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FORMII5500-version08/2014INDEPENDENTINTERMEDIARY/INTRODUCERAGREEMENT獨立中介/介紹人INDEPENDENTINTERMEDIARY/INTRODUCERAGREEMENTBETWEEN獨立中介/介紹 紹 締結(jié)于INVESTORSTRUSTASSURANCE,SPCofSuite4210,2ndFloorCanellaCourt,CamanacalledITAand(以下簡稱為「ITA」)以及The“INDEPENDENTINTERMEDIARY/INTRODUCER”(ashereinafterdefined)「獨立中介/介紹人」(見內(nèi)文定義INTRODUCERINFORMATION(REQUIRED)1(必填CompleteSection1iftheIntroducerisanIndividualorcompleteSection2iftheIntroducerisanOrganization.1Requireds:AclearcopyofavalidcontainingthesignatureRequireds:Aclearcopyofavalidcontainingthesignatureof(ex: ernmentID,etc)andProofofAddress(ex:UtilityBill,BankStatement,etc.) COUNTRYOFPASSPORT/ID MALEFEMALE公司STATEOREPHONECOUNTRYHOMEEPHONECOUNTRYAREAPHONEAREAPHONEFAXEPHONECOUNTRYBUSINESSEPHONECOUNTRYAREAPHONEAREAPHONEE-YEARSOFINSURANCE STATEORCORRESPONDENCEADDRESS(ifdifferentfromaddress聯(lián)絡(luò)地址(若與以上地址不同MIDDLEFIRST名LAST姓INTRODUCERORGANIZATION介紹企業(yè)團體ThissectionmustbefilledoutiftheIntroducerisanOrganization.BUSINESSSTATEORBUSINESSEPHONEFAXEPHONECOUNTRYAREAPHONECOUNTRYAREAPHONEE-Requireds:Clearcopyofs,clearcopyofavalidofatleasttwoDirectors,ProofofAddress(ex:UtilityBill,BankStatement,etc)forOrganizationRequireds:Clearcopyofs,clearcopyofavalidofatleasttwoDirectors,ProofofAddress(ex:UtilityBill,BankStatement,etc)forOrganizationnomorethan3months ORGANIZATIONSTATEORCORRESPONDENCEADDRESS(ifdifferentfromaddress聯(lián)絡(luò)地址(若與以上地址不同YEARSOFINSURANCE NATUREOFCOUNTRYOFusedthroughoutthisAgreement.AllreferencesinthisAgreement,however,to“Introducer”or“IndependentIntroducer”shallbedeemedtomean“Intermediary”or“IndependentIntermediary”as MALEFEMALERequireds:Aclearcopyofavalid(ex: ernmentID,etc.)andProofofAddress(ex:UtilityBill,BankStatement,etc)forthemorethan3monthsold.Ifthe)isnotadirectorpleasesprovingtherelationbetweentheandtheorganization(ex:PowerofAttorney,Boardof 人ThisinformationisrequiredwhensubmittinganagreementonbehalfofanOrganization.EPHONEYEARSOFINSURANCE E-PHONEAREACOUNTRYPHONEAREACOUNTRYPHONEAREACOUNTRYPHONEAREACOUNTRYSTATEORTYPEOFADDRESS公司PASSPORT/ID COUNTRYOFMIDDLEFIRST名LAST姓NOMINATEDBENEFICIARIES(OPTIONAL)指定受益人(們)RELATIONSHIPRELATIONSHIPTOSPOUSECHILDOTHER其他 RELATIONSHIPRELATIONSHIPTOSPOUSECHILDOTHER其他 TERRITORIES(REQUIRED)地區(qū)AGENCY/INTERNATIONALMARKETINGORGANIZATION(IMO)(REQUIRED)辦事處/國際組織(IMO)(必填名INTRODUCERMANAGER(REQUIREDifapplicable)名INTRODUCERCOMMISSIONDISBURSEMENTFREQUENCY(REQUIRED)傭金頻率(必填Biweekly MonthlyCommissionpaymentswillbeprocessedthefirstMondayofeverymonth.傭金 QuarterlyCommissionpaymentswillbeprocessedthefirstMondayofeverySemi-AnnuallyCommissionpaymentswillbeprocessedthefirstMondayofeverysemester.