Application for a Certificate in relation to an Unclassified Fund
This CIF/UCF application form is to be completed in accordance with the requirements of the Collective Investment Funds (Jersey) Law 1988, as amended (the “Law”), and any associated Orders and Regulations.
If more space is needed the answer should be written on a separate sheet of paper with the heading: “Continuation of answer to question _ of this CIF/UCF application form.”
Answers are to be written in black ink in BLOCK CAPITALS or typed.
Section A – The Application
All questions in this section are to be completed by all applicants.
Section A.5: For the purpose of the completion of this form the following definitions will apply:
Single Class Fund: A fund with one class of redeemable units where the assets are held as a single pool.
Multi-class Fund: A fund with more than one class of redeemable units and where the assets are held as a single pool.
Umbrella Fund: A fund with more than one class of redeemable units and where the assets are held separately for each class.
Section B – Details of the Applicant
This Section is to be completed ONCE by each Applicant and all questions are to be completed save that to the extent that answers have already been provided as part of a separate application in accordance with the Financial Services (Jersey) Law 1998, as amended and remain unchanged then please state "As previously advised on [date]" by way of response.
Section B.1: The Commission requires that each holder of a certificate (“Certificate Holder”) nominates only one person as general contact for all correspondence relating to all certificates under the Law granted to the Certificate Holder.
Section B.10: A "Principal Person" is defined in Article 1 of the Law.
Section B.11: A "Key Person" is defined in Article 1 of the Law.
The Commission requires Principal Persons and Key Persons applying for the first time, or those needing to update their information (e.g. adding additional appointments), to do so by completing anelectronicPersonalQuestionnaire(“PQ”)viaitsWeb Portal.
The Commission will no longer accept paper-based PQ or Additional Appointment forms. If you are accessing the Web Portal for the first time you will be required to register before proceeding.
Section C – Details of the AIF (alternative investment fund)
This Section is to be completed in each case where the Applicant is an AIF which intends to:
• be marketed in a Member State of the European Union (“EU”) or other European Economic Area (“EEA”) State to which Directive 2011/61/EU of the European Parliament and of the Council of 8 June 2011 on Alternative Investment Fund Managers (the “Directive”) applies; and
• avail itself of the exemption from the application of the Alternative Investment Funds (Jersey) Regulations 2012 (the “AIF Regulations”) afforded to a Certified Fund under Articles 2 and 4 of the Alternative Investment Funds (Jersey) Order 2013 (the “Order”) and Schedule 2 to the Financial Services (Jersey) Law 1998 as both an AIF and an alternative investment fund manager (“AIFM”) PROVIDED THAT the Commission has granted its prior permission, in writing, for such AIF to be marketed in any Member State of the EU or other EEA State to which the Directive applies.
For the avoidance of doubt, please note that completion of the AIF/EXEMPT notification form is not required in addition to completion (by the Applicant) of Section C of this CIF/UCF application form (Details of the Alternative Investment Fund).
Section D - The Declaration
To be completed by all applicants.
Item (ii), which refers to Section B, should be crossed through only if ALL the required information has previously been given.
Section E - Details of the Fund
This section must be completed ONCE for each fund.
Section F - Details of the Fund
This section must be completed ONCE for each fund. If the fund is an umbrella fund, multiclass or a Protected Cell Company (“PCC”), photocopies should be taken and a separate sheet should be completed in respect of each constituent part of the fund. Alternatively, please provide a schedule with the required information.
Payment of Fees
For this CIF/UCF application form to be valid, the correct fee must accompany each form.
For details of fees payable, see the notice published on the Commission's website in accordance with Article 15 of the Financial Services Commission (Jersey) Law 1998, as amended and Article 7(12) of the Law.
Please pay by cheque and make the cheque payable to the "Jersey Financial Services Commission" and crossed "A/C payee".
Completed Application Forms should be sent to:
The Senior Manager, Funds Authorisation
Jersey Financial Services Commission
PO Box 267,
14-18 Castle Street,
St Helier, Jersey, JE4 8TP
Data Protection (Jersey) Law 2005
Personal data provided to the Commission – a data controller as defined in the Data Protection (Jersey) Law 2005 – will be used by the Commission to discharge its statutory, administrative and operational functions. Further information may be found in the Commission’s Data Protection policy, copies of which are available on request from the Commission and which may also be found on www.jerseyfsc.org.
