VIP Fixed Term Portfolio Order Form

VIP participants may submit this form to indicate their intent to invest in VIP Fixed Term Portfolios. Upon receipt, VIP staff will contact an authorized signer to verbally confirm the order. Participants will then receive an email order confirmation for their records. Important: Fixed Term Portfolios are intended to be held until maturity. Withdrawals prior to the planned redemption date (maturity) would incur an early redemption penalty and the redemption value may be reduced further by losses incurred by the series, if any. Further details about the Fixed Term Portfolio, along with potential risks can be found in the Informational Statement. Past performance is no guarantee of future results. Any financial and/or investment decision may incur losses.

Name(Required)

First Last

Email(Required)

Phone Number(Required)

Required for verbal confirmation of investment

Locality/Account Name(Required)

Please provide the name of your locality/account

VIP Stable NAV Liquidity Pool Account # (please provide the last four digits)(Required)

Funds to be invested in VIP Fixed Term Portfolios will be drawn from the balance in your chosen VIP Stable NAV Liquidity Pool account

3-Month Fixed Term Investment Amount ($)(Required)

Please enter the amount for investment (min $250K per Term). If not investing, enter $0.

6-Month Fixed Term Investment Amount ($)(Required)

Please enter the amount for investment (min $250K per Term). If not investing, enter $0.

9-Month Fixed Term Investment Amount ($)(Required)

Please enter the amount for investment (min $250K per Term). If not investing, enter $0.

12-Month Fixed Term Investment Amount ($)(Required)

Please enter the amount for investment (min $250K per Term). If not investing, enter $0.

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