INCOME & GROWTH VCT (THE) PLC

Registration Form • Nov 30, 2012

GREEN APPLICATION FORM

MOBEUS INCOME & GROWTH VCT PLC

MOBEUS INCOME & GROWTH 4 VCT PLC THE INCOME & GROWTH VCT PLC ("the Companies")

Please complete this green Application Form if it will be received by the Receiving Agent on or before 30 December 2012 (whether you have received advice or not) or if your Application Form will be received on or after 31 December 2012 and you have not received advice from a financial intermediary. A revised Application Form will be published or made available by the Companies (coloured blue) for use by investors who receive advice from their financial intermediary and who send in their application on or after 31 December 2012. The blue Application Form will be available from your financial intermediary, Mobeus on 020 7024 7600 or The City Partnership (UK) Limited on 0131 243 7210 or downloadable from www.mobeusequity.co.uk/investor-area.

Definitions used in the Securities Note (as defined below) apply herein.

Before completing this Application Form you should read the Terms and Conditions of Application and Notes on how to Complete the Application Form. Please send the completed Application Form with your cheque or banker's draft and, if necessary, proof of identity to Mobeus VCTs Linked Offer, The City Partnership (UK) Limited, Thistle House, 21 Thistle Street, Edinburgh EH2 1DF. Cheques should be made payable to "Mobeus VCTs Linked Offer".

The Offer opens on 29 November 2012 and will close at 12.00 noon on 30 April 2013. The Offer may close earlier if fully subscribed or may be extended by the Boards in their absolute discretion, but to no later than 28 November 2013. If tax relief is to be applied for in respect of the subscription monies in the tax year 2012/2013, the closing date will be 12.00 noon on 5 April 2013.

The Companies and the Receiving Agent cannot accept responsibility if any details provided by you are incorrect.

Please complete in BLOCK CAPITALS.

1	Title: Mr/Mrs/Miss/Ms/Dr/Other
	Forenames:
	Surname(s):
	Address:
	Post code:
	Email address:
	Telephone (work): Telephone (home):
	Date of Birth: National Insurance Number: DD MM YYYY
	I wish to subscribe the amount in the Companies, divided between tax years 2012/2013 and 2013/2014 as set out in Box 2 below or such lesser amount for which this subscription will be accepted, on the terms and conditions set out on pages 38 to 42 of the securities note relating to the Offer dated 29 November 2012 ("Securities Note").
	Please confirm below how you would like the Receiving Agent to acknowledge receipt of your application
	Post: Email:
2	Total (to equal at least £6,000) Tax year 2012/2013 Tax year 2013/2014
	£ £ £
	I enclose a cheque or banker's draft drawn on a UK clearing bank made payable to "Mobeus VCTs Linked Offer"
3	By signing this form I HEREBY DECLARE THAT I have read the terms and conditions of the Offer set out on pages 38 to 42 of the Securities Note (and as further contained herein) and agree to be bound by them. I understand this is a long term investment and have read the Risk Factors set out on pages 2
	and 3 of the Securities Note and the Prospectus (as defined in the Securities Note) as a whole.
	Signature Date
	Data Protection Act
4	Mobeus Equity Partners LLP and the Receiving Agent will use the information you give for administration, research and statistical purposes. Information provided by you will be held in confidence by Mobeus Equity Partners LLP and the Receiving Agent and will not be passed on to
	any other product or service companies. Your details may be used by Mobeus Equity Partners LLP and the Receiving Agent to send you information on other products and services they offer. If you would prefer not to receive such information, please tick this box.
5	Electronic Communications
	Each of the Companies provides their Shareholders with the opportunity to receive documents by electronic communication. Should you wish to receive notification of when documents are published on the Mobeus website for each of the Companies, please tick this box.
	Your email address must also be provided in Box 1.
6	Dividend Investment Scheme MIG 4 I&G MIG 4 and I&G operate a dividend investment scheme. Tick the relevant box(es) if you would like to receive the mandate form and terms and
	conditions so that any dividend you may receive from each of MIG 4 and I&G is re-invested in new Shares issued by the relevant Company.

	All dividends on any Shares held in the Companies may be paid directly into bank and building society accounts. In order to help process this, please complete the mandate instruction form in Box 7. Dividends paid directly into your account will be paid in cleared funds on the dividend payment date. Your bank or building society statement will identify details of the dividends as well as the dates and amounts paid.
7	Direct Mandate Please forward, until further notice, all dividends that may from time to time become due to any shares now standing or which may hereafter stand, in my name in any of the registers of members of the Companies to:
	a. Name of Bank or Building Society:
	b. Account number:
	c. Sort code:
	d. Account name (BLOCK capitals, please):
	e. Signature:
	f. Date:
	g. Applicant's name (BLOCK capitals, please): h. Post code of applicant:
8	Intermediary Contact Details Firm name: FSA number:
	Adviser contact: IFA administrator contact:
	Email(s):
	Address:
	Post code:
	Telephone: Fax:
	Please confirm below how you would like the Receiving Agent to acknowledge receipt of your client's application:
	Post: Email:
	Initial and trail commission will be paid to all financial intermediaries for applications which are accepted and which were received on or before 30 December 2012. For applications received after 30 December 2012, initial and trail commission (to the extent possible) will only be paid to financial intermediaries who provide 'execution only' services. You and the intermediary undertake to inform the relevant Company if advice is subsequently given in respect of a holding and trail should no longer be paid.
9	Category of Intermediary Used 'Execution only' services
	Advice provided
10	Commission Options
	Amount of initial commission to be paid to intermediary %
	Amount of initial commission to be re-invested for client % annual trail of one off payment
	0.375% of 0.5% Trail commission payable to intermediary option (please tick)* OR
	(*this option is only relevant for applications which are accepted and which were received on or before 30 December 2012. Applications received after this date will receive annual trail of 0.375% only)
	Commission Payment Details (to be used if commission is to be paid to a network or other third party)
11	Name:
	Contact:
	Address: Post code:
	Email: Telephone:
12	The Companies' intention is to pay all commission by direct transfer; therefore, please supply bank details in the space below. Please forward, until further notice, all commission(s) that may from time to time become due as a result of my client's investment in the Companies
	Name of Bank or Building Society:
	Name of intermediary:
	Account name (BLOCK capitals please):
	Sort code: Account number: