basis by Old Mutual International.

For UK use only.

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Financial Adviser Verification

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