R.J. Nash Consultancy Ltd     
  Independent Financial Solutions
                                                                                              
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Portfolio Healthcheck Form

Please print the Portfolio Healthcheck Form and complete and return it to:

*  R.J. Nash Consultancy Ltd
                31 Turnfurlong Lane, Aylesbury, Bucks, HP217PQ

Appointment of R.J. Nash Consultancy Ltd as Servicing Broker

ISAs, PEPs, Unit Trusts, OEICS & Investment Bonds

        Name of Fund Management Group     Signature                            Date
          (eg Norwich Union)                                            (eg Signature)                               (eg 01/03/04)

1.                 
Please accept this instruction as confirmation that I would like to appoint  RJ Nash Consultancy Ltd as agent for all of my
holdings. I authorise you to send details of all my holdings and treat them as my broker and beneficiary of any renewal.

2.                 
Please accept this instruction as confirmation that I would like to appoint  RJ Nash Consultancy Ltd as agent for all of my
holdings. I authorise you to send details of all my holdings and treat them as my broker and beneficiary of any renewal.

3.                 
Please accept this instruction as confirmation that I would like to appoint  RJ Nash Consultancy Ltd as agent for all of my
holdings. I authorise you to send details of all my holdings and treat them as my broker and beneficiary of any renewal.

4.                 
Please accept this instruction as confirmation that I would like to appoint  RJ Nash Consultancy Ltd as agent for all of my
holdings. I authorise you to send details of all my holdings and treat them as my broker and beneficiary of any renewal.

5.                 
Please accept this instruction as confirmation that I would like to appoint  RJ Nash Consultancy Ltd as agent for all of my
holdings. I authorise you to send details of all my holdings and treat them as my broker and beneficiary of any renewal.

6.                 
Please accept this instruction as confirmation that I would like to appoint  RJ Nash Consultancy Ltd as agent for all of my
holdings. I authorise you to send details of all my holdings and treat them as my broker and beneficiary of any renewal.

________________________________________________________________________________________

                                                                                          Page two

Please accept this instruction as confirmation that I would like to appoint  RJ Nash Consultancy Ltd as agent for all of my
holdings. I authorise you to send details of all my holdings and treat them as my broker and beneficiary of any renewal.

Investment Trusts 

       Name of Investment Trust/s                    Number of Shares Held
1.                                                                                            
2.                                                                                            
3.