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Change of Address Form This form should be completed in BLOCK capitals using black ink. This form can only be used to advise us of a change of address for the existing Authorised Correspondent. Please request a mandate form if you are registering a new correspondent. CCLA account name Old address Postcode New address With effect from Trustees Authorisation This section must be signed by at least two trustees. Change of Address Form This form should be completed in BLOCK capitals using black ink. This form can only be used to advise us of a change of address for the existing Authorised Correspondent. Please request a mandate form if you are registering a new correspondent. CCLA account name Old address Postcode New address With effect from Trustees Authorisation This section must be signed by at least two trustees. We are authorised to act on the behalf of the charity We have read and understood the contents of the Fund s Scheme Particulars We confirm there are no other changes to the mandate Trustee Details 1. 1 Title Forename Middle name Surname Signature Date of birth Position Daytime telephone number Home address Please continue overleaf Date moved to this address Email address 1. 2 If you have lived at this address for less than three years please provide details of previous address below 1. 3 If you do not want to receive information on CCLA s other products and services please tick here Senator House 85 Queen Victoria Street London EC4V 4ET Freephone 0800 022 3505 CCLA Investment Management Limited Registered in England Number 2183088 is authorised and regulated by the Financial Conduct Authority and is the manager of the COIF Charity Funds Registered Charity Nos. 218873 803610 1046249 1093084 1121433. Data Protection Act 1998 CCLA Investment Management Limited is a data controller within the meaning of the Data Protection Act 1998 and will hold relevant personal details which have been supplied to the manager for the purposes of fulfilling its obligations to clients. Data will be stored by CCLA and treated as confidential* CCLA will not provide details to any other party except where necessary to fulfil the service obligations described or where permitted by law. Please request a mandate form if you are registering a new correspondent. CCLA account name Old address Postcode New address With effect from Trustees Authorisation This section must be signed by at least two trustees. We are authorised to act on the behalf of the charity We have read and understood the contents of the Fund s Scheme Particulars We confirm there are no other changes to the mandate Trustee Details 1. We are authorised to act on the behalf of the charity We have read and understood the contents of the Fund s Scheme Particulars We confirm there are no other changes to the mandate Trustee Details 1. 1 Title Forename Middle name Surname Signature Date of birth Position Daytime telephone number Home address Please continue overleaf Date moved to this address Email address 1.

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