Investor Questionnaire

If you were an investor in these schemes, we would appreciate your response by completing this questionnaire and returning it to the SFO as soon as possible. Whilst the responses to these enquiries are voluntary, please be aware that your contribution will greatly assist the SFO investigation. Once we receive your completed questionnaire we may contact you for further information.

Your Investor Details

Q1) Title (of investor):

Q2) Surname (of investor):

Q3) First Name (of investor):

Q4) Name in which investment was made (if not in investor's own name)

Q5) Home Address:

Q6) Postal Address:

Q7) Email Address:

Q8) Home Telephone Number:

Q9) Mobile Telephone Number:

Q11) Preferred contact method:

Q12) Date of Birth:

Q13) Occupation:

Q14) Are you making this report on behalf of someone else?

Yes

Please provide your name:

Postal Address:

Email address:

Home Telephone Number:

Mobile Number:

Investment Details

Q15) What was the type of scheme you invested in?

Henley Retirement Benefit Scheme

Capita Oak Pension Scheme

Westminster Scheme

SIPP

Other

Please describe the nature of your investment:

Q16) How and when did you hear about any of the schemes or plans?

Q17) What were you told about the investments and by whom?

Q18) Did you get independent financial advice about the scheme? If so please provide the name and company, if known, of the Independent Financial Adviser.

Q19) Who sold you the investment?

Q20) Were you promised any upfront returns and if so how much?

Q21) How much did you invest?

Q22) Please provide the date(s) of your investment(s).

Q23) What reference numbers were you given in relation to your investment(s), if any?

Q24) Please provide details of where you made payment to - including the payee bank account name, sort code, number and name of institution (payee details, not your bank details). Please state if your payment was made to an overseas account and which country this was (where known):

Q25) How were payment instructions provided, and by whom?

Q26) Do you have a copy of your payment instructions and any receipts? If so please retain these.

Yes

Q27) Were you told what product or service you would be investing in?

Q28) At the time of the investment or later, what was communicated to you either verbally or in writing regarding your ability to cash in on the product at any stage in the life cycle of your investment?

Q29) Were you at any stage informed that a percentage of your investment would be paid to any other party as a) commission b) fees c) any other deductions/charges? If so please provide details.

Q30) If your investment was in storage pods what service charges would you be required to pay? What were you told about having to pay insurance charges, contents or otherwise?

Q31) What administration charges were you told about having to pay in respect of the scheme? What did these administration charges cover?

Agent/ Promoter Details

Q32) Did you invest through an agent or promoter?

Yes

What is their name, and the company name (if any)?

What are their contact phone numbers, email address, office and postal addresses?

Investments Returns

Q33) Were you offered any financial inducements (for example involving the release of your pension funds) to invest in the scheme?

Yes

How much did you receive?

What was the name, address and account name of the party that sent you the funds (not your details, the sender's details)?

Q34) Have you received any returns on your investment?

Yes

How much was paid?

When was this received?

How did you receive this payment?

What was the name, address and account name of the party that sent you funds (not your details, the sender's details)?

Q35) Are you expecting any further returns on your investment?

Yes

How much are you expecting, and when?

What were you told about these further returns?

Q36) Which company or person made this payment and when was it paid?

Investment Source

Q37) What was the source of your investment funds?

Q38) Did you invest through a Self Invested Personal Pension (SIPP)?

Yes

Which SIPP company did you use?

Updates

Q39) Have you received any updates on your investment?

Yes

What were the updates?

Who provided the updates?

Q40) Who else have you contacted regarding your investment?

Q41) Have any changes been made to your investment?

Yes

What were the changes, and who made these?

Did you consent to these changes?

Yes

Civil Action

Q42) Have you taken or been a creditor in any civil action in relation to your investment?

Yes

Which individuals or companies was that action taken against?

What was the nature of that action?

When was that action taken and is it ongoing?

Have you received any monies as a result of that action, if so, how much?

Other issues

Q43) Please describe any problems you have had with your investment.

Q44) Do you have any other documents relating to your investment? (please ensure you retain these documents)

Q45) What documents do you have?

Q46) Do you have any notes of conversations, or recordings of these, relative to your investment?

Q47) If you have lost any money, what impact has this had on you?

Q48) Have you been contacted recently in relation to your investment, if so by whom, when and what were you told?

Q49) Please provide any further details, or comments.

Q50) Are you willing to provide a witness statement in relation to these investments?

Yes

Q51) Are you willing to attend Court and give evidence?

Yes

Checklist

Can you please check that you have:

Included your contact details

Completed all questions as fully as you can

Please note that your completed questionnaire will also be forwarded to Action Fraud at the National Fraud Investigation Bureau. Thank you.

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