Disclosed Beneficial Purchaser Information. If the Subscriber is signing as agent for a principal and is not deemed to be purchasing as principal pursuant to NI 45-106 (as defined herein) by virtue of being either (i) a trust company or trust corporation acting on behalf of a fully managed account managed by the trust company or otherwise or, (ii) a person acting on behalf of a fully managed account managed by it, and in each case satisfying the criteria set forth in NI 45-106, complete the following and ensure that Schedule A is completed in respect of such principal: (Full Name of Principal) (Principal’s Residential Address) (Telephone Number (including area code)) (Email address) The undersigned (hereinafter referred to as the “Subscriber”) hereby irrevocably subscribes for and agrees to purchase the number of Series C Preferred Shares (“Preferred Shares”) of the Corporation set forth below for the aggregate consideration set forth below, representing a subscription price per Preferred Share equal to the net asset value per Preferred Share to be determined as at the Closing Date (defined below) and as set forth below, upon and subject to the terms and conditions set forth in “Terms and Conditions of Subscription for Preferred Shares of Xxxxxxxx Xxxxxxx Mortgage Corporation” attached hereto (the “Subscription Agreement”). In addition to this face page, the Subscriber must also complete all applicable schedules attached hereto. Full Legal Name of Subscriber (Please Print) By: Signature of its Authorized Representative Official Title or Capacity (please print) Name of Signatory (please print name of individual whose signature appears above if different than name of Subscriber) Address Telephone Number (including area code) Social Insurance Number or Business Number as applicable Indicate if Subscriber is registered or required to be registered under applicable securities legislation. Yes/No If Yes, please provide details below: Aggregate Subscription Amount: $ Div. Reinvest: ☐ Yes ☐ No (Please review the dividend reinvestment plan of the Corporation attached hereto as Schedule “B”.) FUNDSERV: ☐ Yes ☐ No Direct Deposit: ☐ Yes ☐ No Banking Information for Direct Deposit (please attach void cheque) