Page 1 of 6 187-210108

I the undersigned hereby irrevocably agree to subscribe to the Excelsior 2 Year Growth Bond as set out in Box 1

below and understand the conditions set out in Box’s 1 and 2 below.

I wish to subscribe the amount stated below into the Excelsior 2 Year Growth Bond as I have elected in Box 1

below.

Note: Investments can be made in GB Pounds, US Dollars or Euro (subject to the minimum and maximum permitted investments as in Box 2). Interest and maturity proceeds will be paid in the same currency of the subscription currency. One currency per bond is permitted.

I enclose a cheque or banker’s draft drawn on a UK clearing bank or building society, for the total amount, made payable to Excelsior Worldwide Limited or I have instructed my bank to transfer the total investment amount to account of Excelsior Worldwide Limited

Note: Excelsior Worldwide Limited bank account details are set out on Page 4 and 5 of this Application Form. It is important that the correct bank account number is used for the corresponding currency.

BOX 1

Current Bond Offering: I wish to invest the amount as set out above in the following bond – (please tick the box below): Maximum Term / Interest payable

2 years: 6% per annum Note: If you wish to invest in more than one currency, then a separate application for each currency is required. Each application is subject to the minimum permitted as set out in Box 2.

BOX 2

Type: Fixed Rate Bond Income Interest: Annual All Subscription Minimum : $5,000 / €5,000 / £5,000 All Subscriptions Maximum: $45,000 / €45,000 /

£45,000 Investor Age Limit: 18 – 85 years Frequency of Interest: Interest paid annually in arrears Interest Payment Date: Each year from commencement date Early Redemption: Not permitted

Excelsior 2 Year Growth Bond

Application Form

USD GBP EUR

Page 2 of 6 187-210108

Applicant / Contact Person

Title:

First Name:

Surname:

Maiden/Previous Name:

ID/Passport/Registration/Include Number:

Nationality:

Country of Residence:

Permanent Physical Address:

Postal Code:

Postal Address:

Postal Code:

Email Address:

Telephone (include area codes):

Daytime: Home: Mobile: Fax: Occupation:

Name of Employer/Position in Office:

Nature of business if self-employed:

Source of Funds:

Page 3 of 6 187-210108

Account Holder:

Name of Bank:

Branch Name and Full Address:

Sort Code/Swift Code:

Account Number:

IBAN:

I HEREBY: Confirm that I fully understand the terms and information provided to relating to the Excelsior 2 Year Growth Bond subscribed to herein; Confirm that I have not relied on any document or other information supplied to me by the Excelsior Worldwide Limited or the Directors. Acknowledge that the Excelsior 2 Year Growth Bond issued to me will subject to the Excelsior 2 Year Growth Bond Terms and Conditions and I shall be bound by the terms and conditions accordingly. Agree that, the Excelsior 2 Year Growth Bond application form and the contract created by it are governed by Bahamas Law. I submit to the exclusive jurisdiction of the Bahamas courts in relation to any dispute concerning the Offer or this the Excelsior 2 Year Growth Bond application form.

Investor Banking Details

Bank Details for Maturity & Dividend Purposes Only

Please note that maturity/dividend proceeds will only be made to the bank account of the applicant – it will

not be possible to make any maturity/dividend payments to a third party. Any changes to these banking

details must be notified in writing (not by Fax) to Excelsior Worldwide Limited.

Declaration by Applicant

Page 4 of 6 187-210108

This form can be used to instruct your bankers to transfer funds. Your bankers should always include the reference number in your telegraphic transfer to help avoid delays. Note that we have no control over bank transfers. your bank will levy bank charges, for the telegraphic transfer of funds to the custodian ‘Standard Bank, One Circular Road, Douglas, Isle of Man, IM1 1SB.

Investor Banking Details

Name of Bank:

Account Name: Account Number:

Swift Code: Sort Code:

Currency Amount: USD GBP EUR All charges for

remitter’s account

Please Make Payment to: Excelsior Worldwide Limited

IBAN of the EUR Account: IBAN of the GBP Account: IBAN of the USD Account:

GB59SBIC40485211588772 GB02SBIC40485243048256 GB45SBIC40485243048258

Select (√): Select (√): Select (√):

Note: To prevent delays, it is important that the correct bank account is credited for the currency invested

Clients full name:

Account Number: EUR 11588772 GBP 43048256 USD 43048258

Swift Code: SBICIMDX Sort Code: 40-48-52

Surname/Company/ Bond Name:

Excelsior 2 Year Growth Bond

Initials: Date of Birth

(dd/mm/yyyy):

Existing Investment No. (if applicable):

Company/Bond Reg. No:

Excelsior 2 Year Growth Bond

Foreign Currency Transfer Instruction

Investors should forward this form directly to the Banks and attach a copy to this application form.