傭金 AnnuallyCommissionpaymentswillbeprocessedthefirstMondayofevery CURRENCY(REQUIRED)CommissionswillbepaidtotheIntroduceraccordingtothecurrencyselected.EURACCOUNT(Leaveblankifpendingaccount(若帳戶仍 作業(yè)中請保留空白ACCOUNT(Leaveblankifpendingaccount(若帳戶仍 作業(yè)中請保留空白COMMISSIONDISBURSEMENTINSTRUCTIONS(REQUIRED)CommissionswillbepaidonlytotheIntroduceraccordingtotheselectionbelow,unlessotherwiseagreedinwritingandacceptedby (PLEASEATTACHVOIDCHECKORACCOUNTSTATEMENTDIRECTDEPOSITTOTHEINTRODUCER’SDAILYDOLLARACCOUNT(DDA)(USDonly)銀行自動轉(zhuǎn)帳存入介紹人的尊榮帳戶(DDA)DIRECTDEPOSITTOTHEINTRODUCER’SCAYMANNATIONALBANKACCOUNT(CNBACCOUNT)(USDonly)銀行自動轉(zhuǎn)帳存入介紹人的開曼銀行帳戶(CNB)ROUTINGACCOUNTCommissionswillbepaidonlytotheIntroduceraccordingtotheselectionbelow,unlessotherwiseagreedinwritingandacceptedbyNameofaccountNameofaccountholder,asitappearsonbankrecords(onlytheIntroducerwillbe FinalBeneficiaryAccountFinalBeneficiaryBankFinalBeneficiaryBankfullSortcode,SWIFTcodeorABAnumberasIntermediaryIntermediaryBankIntermediaryBankfullAnyAnyotherinformationi.e.forfurthercredit ASSIGNMENTOFCOMMISSIONSASSIGNEE’STheIntroducerdoesherebystatethefollowing介紹人在此以下事ThattheIntroducerherebytransfers,setsoverandassigns,subjecttoacknowledgementbyITA,untothe“Assignee”mentionedabove,anyandallcommissionsgeneratedasinitial?rstyearcommissions,renewalcommissions,bonusesandallowanceswhichmayhereafteraccrueinfavoroftheIntroducerbyvirtueoftheCompensationScheduleAgreementtheretonowinorhereafterenteredintobyandbetweentheIntroducerandITA,itbeingunderstoodandagreedthatthisAssignmentandtherightsassignedhereunder,shallbesubjectto:a)anypresentindebtednessoranywhichmayhereafteraccrueorbedueandowingITAand;b)allthetermsandconditionsoftheagreement.ThisAssignmentrelatesonlytotheIntroducerstatedabove.ThisAssignmentshallbebindingupontheheirs,successorsandsubsequentassignsof,oranyotherpartyclaimingthroughorundertheThisAssignmentwillnotbeeffectiveuntilprocessedandapprovedinwritingbyTheIntroduceracknowledgesthathe/sheisinagreementwiththeAssignmentTheIntroducerherebywaives,andagreesthathe/she/itshallnotdemandpaymentfromITAof,anysuchcommissionsorremunerationofanyCOMMISSIONDISBURSEMENTMINIMUMAMOUNT(OPTIONAL)傭金最低金額(若適用CommissionsCommissionswillbepaidoutoncethecommissionbalancereachesaForDIRECTDEPOSITTOABANKACCOUNTINTHEUNITEDSTATESaminimumbalanceofUSD ForDIRECTDEPOSITTOTHEINTRODUCER’SCAYMANNATIONALBANKACCOUNT(CNBACCOUNT)nominimumbalanceisForWIRETRANSFERaminimumrequiredbalanceofUSD/EUR/GBP: 5.ForASSIGNMENTOFCOMMISSIONSnominimumbalanceisTheIntroducermaychoosetoindicateahigheramounttobeusedasaminimumbalance, MinimumBalanceAmount PREFERREDLANGUAGEFORCOMMUNICATIONS(REQUIRED)語言偏好WEBUSER(REQUIRED)網(wǎng)路使用者Activatione-mailwillbesenttothee-mailprovidedinSectionA.AANTI-MONEYLAUNDERINGCERTIFICATION洗錢防制 