CIF/UCF June 2015 Page 15 of 16
Section A Details of the Application
A.1 Full Legal Name of Fund:
A.2 Full Legal Name of Applicant:
A.3 Function(s) to be performed by the Applicant for the Fund named above:(Please tick appropriate box(es))
Company Issuing Units / Trustee / General PartnerA.4 Is the Applicant already a holder of a certificate/permit or waiting to be granted a certificate/permit in relation to either an Unclassified or Recognized Fund under the Law?
/ Yes/ No
If yes, the date on which the previous application form was signed (dd/mm/yyyy): / //
Please state the name of the fund for which the previous application was made:
A.5 Please specify if this application is in connection with an umbrella, multi-class fund or PCC: (see notes)
Umbrella: / Multi-class: / PCC:The number of constituent parts of the Fund:
The number of constituent parts that this application relates to:
Section B Details of the Applicant
To the extent that answers have already been provided as part of a separate application in accordance with the Financial Services (Jersey) Law 1998, as amended and remain unchanged then please state "As previously advised on [date]" by way of response.
B.1 Certificate contact name and address for Applicant in relation to any certificates issued: (see notes)
Name:Address:
E-mail address:
Telephone: / Facsimile:
B.2 Is the registered office address different to answer B.1? (If yes, please enter details below)
/ Yes/ No
B.3 Is the principal place of business different to answer B.1?(If yes, please enter details below)
/ Yes/ No
B.4 (a) Country of Incorporation of Applicant:
(b) Date of Incorporation of Applicant:(c) Company Registration Number:
B.5 (a) Ultimate Beneficial Owner of Applicant:
(b) Legal structure of ultimate Beneficial Owner(including partnership/trust etc.)
(c) Country of formation of ultimate Beneficial Owner
(d) Does the Fund issue management shares or similar:
(If yes, please state the name of all legal and ultimate beneficial owners of the management shares) / Yes
/ No
B.6 (a) First accounting date for audited financial statements:
/ //(b) Subsequent accounting date for audited financial statements:
(where different) / //
(c) What accounting standards will be adopted by the Applicant?
B.7 Auditor of Applicant:
Name:Address:
E-mail address:
Telephone: / Facsimile:
B.8 (a) Does the Applicant use, or propose to use a business or trading name different from that given in the answer to A.2?
/ Yes/ No
(b) If yes, please state name:
B.9 (a) Is the Applicant a member, has applied, or intends to apply for membership of any self-regulatory organisation, professional body, investment exchange or clearing house in the UK or overseas?
/ Yes/ No
(b) If yes, please give details
Organisation:
Membership No.: / Date: / //
B.10 Principal Person information, please indicate clearly who from the list of Principal Persons is the Managing Director (see notes). If the Applicant is a PCC, please indicate who the directors are, and of each cell of the PCC. For regulatory purposes, the Commission prefers that the directors of the PCC and the PCs are the same.
Full Name / Capacity in which you act / JerseyResident / Electronic PQ already submitted? / %
Beneficial Ownership /
Please chooseDirector - AlternateDirector - ExecutiveDirector - InfluentialDirector - ManagingDirector - Non-ExecutiveShareholder ControllerSpan of Control / Yes/NoYesNo / Yes/NoYesNo
Please chooseDirector - AlternateDirector - ExecutiveDirector - InfluentialDirector - ManagingDirector - Non-ExecutiveShareholder ControllerSpan of Control / Yes/NoYesNo / Yes/NoYesNo
Please chooseDirector - AlternateDirector - ExecutiveDirector - InfluentialDirector - ManagingDirector - Non-ExecutiveShareholder ControllerSpan of Control / Yes/NoYesNo / Yes/NoYesNo
Please chooseDirector - AlternateDirector - ExecutiveDirector - InfluentialDirector - ManagingDirector - Non-ExecutiveShareholder ControllerSpan of Control / Yes/NoYesNo / Yes/NoYesNo
Please chooseDirector - AlternateDirector - ExecutiveDirector - InfluentialDirector - ManagingDirector - Non-ExecutiveShareholder ControllerSpan of Control / Yes/NoYesNo / Yes/NoYesNo
Please chooseDirector - AlternateDirector - ExecutiveDirector - InfluentialDirector - ManagingDirector - Non-ExecutiveShareholder ControllerSpan of Control / Yes/NoYesNo / Yes/NoYesNo
B.11 Key Person Information of the Fund, if there is a change of the Key Persons of the Trustee or the General Partner, please advise separately.
