PERSONAL DETAILS

We are GDPR compliant (see privacy policy)

We may contact you by phone or email as part of our application process, as permitted by the GDPR.

You can also choose whether to receive our marketing communications, such as newsletters and offers.


INVESTMENT OPTION

3 YEAR TERM
7.9% p.a.
5 YEAR TERM
9.9% p.a.

Interest paid quarterly

How much would you like to invest?

£
Input must be no less than £25,000



Source of Wealth

Please select the appropriate box.



A brief description is also required below:

BANK DETAILS

Please Note:
We do not take funds from your account.
All details are held securely and for interest payments only.

INVESTOR APPLICATION

As a responsible investment company, Blackmore International ensure that investors have suitable knowledge and or experience to proceed with this investment.

Suitability is assessed by reference to your personal and financial circumstances identified by one of the following 4 categories:

Self-Certified Sophisticated

In the last two years, I have invested in more than one company which is not listed on the stock exchange or been a member of an Angel Investment Group for at least six months.



High Net Worth

I earn more than £100,000 annually or I have net assets (i.e. not including your home) with a value of £250,000 or more.



Restricted Investor

I am not investing more than 10% of my net assets.



Sophisticated Investor

I have been certified as a Sophisticated Investor by a suitably qualified and regulated individual..


SUMMARY

PERSONAL DETAILS:


Introducer ID:
Name:
Date of Birth:
Email Address:
Country:
Region:
Current Address:
Postcode/Zip Code:
Mobile Number:

INVESTMENT TYPE:


Application Type:
Investment Type:
Investor Classification:
Investment Amount:
Currency:
Source of Wealth:
Description:

BANK DETAILS:


Bank Name:
Bank Address:
Account Holder's Name:
Account Number:
IBAN:
Swift Code/BIC Code:
Sort Code:

INVESTOR CLASSIFICATION

DECLARATION

1.) I/We are making this investment on the basis of information contained in the Information Memorandum only and not any other information contained in any marketing or promotional material relating to the bond or any other information provided orally or in writing by a third party.


2.) I/We confirm that I am/we are aged 18 years or over. I am/We are fully aware that I/we will need to supply the required information with my/our application.



Signature


Please select how you would like to sign this application.

ANTI-MONEY LAUNDERING REQUIREMENTS
To comply with UK Anti-Money Laundering regulations, we require Proof of Identification and Proof of Address Documents.
Identification:
Please provide a copy of your Passport (clearly showing all of the text on the information page) or National ID Card
(File Types Supported: PDF, JPG, PNG. Max file size : 5MB)

Proof of Source of Funds:
One month’s bank statement for the bank account where funds are coming from.
If funds are coming from a surrendered policy, please provide a copy of the policy by way of statement.
(File Types Supported: PDF, JPG, PNG. Max file size : 5MB)

Proof of Address:
Please Provide one of the following
- Valid Driver’s Licence or National ID Card (with photograph)
- Bank Statement dated within the last 3 months
- Utility Bill dated within the last 3 months (mobile phone bills not accepted)
(File Types Supported: PDF, JPG, PNG. Max file size : 5MB)