andProceduresHandbookandtheIntroducer’sresponsibilityefamiliarwithcontents.TheIntroducerfurtherunderstandsandagrees代表介紹人已收到ITATheIntroducerhasread’sAnti-MoneyandProcedure TheIntroducerunderstandshis/her/itsanti-moneylaunderingresponsibilitiesastheypertaintothebusinessrelationshipwithTheIntroducerhasbroughtallmattersofanti-moneylaunderingconcern,ifany,totheattentionofthe TheIntroducerissatis?edwiththeleveloftrainingandguidanceavailabletoIntheeventthattheIntroducerisnotsatis?edwiththeleveloftrainingorguidanceprovidedtohim/her/it,theIntroducerwillimmediayinformComplianceOf?cerand/or DECLARATIONITAisaCaymanIslandssegregatedportfolio withanUnrestrictedClass‘B’Insurer’sLicenseissuedundertheCaymanIslandsInsuranceLaw;ThroughitsInvestorsTrustSegregatedPortfolio,ITAissuesvariableandequityindexedannuityproductswith?xedmaturitydatesunderthetradenameInvestorsTrust?;ITAdesirestoengageanddoesherebyengagetheabove-namedpartyasanINTRODUCERforitsInvestorsTrustproductssubjecttothetermsandconditionsofthisAgreement;INTRODUCERacknowledgesandacceptstheappointmentsubjecttothetermsandconditionsofthisAgreement.NOW,THEREFORE,inconsiderationofthemutualcovenantsandpromisescontainedhereinandothervaluableconsideration,thereceiptandsuf?ciencyofwhichisherebyexpresslyInthisAgreementthefollowingtermshavethemeaningssetforthinthisSection1:“Business”Theintroductionofs(ashereinafterde?ned)forthepurposesofproposalorapplicationfororeffectingoracquiringanyoftheProducts(ashereinafterde?ned)ordealingwiththesamefororonbehalfofsuchs. anINTRODUCERinrespectofanyoftheProducts.“Introducer” ,?rm, orotherlegalentityactingbehalfof inrelationtoallaspectsofthe ”Eachandevery nissuedbyITAcomprisingtheSubscriptionAgreementandSupplementalDeclarationofTrust.Theheadingsareforconvenienceonlyandshallnotaffecttheinterpretationofthisincludetheplural,andviceversa.ITAherebyengagesINTRODUCERasanINTRODUCERfortheBusiness,andconditionssetforthherein.INTRODUCERandanyrepresentativeofINTRODUCERshallbeconsideredtheagentofthe.Exceptasagreeduponinwritingbetweentheparties,ITAwillonlyacceptBusiness(the“Territory”).shallconductorintroduceBusiness,asDe?nedherein,intheUnitedStatesorinanyotherjurisdictionwhereBusinessmaynotlawfullybeconductedorintroduced.INTRODUCERshallconductBusiness(1)withanypotentialwhoisacitizenorbeconducted,or(2)withanypotentialwhoispresentwithintheUnitedStatesoranyotherjurisdictionwhereBusinessmaynotlawfullybeconducted.INTRODUCERINTRODUCERisnotinbreachofanyexpressorimpliedtermsofanycontractoranyotherlegalobligationbindinguponhimorofanylaws,regulationsorrulesofanyTherightsandobligationscontainedinthisAgreementmaynotbetransferredorassignedtoathirdpartywithouttheexpresswrittenconsentofITA.

