| Document Date: 2014-06-11 20:35:43
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Company Perpetual Pure Value Share Fund Perpetual Investment Management Limited / / Country Australia / United States / / / Facility facility Investor Online Account Access / / IndustryTerm Online Account Access Note / bank account / dealer / Online Account Access / / Organization Perpetual’s Investor Service Centre / Pure Value Share Fund / Perpetual Pure Value Share Fund / / Person Note / Complete / / / Position attorney / financial adviser / financial advisor / representative / attorney / the attorney / dealer / co-operative / officer / authorised representative / Adviser / / URL www.perpetual.com.au / /
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Perpetual Pure Value Share Fund Perpetual Investment Management Limited ABN[removed]AFSL[removed]Change of instructions form Please complete this form in black ink using BLOCK letters.