Please state the name of the Fund’s Compliance Officer:Please state the e-mail address of the Compliance Officer:
PQ already submitted? / Yes
/ No
Please state the name of the Fund’s Money Laundering Reporting Officer:
Please state the e-mail address of the Money Laundering Reporting Officer:
PQ already submitted? / Yes
/ No
Please state the name of the Fund’s Money Laundering Compliance Officer:
Please state the e-mail address of the Money Laundering Compliance Officer:
PQ already submitted? / Yes
/ No
B.12 Where the Fund is currently an unregulated fund within the meaning of the Collective Investment Funds (Unregulated Funds) (Jersey) Order 2008, please confirm that, subject to the grant of a certificate under the Law to the Applicant by the Commission, that the list of unregulated funds may be updated by removal of reference to the Fund.
/ YesCIF/UCF June 2015 Page 15 of 16
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Section C Details of the Alternative Investment Fund (the “AIF”)
C.1 For information purposes only, please indicate the EU Member State(s) and/or other EEA State(s) in which the Applicant intends to market subject to the Commission’s prior approval.
(Please refer to the Commission’s Website for the list of EU/EEA States with which the Commission has signed the required bilateral cooperation agreement.)CIF/UCF June 2015 Page 15 of 16
AustriaBelgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
Lithuania
Luxembourg
Malta
Norway
Poland
Portugal
Romania
Slovak Republic
Slovenia
Spain
Sweden
The Netherlands
United Kingdom
Any of the above
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C.2 (a) Will the Applicant be relying upon any transitional arrangement(s) adopted by any EU Member State and/or other EEA State to which the Directive applies and under which the Fund is marketed (“Transitional Arrangements”) which would operate to exclude the Applicant from the scope of Jersey’s AIFMD regime up until the expiry of the first of any such Transitional Arrangements?
/ Yes / No(b) If so, please confirm on what date will the first of any such Transitional Arrangements expire? / //
C.3 If the answer to A.3 is Company Issuing Units, will the Applicant be a self-managed AIF (i.e. managed internally by its board of directors) also making the Applicant an Alternative Investment Fund Manager (the “AIFM”) (within the meaning of the Directive)?
/ Yes / NoC.4 Unless the Applicant has confirmed in the answer to C.3 that it will be a self-managed AIF please state the full name and registered office of the AIFM.
Name of AIFM:Registered office:
C.5 For the purpose of compliance with the Codes of Practice for Alternative Investment Funds and AIF Services Business (the “AIF Codes”), will the Applicant be subject to the sub-threshold provisions, the private placement rules or full compliance for passporting purposes?
Sub-Threshold Provisions: / Private Placement Rules: / Full Compliance:It is important to note that a Jersey self-managed AIF that is a Certified Fund MUST comply with the applicable sections of the AIF Codes relating to it in its capacity as both an AIF and an AIFM.
The requirements of any EU Member State or other EEA State to which the Directive applies should be considered separately by the Applicant and, to the extent applicable, complied with in addition to the requirements of the AIF Codes.
C.6 Where the Applicant has appointed an AIFM which is authorised or registered in an EU Member State and/or other EEA State, please state the full name and registered office of the depositary appointed.
Name of Depository:Registered office:
C.7 In respect of a depositary referred to in C.6 which is established in Jersey, please tick the relevant box to indicate whether the services to be provided by such depositary shall be performed:
In full compliance with Article 21 of the Directive:In accordance with Article 36 of the Directive:
In accordance with Article 21 and Recital 34 of the Directive (a private equity/real estate depositary for closed-ended funds):
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Section D Declaration (see notes)
The Applicant is required to notify the Commission immediately of:
(a) any other information which it considers relevant to this application; and
(b) any significant changes in the information provided in this application which occur after the date of submission of the application and prior to the Applicant receiving notification of the Commission’s decision concerning the application.