INTRODUCERshallatalltimesadheretoanyrules,guidelinesand/orpoliciesadoptedINTRODUCERshallatalltimesobservetheprovisionsofthisAgreementandanyamendmentssubsequentlymadeandITAreservestherighttomodifythisAgreementnecessaryandappropriateinthefurtheranceofitsbusiness.INTRODUCERagreesnottodisparageITAoranyofitsaf?liatesorbusinesspartnersoranyoftheirshareholders,of?cers,directors,members,managers,attorneys,agents,representatives,successorsandassignsatanytime,eitherduringorafterthetermofthisAgreement.employeesoragentswhetherinconnectionwithBusinessorotherwise.INTRODUCERrepresentsthathe,andanyrepresentative,agentoremployeeofIntroducer,is,andwill,atalltimes,beincompliancewithallapplicablelaws,regulationsandrulesoftheappropriate inanyjurisdictioninwhichlicensedandthatINTRODUCERshallcontinuetobedulyauthorizedandlicensedtopromote,marketandselltheProductsintheTerritoryandotherwiseperformunderassessmenttoensureINTRODUCERisactinginaccordancewiththestandardsintheindustryandabidingbytheprovisionsofthisAgreementand/oranyrules,regulationsorguidelinesadoptedbyITA.ThepartiesagreeandacknowledgethatINTRODUCERisandshallremainatallrepresentativeofITAforanylegal,regulatory,taxorotherpurpose.Thereisnoexclusiverelationshipbetweentheparties.INTRODUCERmayrepresent,performservicesfor,and/orbeemployedbyothers,sorcompanies.INTRODUCERshallnothaveandagreesthatitshallnothaveanyauthoritytoactfor,representbyactoromission,thatithastheauthoritytobindITA.INTRODUCERshallnotdirectlyorindirectlyincur,createorassumeanyliability,obligation,commitmentorundertaking,contractualorotherwise,for,onbehalfofforegoing,INTRODUCERshallnotgivecovernotesforanyrisk,issueanyacceptanceletterorsettleoradmitanyclaim,surrender,orliabilityonbehalfofITA.allowedforthepaymentofapremiumoradvanceapremiumonbehalfofa.INTRODUCERisnotauthorizedtoendorsechecksonbehalfofITA,receivecashpaymentsfromsortoreceivepremiumpaymentsinthenameofINTRODUCER.INTRODUCERisherebyprohibitedfromusinganylogo,trademark,servicemarksubsidiaryoraf?liateorany INTRODUCERshallbeentitledtoreceivecommissiononlyinrespectofBusinessproposedbyINTRODUCERandacceptedbyITA.Thescalesorratesofcommissionandthetermsofpaymentthereofdescribedinthecommissionaddendumandattachedheretomaybemodi?edatanytimeandfromtimetotimebyITA,initssoleandabsolutediscretion,upon30daysnoticetoDECLARATION()Nocommissionwillbepaidwhereallpremiumswithrespecttoaarerefunded,andanycommissionpreviouslypaidwillbedebitedinfullfromINTRODUCER.IfITArefundspartofthepremiumwithrespecttoany,INTRODUCERwillbedebitedheretounlessotherwiseagreedinwritingbetweenITAandINTRODUCER.CommissionswillbepaidinthecurrencyselectedinthisNorenewalorothercommissionwillbepayabletoINTRODUCERwithrespecttoanywheretheappointsanalternateINTRODUCERtoactforhimorifthedecidesthatINTRODUCERshallnolongeractonthe’sorrepresentativeofINTRODUCERwithrespecttocommissions.INTRODUCERonaregularbasis.INTRODUCERisdeemedtohavewarrantedthetruthofallinformationdbyhimatanytimetoITAconcerningINTRODUCERandINTRODUCER’sbusiness.Ifanyinformationshallemateriallydifferentoruntrueafterithasbeendcorrectinformationasmaybenecessary,inITA’ssolediscretion,beforeITAconductsanyfurtherBusinesswithINTRODUCER.Ifanyinformationdshallprovetobefalseormisleading,orifINTRODUCERshallfailtocomplywithitsobligationsunderthisAgreement,thenwithoutprejudiceanyotherprovisionsofthisAgreement,ITAshallbeentitledtoceaseallpaymentsofcommissioninrespectofanyandallBusinessintroducedbyINTRODUCER.LIABILITYOFINTRODUCER,onINTRODUCER’SownbehalfandonbehalfoftheagentsorrepresentativesappointedbyINTRODUCERandeachoftheirsuccessorsandassignsandanyotherthatmayclaimby,throughorunderanyofthem,herebyagreestoindemnify,defendandholdITAanditssubsidiariesandaf?liatesandtheirrespectivepresentandfuturemembers,managers,shareholders,assigns,harmless,fromandagainstanyandallclaims,liabilities,obligations,ornature,whetherhavingarisen,accruedormaturedheretoforeorhereafter,asaresultof,relatingtoorconcerninganybreachbyINTRODUCERofthisAgreementoranyotherAgreemententeredintowithITAoranyITAsubsidiaryoraf?liateortheconductofINTRODUCERoranyofitsemployeesorrepresentativesinthecourseofitsbusinesswithITAorinanywayrelatingtothisAgreement.NoagentorrepresentativeappointedbyINTRODUCERshalleanagentofITAandthisAgreementdoesnotgiverisetoanyagency,partnershiporothercontractualrelationshipbetweenITAandanysuchrepresentativeunlessotherwiseexpresslyagreedinwritingbetweenITAandsuchrepresentative.INTRODUCERshallrequire,andshallbecompleyresponsiblefor,observancebyallagents,employeesandrepresentativesofINTRODUCERofanyandallobligationsguidanceadoptedbyITArelatingtothemarketinglituretobeused,administrativeprocedurestobefollowed,representationstobemadeconcerningtheProductsfromNeitherINTRODUCERnoranyofINTRODUCER’sagents,employeesorrepresentativesshallrepresentorholdhimselforherselfoutasanagentoremployeeofITAatanytime.INTRODUCERherebyacknowledgesandagreesthatintheeventthatanyamountisoresdueorpayablebyINTRODUCERtoITAasdamagesorotherwise,ITAshall

havetheoption(butnottheobligation)toelectto(i)reduce,onadollar-for-dollar(orselectedcurrency)basis,anyamountowed,dueorpayabletoINTRODUCERunderelectiverightofsetoffshallbecumulativeandinadditiontoanyandalladditionalremediestowhichITAmaybeentitledatlaworinequity.Smakeanywrittenororalstatements,promisesorrepresentationswhichcouldinanyanylifeassurancecovertemporaryorotherwise,nortoreinstateanywhichhaslapsedatanytimeorhasotherwisebeendis Agreement,INTRODUCERandINTRODUCER’sagents,employeesandrepresentativesshallnot:issueanymaterial( certi?cate,receiptorany onbehalfofpurporttoallowcredittoanyforapremiumorinvestmentorextendthealteranyinformationdbyITAorINTRODUCER’SsandaccurayrepresentanysuchinformationsoinconnectionwithBusinesstransactedwithITA.INTRODUCERwillmaintainalistofallINTRODUCER’ssandsoftherepresentatives(ifany)ofINTRODUCERuponrequest.Allbooks,records, INTRODUCERfromtimetotimeduringthetermofthisAgreement,mustatalltimesbeavailabletoITAforinspectionandbedeliveredtoITAbyINTRODUCERondemandand,inanyevent,uponterminationofthisAgreement.INTRODUCERacknowledgesandagreesonbehalfofINTRODUCERandINTRODUCER’semployees)shallnotuseordisclose(i)thetermsofthisAgreement;(ii)anynon-publicinformation,knowledgeordatarelatinginanywaytotheBusiness(whetherornotacceptedbyITA),?nancialcondition,sales,customers,rs,operations,products,inventions,businessrelationships, orservicesofITA;or(iii)anyotherproprietaryorcon?dentialinformation,knowledge,dataordetailsofthepast,quotations,softwareorinformationaboutITAsystems,manualsandcommissionrates(collectivelyreferredtoas“Con?dentialInformation”),exceptasspeci?callyINTRODUCERandINTRODUCER’sagents,employeesandrepresentatives,mayobtainaccesstocertain