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Rhodia Enrolment Form

I hereby request the trustees to enroll me as a member of my employer’s global retirement plan.

I understand that any income tax liabilities that arise from my contributing to or ultimately taking benefits from the plan will be dealt with by me on a personal basis and no liability rests with my employer or the trustees of the plan.

I confirm that if my employer or the trustees of the scheme are approached by any fiscal authority for information relating to my benefits in the plan they have my full authority to comply with such requests.

1. Employee details

2. Identification

3. Level of contribution


Note: Elected level of employee contribution should be in whole numbers between 1% and 50%

4. Investments

You now have to decide how you would like to invest the contributions that will be made. Please read all of the information below in order to help you make the most appropriate decision.

Option 1: Invest into a Target Date solution.

Option 2: Select and monitor your own funds from the list of investments provided in this form. If you wish to use this option, then please enter the percentage of your monies that you would like to invest into each of your chosen funds.

IMPORTANT NOTE: you must only select option 1 or option 2.

Option 1:Target Date solutions

The investment option shown on this page is designed to make your initial investment selection, and the monitoring thereafter, significantly easier.

To select a target date model, simply add 65 (or you target retirement age) to the year you were born e.g. Born 1980, (1980+65 = 2045) therefore you would select a 2045 Target date fund.

Option 2: Investment choices

Risk Level Description
1 - Low Risk Greater emphasis is placed on capital preservation rather than maximizing returns. This means that these types of funds will generally aim to preserve the value of your investments but in return will usually offer a lower rate of growth. Please note that low risk does not mean that the fund’s value would not fall.
2 - Medium Low Risk/Return Less emphasis is placed on capital preservation than in the lower risk/return category introducing a chance of higher potential returns. Compared to the lower risk/return category there is more of a risk of your fund value going down but in return for this there might be a better chance of your fund value experiencing a higher rate of growth.
3 - Medium Risk/Return The potential for capital growth is generally better than the lower risk/return and lower-medium risk/return categories but the value of the fund may vary considerably either up or down
4 - Medium High Risk/Return The potential for capital growth is higher than the medium risk/return category, but risk is increased. Funds in this category can often experience large fluctuations in value, either up or down, especially in the shorter term.
5 - High Risk/Return The potential for capital growth could be high, but with a corresponding level of risk. Funds in this category can often experience extreme fluctuations in value, either up or down, especially in the shorter term.

IMPORTANT NOTES: The risk level shown for each fund relates to the risk level of that particular fund within that particular category. For example, the Pioneer Emerging Markets Bond has a medium risk level within the bond category.

I elect that contributions made on my behalf be invested as follows:


USD funds Category Risk Level Share Class Percentage (%)
Elections must be in
1% increments
Investec USD Money Market USD Money Market 1 I shr
PIMCO Global Bond Fixed Income – Global Bond 2 I shr
BGF Short Duration USD diversified bond short term 2 D2 shr
Pioneer Emerging Markets Bond Fixed Income – Emerging Markets 3 I shr
Pioneer U.S. Research Equity – US Large Cap Blend 4 I shr
Investec GSF Global Franchise Equity – Global Large Cap Blend 4 I shr
Investec GSF Asian Equity Equity – Asia equity 5 I shr
JP Morgan Latin American Equity Equity – Latin American 5 B shr
JP Morgan Emerging Markets Equity Equity – Emerging Markets 5 B shr
Investec GSF Global Energy Equity – Global Energy 5 I shr
Janus Global Real Estate Equity – Real Estate 5 I shr
EURO funds Category Risk Level Share Class Percentage (%)
Investec GSF Euro Money EUR Money Market 1 A shr
Investec GSF Global Strategic Managed Moderate Allocation 3 F shr
Pioneer Top Ten European Players Equity – Europe Large Cap 4 I shr
MFS Merdian Global Research Equity - Global Large Cap Value 4 I shr
GBP funds Category Risk Level Share Class Percentage (%)
Investec GSF Sterling Money GBP Money Market 1 A shr
Templeton Global Bond Fixed income - Bond Global 2 I shr
MFS Meridian UK Equity Equity – UK 4 I shr
JPY funds Category Risk Level Share Class Percentage (%)
Aberdeen Global Japanese Equity Equity – Japan 5 A shr
TOTAL (must be 100%)

This election authorises the investment of my contributions made into the plan in the various funds according to the above investment selections. This election shall remain in effect until I revoke it in writing, or change my contribution election percentage or investment selection in accordance with the terms of the plan.

I understand that the plan permits me to invest contributions made into the plan on my behalf into various funds, each with a different investment strategy. I understand that my investment election is made entirely at my own risk and that my election must be made according to the terms of the plan. I am aware that no responsibility for my decision in this regard can revert to the company or to the trustees.

I confirm that I am fully aware of the level of investment costs which the underlying investment manager(s) charge having considered either (a) the fund fact sheets which my employer provided or (b) the details available on the website.

I am aware that membership of this plan is not open to US persons (as defined according to FATCA legislation) or residents of the island of Jersey and I can confirm that I am neither of the above and subsequently eligible for plan participation.

Individual Self Certification

Tax regulations require us to collect information about each investor’s tax residency. In certain circumstances (including if we do not receive a valid self–certification from you) we may be obliged to share information on your account with the relevant taxation body.

If you have any questions about your tax residency or question on how to complete this form, please contact your tax advisor.

Should any information provided change in the future, please ensure you advise us of the changes promptly.

Tax Residency*

You are required to indicate all countries in which you are resident for tax purposes and the associated Tax Reference Number in the table below. If you are a US citizen or resident, please include United States in the table along with your US Tax Identification Number.

If you are a UK, Jersey, Guernsey, Isle of Man or Gibraltar resident then please supply your National Insurance or Social Security Number as appropriate, in addition to your Tax Reference Number.


*As you may be aware, the US passed the Foreign Account Tax Compliance Act, (FATCA) in 2010. Beginning on July 1, 2014 foreign financial institutions (FFI) such as the Participants in the Plan are required to report information regarding accounts of relevant US persons. Additionally, certain other countries including the UK have passed similar laws where reporting is required upon payment of funds from a foreign account. Consequently all plan participants are required to provide information regarding their tax residency.