Samuel's Gift
BENEFICIARY
Name :
Address :
City :
Zip Code :
Phone No :
e-Mail :
APPLICANT
Name :
Address :
City :
Zip Code :
Phone No :
e-Mail :
G I F T
Value :
Fund :	Choose Fund SAM DANA PASTI PLUS Samuel Dana Pasti SAM DANA BERKEMBANG

*) The Gift Value is subject to selling and administration fee of 1% flat collected by Investment Manager.

Disclaimer – Samuel Asset Management is the investment manager for SAM Mutual Funds. Mutual fund investment is subject to losses in the invested capital. Success in past performances does not serve as a guarantee for future success. Read the prospectus carefully.