s,reports,memoranda,?les,customerandrlists,containorrelatetoCon?dentialInformation(collectively“Con?dentialMaterials”).INTRODUCERcovenantsandagrees,onbehalfofINTRODUCERandINTRODUCER’sagents,employeesandrepresentativesthat(i)allCon?dentialMaterialsareandshallremainatalltimesthesoleexclusivepropertyofITAand(ii)upontherequestofITAoruponterminationofthisAgreement,INTRODUCERshallpromptlyreturnallCon?dentialMaterials(includingallCon?dentialMaterialsinthepossessionofcirculatedordisclosedinanymannerwhatsoever,exceptasspeci?callyauthorizedinthisprovisionbyINTRODUCER’sagents,employeesandrepresentatives.ThisAgreementandtheappointmentofINTRODUCERmaybeterminatedwithorathis/her/itslastknownaddress(hereinafterreferredtoas“TerminationNotice”).Suchnoticeshallbeeffectiveifservedviafacsi,electronicmail,hand-delivery,commercialcourierorregisteredmail.ThisAgreementandtheappointmentofINTRODUCERwillterminateautomatically,withoutnotice,uponthedeath,disability,bankruptcy,dissolution,insolvencyorofINTRODUCER’screditors.RemitallmoniesdueandowingtoReturnallITAliture,promotionalmaterial,computersoftwareandotherCon?dentialMaterialsinthepossessionofINTRODUCERorINTRODUCER’semployees,agentsorrepresentatives.Unlessotherwiseagreedtoinwritingsignedbyboththe andtheIntroducer,receivedbythe shallbepayabletotheIntroduceruponterminationofthisAgreement.Paymentofanycommissionsonpremiumereceivedbythepost-terminationonpoliciessecuredbytheIntroducerduringtheperiodinwhichtheDuringthetermoftheAgreement,theIntroducerwasincompliancewith ’spersistencystandards;andHowever,notwithstandingtheforegoing,nopaymentshallbemade:Forpoliciesenteredintoafterthedateoftermination;including,butnotlimitedto,breachofanyofthetermsandconditionsofthisAgreement,fraud,deceit,orotherbreachoftrust.thisAgreementthatwouldbeexpectedtosurvivetheterminationofthisAgreementshallcontinueinfullandeffect,including,butnotlimitedto,Sections2.5,2.6,2.8,2.9,2.10,3.7,4.3,4.10,4.11,5.1,5.5,7.1,7.2,9.1,10.3,10.4,10.5and10.6.

AnynoticeorotherwrittencommunicationtobegivenbyITAtoINTRODUCERorviceaddresssetoutbeloworsuchotheraddressasmaybeprovidedinwritingbythegivenatthetimeitwassodeliveredor,inthecaseofservicebypost,onthetenthserviceshallbesuf?cienttoprovethattheenvelopecontainingthenoticewasproperlyaddressedandposted.GENERALITAreservestherighttomodifythisAgreementsubjectto30dayswrittennoticebeinggiventoINTRODUCER.Suchmodi?cationwillnotaffectanyinAgreement.INTRODUCER,bycontinuingtotransactBusinesshereunder,shallbedeemedtohaveaccepted,andshallbeboundby,anymodi?cation.NotwithstandinganyoftheotherconditionsinthisAgreement,ITAreservestherightatitssolediscretionnottoacceptBusinessfromINTRODUCERandshallbeundernoobligationwhatsoevertogiveanyreasonsforsuchrefusal.IfINTRODUCERisinbreachofanyofthetermsofthisAgreement,ITAshallbeentitledforthwithandwithoutnoticetorefusetoacceptanyfurtherBusinessfromINTRODUCER.ThisAgreementshallbeernedbyandinterpreted,andtherightsanddutiesofthepartieshereunder,bothproceduralandsubstantive,shallbedeterminedunderhereafteredomiciledinadifferentstateorjurisdiction.construedasawaiverofanysubsequent

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