Step 1 of 6 16% Please provide your Name and Account Number hereFHUT Account Number(Required)Name(Required) Account DetailsType of Account (Select the appropriate Option)(Required)IndividualJointInstitutionTrustAs TrusteeGroup / ClubOtherOther (please specify) Meeting MinutesMax. file size: 200 MB.Please state reason for withdrawal request(Required) Make a Redemption RequestRedemption Request (Select the appropriate option)(Required)Full RedemptionPartial RedemptionAmount ($)Please make redemption payable to(Required) (Refer to Indemnity Clause) Dispatch Details of Redemption Request(Note: Compulsory to provide the bank statement to verify the correct account details.) Bank Account Details Account Name Name of Bank Account No. Branch Actions Edit Delete There are no Entries. Add Entry Maximum number of entries reached. Upload Bank Statement(Required)Accepted file types: jpg, jpeg, png, pdf, Max. file size: 5 MB.Upload Photo ID(Required)Max. file size: 200 MB. Contact DetailsPlease fill in your contact details Telephone (H) Mobile Work Fax Email Actions Edit Delete There are no Entries. Add Entry Maximum number of entries reached. Signature of Unitholders – This Must Be Completed by the Authorized Signatory / (RIES)Signature of Unitholders Name (Unitholder / Trustee / Director) Signature Actions Edit Delete There are no Entries. Add Entry Maximum number of entries reached. INDEMNITY CLAUSEI/We_________, a unit holder and Authorized Trustee/s of theFull Name(Required) FHUT Account No:_________, hereby request for withdrawal to be made payable to____________FHUT Account No:(Required) Payable to:(Required) I/We_________, acknowledge that I/we fully understand the capital loss and the terms and the terms and conditions of my/our withdrawal from our Fijian Holdings Unit Trust investment account during this short-period. I/we have also been well advised by a licensed representative of the capital loss I/we will face if I/we withdraw our investment in less than 3 to 5 years.Full Name(Required) I/We, hereby release from all liability, indemnify and shall keep indemnified FHL, FHUT and FHL Trustee Ltd in respect of any claim of any nature whatsoever at any time made against any one or more of the said entities by any person or entity including but not limited to me/us where such a claim arises out of or is associated with the sale of units and withdrawal of units with Fijian Holding Unit Trust.Consent(Required) I agree to the Indemnity ClauseForm Filled By(Required) I have filled in the form myself. A Customer Service Officer has filled in the form on my behalf. Verified By: Approved By: Unit balance before redemption request Date MM slash DD slash YYYY Number of units redeemed Confirmed exit price/unit Redemption Value Certificate Number and Amount of units redeemed Checking of Signatures Checking for encumbrances New unit balance Date DD slash MM slash YYYY
