All Subscribers. □ Complete and sign the first page of the Subscription Agreement (i.e. the page following this one). □ You are subscribing under the “accredited investor exemption” as described in Section 7(e)(ii) of the Subscription Agreement and must qualify under the description as an “accredited investor”. Please: □ complete and sign the Accredited Investor Certificate (Schedule A to the Subscription Agreement, including Appendix I to Schedule A); □ if you are purchasing as an individual (as opposed to a corporation or other entity) and relying on category (j), (k) or (l) of the Accredited Investor Certificate (and do not meet the higher financial asset threshold set out in paragraph (j.1) of the Accredited Investor Certificate), complete and sign the Form 45-106F9—Form for Individual Accredited Investors (Schedule B to the Subscription Agreement); and □ if you are relying on category (q) of the Accredited Investor Certificate (registrant acting on behalf of a fully managed account managed by you), also provide the Managed/Discretionary Account Details (Schedule D to the Subscription Agreement). □ Complete the FATCA identification form in Schedule C. Your subscription is made on the terms and conditions set out in the Subscription Agreement. Ensure that you read the entire agreement carefully, and seek independent investment, legal, tax and other professional advice as you consider necessary. The securities for which you are subscribing are securities of a private entity and are subject to an indefinite hold period. The undersigned (hereinafter referred to as the “Subscriber”) hereby irrevocably subscribes for and agrees to purchase up to that number of Canadian dollar denominated units of the Trust (“CAD Units” and singularly, a “CAD Unit”) and/or US dollar denominated units of the Trust (“USD Units” and singularly, a “USD Unit”) (CAD Units and USD Units collectively referred to herein as the “Units” and singularly, a “Unit”) set out below at the price of CAD$10.00 per CAD Unit or US$10.00 per USD Unit, as applicable, upon and subject to the terms and conditions set forth in the “Terms and Conditions of Subscription for Units of US Bridge Loan Fund Trust” attached hereto (together with this page and the attached Schedules, the “Subscription Agreement”) and in accordance with the terms of the Declaration of Trust of the US Bridge Loan Fund Trust made as of September 23, 2020, as may be amended from time to time (the “Declaration of Trust”). I-CLASS (Name of Subscriber - please print) (Authorized Signature) (Official Capacity or Title - please print) (Please print name of individual whose signature appears above if different than the name of the subscriber.) (Subscriber’s Address) (Telephone Number) (E-Mail Address) (Social Insurance Number, Federal Corporate Tax Account Number or Corporate Identification Number, as applicable) Aggregate Number of Units: CAD Units: USD Units: Aggregate Subscription Price: CDN$ USD$ If the Subscriber is signing as agent for a principal, unless it is deemed to be purchasing as a principal under NI 45- 106, complete the following and ensure that the applicable Exhibit(s) are completed on behalf of such principal: (Name of Principal) (Principal’s Address) (Social Insurance Number, Federal Corporate Tax Account Number or Corporate Identification Number) Register the Units as set forth below (if left blank, securities will be registered in the Subscriber name provided above): (Name) (Account reference, if applicable) (Address) (Address Deliver certificates for the Units as set forth below (if left blank, securities will be delivered to the address provided above): (Name) (Account reference, if applicable) (Contact Name) (Address) (Address)
Appears in 2 contracts
Sources: Subscription Agreement, Subscription Agreement