Application Form

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Before completing and submitting the below application form, please ensure you have read the prospectus. Pay particular attention to the risk factors as set out on page 16 and, if in doubt, consult your Financial Advisor.

If you would prefer to print out the application form:- Word Version | PDF Version

Please note that we will require proofs of identity and will request these on receipt of this application

Section A - Bond Details

Amount to be Invested: (minimum £2000 and increments of £1000)

Bond Term: Three Years

*Amount to be invested: £0-£50k Interest payable to you:12% per annum ( paid quarterly in arrears )
Amount to be invested: £0-£100k Interest payable to you:16% per annum ( paid quarterly in arrears )
Amount to be invested: £100k plus Interest payable to you: 20% ( paid quarterly in arrears )

NB. Where a client tops up an initial investment which takes the overall investment into a higher interest category, he qualifies for the higher interest on the whole of his investment from that date.

Section B – Personal Details

Section C – Banking / Finance Details

All transactions in and out of the bond are undertaken by the trustees, Jade State Wealth Ltd

Bank transfer to: Bond Application Account,
Sort code: 60-24-12, Account Number: 88870421.
IBAN: GB74NWBK60241288870421
Reference: Client Name
Cheques payable to: Jade State Wealth Ltd

How are you depositing funds? (Bank Transfer, Cheque etc..)

Your interest and Capital
Interest and capital is paid by via bank transfer. Please provide the account details where you would like the interest and capital repayments to be made.
Account Name:
Account Number:
Sort Code/IBAN:
Bank Name:


Proof of Identity

Please provide clear colour photographs of two pieces of Identification:
One piece of photo ID, such as a valid passport or driving licence, and One piece to verify address, such as a utility bill or bank statement (within the last 3 months).

Email a scan of this document to, or alternatively, post the completed form to:
Applications Team,
Helandal Ltd,
24 Queen Avenue,
Dale St,
L2 4TZ

Section D: Declarations

I declare that for the purposes of the Financial Services and Markets Act 2000 (Financial Promotion) Order 2005, I am one of the following (please tick)

Please state which applies to you:- High Net Worth Individual, Self-Certified Sophisticated Investor, Everyday Investor, Advised Investor

I understand that this means:
a) I can receive financial promotions that may not have been approved by a person authorised by the Financial Conduct Authority; b) The content of such financial promotions may not conform to rules issued by the Financial Conduct Authority; c) By signing this statement I may lose significant rights; d) I may have no right to complain to either of the following: (i) the Financial Conduct Authority or (ii) the Financial Ombudsman Scheme;(iii) I may have no right to seek compensation from the Financial Services Compensation Scheme.
High Net Worth Individual
• Having an annual income of £100,000 or more during the year immediately preceding the date of self-certification; or
• Having net assets of £250,000 or more - not including a primary residence, rights under an insurance contract or pension or termination benefit
Self-Certified Sophisticated Investor
• Being a member of a network or syndicate of business angels for at least six months before the date of self-certification; or
• Having made more than one investment in an unlisted company in the two years before the date of self-certification; or
• Working in a professional capacity in the private equity sector or financing small and medium enterprises (‘SMEs’) in the two years before the date of self-certification; or
• Having been a director in the two years prior to self-certification of a company with annual turnover of £1 million or more.
Everyday Investor
• in the twelve months preceding, I have not invested more than 10% of my net assets in unlisted shares or unlisted debt securities
• in the twelve months following I will not invest more than 10% of my net assets in unlisted shares or unlisted debt securities.
Advised Investor
• An ‘Advised Investor’ is someone who has an FCA regulated advisor, perhaps an Independent Financial Advisor (IFA), and will receive advice from them about each investment they make.

You hereby confirm as the Lender that: 1. You understand that this is a “direct offer” product and no financial or other advice has been received by you in relation to this offer from Helandal Limited, or your agent. 2. You agree to irrevocably subscribe the sum specified in this application for Bonds to be issued by Helandal Limited (“Helandal”) according to the terms of the information memorandum (the “IM”) relating to the Bonds. 3. The expressions used in this Application shall have the meaning attributed to them in the IM except where the context otherwise requires. 4. You undertake to Helandal that the company may rely on the offer made by you as the Lender to subscribe for the Bonds pursuant to this Application and accordingly that this offer may not be cancelled, rescinded or otherwise revoked after the date of this Application Form. 5. You agree to transfer the bond sum specified in this Agreement to the account of Helandal Holdings (details above) within 7 days of completing this Application 6. You hereby warrant to Helandal that: 6.1 You are either i) a person at least 18 years of age or ii) a SIPP or other pension scheme, charity, trust or company; in either case resident in the UK and with full power and authority to enter this Application 6.2 you are not a US Person, are not receiving the Bonds in the United States, and are not acquiring the Bonds for the account of a US Person; 6.3 you are investing in the Bonds on your own account; 6.4 you have received the IM and are aware of the aims and objectives of Helandal and have relied on the advice of, or have consulted with, your own professional advisers with regard to the tax, legal, financial and other economic considerations related to this subscription to the Bonds; 6.5 you have received and have read and understood the terms of the IM, and particularly the section headed “Risk Factors”, and are aware of the risks attached to investment in the Bonds; 6.6 you recognise that there is no established market for the Bonds, that they cannot be sold or otherwise disposed of except in the manner set out in the IM and that you may have difficulty in obtaining reliable information about their value; 6.7 you have the financial ability to bear the economic risk of investing in the Bonds, have adequate means for providing for your current needs and possible contingencies and have no need for the liquid funds representing your investment in the Bonds; and 6.8 you acknowledge that in making this application you have relied on the information in the IM only and have not relied on any other representation or information. 6.9 you understand that this offer falls outside of the Financial Services and Markets Act 2000 (Financial Promotion) Order 2005. This means that it is not a product which is regulated by the Financial Conduct Authority. 7. You agree that, by executing this Application Form you agree to be bound by the terms of the IM. 8. You agree that this Application Form constitutes an agreement which shall be governed by, and construed in accordance with, the laws of England and Wales, and the appropriate Court of Law in England is to have exclusive jurisdiction in relation to all matters, claims and disputes arising out of or in connection with this Agreement. 9. You acknowledge that you are responsible for submitting a declaration of your investor status, in the form provided and if this declaration is not provided or if Helandal in its absolute discretion deems the Bonds are an unsuitable investment for the Applicant the application will be rejected. 10.You acknowledge that Helandal may in its absolute discretion reject your application in whole or part. 11.You will be responsible for any fees incurred as a result of bank charges for wire transfer payments. 12.You understand that Helandal Holdings Limited will pay gross interest to the Lender and will not be responsible for making any deductions for tax liabilities which may be incurred by the Lender. Helandal Holdings recommend that investors seek their own professional tax advice prior to investing.
Signing this document constitutes a formal application to enter a Bond Agreement with Helandal, I confirm that I have read and understand the above declaration and the Helandal Holdings Property Bond Information Memorandum, and that I understand the risks associated with investing in the bond, as outlined in the Risk Factors section of the Information Memorandum.

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