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This form can be used to instruct your bankers to transfer funds. Your bankers should always include the reference number in your telegraphic transfer to help avoid delays. Note that we have no control over bank transfers. your bank will levy bank charges, for the telegraphic transfer of funds to the custodian ‘The Siam Commercial Bank Public Company Limited, 32/20 Sino-Thai Tower, Soi Sukhumvit 21 (Asoke), Sukhumvit Road, Khlongtoeynua, Wattana, Bangkok 10110, Thailand.

Investor Banking Details

Name of Bank:

Account Name: Account Number:

Swift Code: Sort Code:

Currency Amount: USD GBP EUR All charges for

remitter’s account

Please Make Payment to: Excelsior Worldwide (Siam) Limited

EUR Bank Account Number: GBP Bank Account Number:

032-200307-8-978 032-200308-6-826

Select (√): Select (√):

USD Bank Account Number:

032-200309-4-840

Select (√):

Note: To prevent delays, it is important that the correct bank account is credited for the currency invested

Clients full name:

Account Number: EUR 032-200307-8-978 GBP 032-200308-6-826 USD 032-200309-4-840

Swift Code: SICOTHBK Sort Code: -

Surname/Company/ Bond Name:

Excelsior 2 Year Growth Bond

Initials: Date of Birth

(dd/mm/yyyy):

Existing Investment No. (if applicable):

Company/Bond Reg. No:

Excelsior 2 Year Growth Bond

Foreign Currency Transfer Instruction

Investors should forward this form directly to the Banks and attach a copy to this application form.

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It is the responsibility of the applicant to ensure they are eligible to invest in this product and by signing this the Excelsior 2 Year Growth Bond application form I hereby irrevocably make all the declarations set out in declaration by applicant of this application form and in witness where of the applicant hereto has executed the Excelsior 2 Year Growth Bond application form as a deed on the date stated below: Signed at (Place) On this the Day of 20

If Signing in as:

Applicant

Witness: Witness Signature: Witness Address:

If Signing on behalf of a:

Applicant

Witness: Witness Signature: Witness Address:

Errors and omissions excepted. Copyright © 2021 by Excelsior Worldwide Ltd. All rights reserved. These documents or any portion thereof may not be reproduced or used in any manner whatsoever without the express written permission of Excelsior Worldwide Ltd 1st Floor, King Court, Bay Street, P.O. Box N-3944, Nassau, Bahamas. enquiries@excelsiorworldwideltd.com www.excelsiorworldwideltd.com

Signature Section

Excelsior Worldwide Limited 1st Floor, Kings Court, Bay Street, PO Box N3944, Nassau, Bahamas

enquiries@excelsiorworldwideltd.com, Fax: +66 2 261 0919

USD: GBP: EUR: Title: First Name: Surname: MaidenPrevious Name: IDPassportRegistrationInclude Number: Nationality: Country of Residence: Permanent Physical Address: Postal Code: Postal Address: Postal Code_2: Email Address: Telephone include area codes: Daytime Home Mobile Fax: Occupation: Name of EmployerPosition in Office: Nature of business if selfemployed: Source of Funds: Account Holder: Name of Bank: Branch Name and Full Address: Sort CodeSwift Code: Account Number: IBAN: Name of Bank_2: Account Name: Account Number_2: Swift Code: Sort Code: To prevent delays it is important that the correct bank account is credited for the currency investedClients full name: Excelsior 2 Year Growth BondInitials: Date of Birth ddmmyyyy: Excelsior 2 Year Growth BondExisting Investment No if applicable: CompanyBond Reg No: Name of Bank_3: Account Name_2: Account Number_4: Swift Code_3: Sort Code_3: To prevent delays it is important that the correct bank account is credited for the currency investedClients full name_2: Excelsior 2 Year Growth BondInitials_2: Date of Birth ddmmyyyy_2: Excelsior 2 Year Growth BondExisting Investment No if applicable_2: CompanyBond Reg No_2: Signed at Place: On this the: Day of: 20: Check Box1: OffCheck Box2: OffCheck Box3: OffText4: Text5: Text6: Text7: Text8: Text9: Check Box10: OffCheck Box11: OffCheck Box12: OffCheck Box13: OffCheck Box14: OffCheck Box15: OffText16: Text17: Text18: Text19: Text20: Text21: Text22: Text23: Text24: