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Applicant Details Applicant Full Name *required Applicant Full Name is required Applicant Firm (if applicable) Address Phone Email *required Email is required Trust to be known as (Name of Trust) *required Trust to be known as (Name of Trust) is required Settlement Sum Settlor Settlor Full Name Settlor Address Trustees Number of Individual Trustees 0 1 2 3 4 5 Full Name (First Trustee) Address (First Trustee) Full Name (Second Trustee) Address (Second Trustee) Full Name (Third Trustee) Address (Third Trustee) Full Name (​Fourth Trustee) Address (Fourth Trustee) Full Name (Fifth Trustee) Address (Fifth Trustee) Is there a Corporate Trustee? Yes No Company Name A.C.N. Registered Office Address Specified Beneficiaries Number of Specified Beneficiaries 1 2 3 4 5 Full Name (First Beneficiary) Address (First Beneficiary) Full Name (Second Beneficiary) Address (Second Beneficiary) Full Name (Third Beneficiary) Address (Third Beneficiary) Full Name (Fourth Beneficiary) Address (Fourth Beneficiary) Full Name (Fifth Beneficiary) Address (Fifth Beneficiary) Appointors Number of Appointors 1 2 3 4 5 Full Name (First Appointor) Address (First Appointor) Full Name (Second Appointor) Address (Second Appointor) Full Name (Third Appointor) Address (Third Appointor) Full Name (Fourth Appointor) Address (Fourth Appointor) Full Name (Fifth Appointor) Address (Fifth Appointor) Additional information that you would like to advise us Payment Details Direct Deposit Yes Credit Card Yes One of our team members will contact you upon receipt of your application to discuss payment. Submit