Introducer registration (Form A)

All introducer activity, marketing and investor communications are subject to the approval and regulatory oversight of Amersham Investment Management Limited (FCA FRN 507460).

01 — Introducer

Company Name * Company Reg Number Principal Contact * Email * Landline Mobile Registered Office Address * Postcode * Trading Address (if different) Trading Postcode

02 — Regulation

Yes — the company is regulated No — acting solely as introducer

Regulatory Status Regulatory Body Licence / Regulatory Number

The company confirms it will act solely as an introducer and will not carry out any regulated activities within the meaning of FSMA 2000.

03 — Introducer status I confirm the introducer will act solely as an introducer of Prospective Clients; will not advise, arrange or execute; will not hold client money; will not represent itself as acting on behalf of AIML or NAHL; and will comply with Form B.

04 — Promotional plans

Are you only promoting products in jurisdictions where you are legally permitted to do so?

Yes No

The Introducer confirms it will not communicate any Financial Promotion in breach of applicable laws, including section 21 of FSMA 2000.

05 — Platforms & promotion types Please list any platforms that you use or want to use

All marketing methods, platforms and communication channels listed above are subject to prior approval by Amersham Investment Management Limited. No marketing activity may be undertaken without such approval.

06 — Data source

Is the data source opt-in?

Yes No

How did you obtain the data?

The Introducer confirms that all personal data has been obtained lawfully, that appropriate consent has been obtained where required, and that such data may be shared with Amersham Investment Management Limited and/or New Amersham Holdings Limited in compliance with applicable data protection laws.

08 — Sub-introducers Yes No Upstream introducer details (if any) All sub-introducers will be contracted using Form B.

09 / 10 / 11 — Compliance & risk confirmations We will not create, amend or distribute marketing without AIML's written approval; we will only use AIML-approved materials; all communications will be fair, clear and not misleading. We will comply with FSMA 2000, FCA rules, the Bribery Act 2010, DPA 2018 / UK GDPR, and all other applicable laws. We acknowledge that the Products may be high risk and illiquid, capital is at risk, and the Products may not be suitable for all investors.

12 — Additional notes

13 — Signature

Name printed * Date *

Supporting documents

Passport / Driving Licence

Utility Bill / Bank Statement (last 3 months)

ICO licence / confirmation

Regulatory licence (if applicable)

Introducer registration (Form A)

Promotion Target (B2B)

Promotion Target (B2C)