August 2020 GIP Change Consent

First Name*

Surname*

Date of Birth*

Reference (See covering letter or email)*

Please tick ONE of the below statements

I confirm I have read and understood the portfolio booklet dated August 2020. I agree to proceed with LEBC’s advice and for LEBC to make the changes to my investments which are outlined in the portfolio booklet(s):

I do not wish to proceed with all the recommendations outlined in the portfolio booklet(s) dated August 2020. I would like my financial adviser to discuss with me further:

Governed Investment Portfolios - Your Consent is Required

Please tick ONE of the below statements