Application Form for Certification of Islamic Funds for Tax Incentive

Appendix 1 APPLICATION FORM FOR CERTIFICATION OF ISLAMIC FUNDS IN RESPECT OF TAX INCENTIVE FOR THE ISLAMIC FUND MANAGEMENT INDUSTRY SECURITIES COMMISSION MALAYSIA 1 APPLICATION FORM FOR CERTIFICATION OF ISLAMIC FUNDS IN RESPECT OF TAX INCENTIVE FOR THE ISLAMIC FUND MANAGEMENT INDUSTRY Name of Applicant: Licensing No: Financial Year End: Year of Assessment: Income Tax Reference No: Name of Contact Person of Applicant: Telephone No: Fax No: E-mail: Kindly provide the list of Islamic funds managed below: No. Name of Fund Please specify if it is a unit trust fund/close-end fund/ exchange traded fund, wholesale fund, Islamic REITS or Islamic business trusts Managing for Local/ Foreign Investors (please specify) If there is insufficient space in the application form to give the required information, the information is to be given in a separate annexure. Please ensure that the following documents are provided with this application form: a) a written declaration to SC by the applicant that the fund management business is carried out in accordance with Shariah principles similar to the one required under section 9.01 of the Islamic Fund Management Guidelines; and

Appendix 1 APPLICATION FORM FOR CERTIFICATION OF ISLAMIC FUNDS IN RESPECT OF TAX INCENTIVE FOR THE ISLAMIC FUND MANAGEMENT INDUSTRY SECURITIES COMMISSION MALAYSIA 2 b) a written confirmation from the appointed Shariah Adviser that the Islamic fund(s) has/have been managed according to Shariah principles. (Kindly list down the Islamic funds managed which have received the approval from the Shariah Adviser in the same letter). a) and b) above are not applicable to fund managers of unit trust funds, close-end funds, exchange-traded funds, wholesale funds, REITS managers of Islamic REITS and trustee-managers of Islamic business trusts. Declaration (the declaration must be signed by the Executive Director and Compliance Officer). i. I hereby certify and declare that all the particulars furnished in this form are true and correct. Signature: Name: Designation: Company Seal or Stamp: Date: ii. I hereby certify and declare that all the particulars furnished in this form are true and correct. Signature: Name: Designation: Company Seal or Stamp: Date: