This form must be completed by any person who has a deposit in Kaupthing Singer & Friedlander (Isle of Man) Limited ("KSFIOML") (which is in default), and who wishes to claim compensation under the Depositors' Compensation Scheme 2008 ("the Scheme").

Potential claimants should note the terms of the Compensation of Depositors Regulations 2008 (as amended) ("the Scheme Regulations") before submitting a claim, in particular the maximum compensation payable (regulation 11) and the subrogation requirements (regulation 16).

These documents are important and require your immediate attention. These notes are not intended as definitive legal advice. If you are in doubt as to what action you should take, you are advised to seek professional advice.

Using the Accounts form please list each sterling (£) or non-sterling account which you hold with KSFIOML.

Where an account is held in joint names, all joint accountholders must sign a separate claim form. However, each joint accountholder will be treated as holding an equal share in the deposit and will, subject to satisfying all necessary conditions, be entitled to compensation up to the maximum compensation payable.

You should note that if you choose to claim from the Scheme it will not be necessary for you to also make a claim directly in the liquidation. The Scheme Manager will do do on your behalf. You should NOT therefore return a separate proof of debt to the Liquidator

You should also note that, by submitting the claim form, you are transferring certain rights and claims to the Scheme Manager and you are undertaking to do certain things as set out in the form entitled 'Assignment of Rights'; you are also giving the warranties and representations set out in that same form.

In order to claim compensation under the Scheme you are required to assign to the Scheme Manager all such rights as you may have in relation to the accounts to which this form relates. If you have already received compensation under the KSFIOML Early Payment Scheme ("EPS") and/or KSFIOML Early Payment (No. 2) Scheme ("EPS2") then you will already have assigned part of your rights in the account to which this form relates and by submitting this claim form you are assigning any and all remaining rights that you have.

To the extent that the Scheme Manager, in exercising such rights, recovers sums in excess of the amount of compensation paid to you as described by the Scheme, the excess will be paid to you.

Please note that any compensation you receive or have received from another source may be deducted from any compensation to which you may be entitled under the Scheme.

The Scheme Manager will not pay compensation where the transaction giving rise to this claim is or was part of any criminal activity.

The Financial Supervision Commission as Scheme Manager is registered as a Data Protection Controller under the Isle of Man Data Protection Act and is therefore obliged to ensure that the information you provide is held confidentially. By signing this form you give the Scheme Manager your permission to share the information contained in this form with

  • (i) the Liquidator or its servants or agents
  • (ii) the new owner of KSFIOML assets following any restructuring or sale
  • (iii) the Isle of Man Treasury as administrator of the EPS and EPS2

In this claim forms

  • (i) "date of default" means 27 May 2009
  • (ii) "KSFIOML" means Kaupthing Singer & Friedlander (Isle of Man) Limited
  • (iii) "Scheme" means The Depositors' Compensation Scheme 2008
  • (iv) "Scheme Manager" means the Isle of Man Financial Supervision Commission c/o PO Box 201, Douglas, Isle of Man, IM99 1TR
  • (v) "Scheme Regulations" mean the Compensation of Depositors Regulations 2008. The can be found at
  • (vi) unless the context otherwise requires, the term "deposit" and the term "account" mean the same.
  • (vii) the numbered references in brackets are references to the relevant Scheme Regulation
  • (viii) "Liquidator" means the Joint Provisional Liquidators, Michael Simpson and Peter Spratt both of PricewaterhouseCoopers and whoever in due course and from time to time is appointed Liquidator of KSFIOML by the Court
  • (ix) "EPS" means the KSFIOML Early Payment Scheme
  • (ix) "EPS2" means the KSFIOML Early Payment (No. 2) Scheme

If you are unable to answer any question or supply any requested documents, please attach a suitable explanation.

There is a limit on the amount of contributions which the Scheme Manager can levy to meet the costs of compensation to depositors in any one year. If the claims of depositors on the Scheme in any year exceed the amount of levies and any borrowing, you may receive in that year only part of any compensation due to you; any balance due to you will be carried forward to succeeding years and paid as soon as funds are available. It is the Scheme Manager's current intention and objective to pay all compensation due to claimants by September 2009.

The Scheme Manager has appointed KPMG LLC as its agent for the purpose of the administration of claims under the Scheme.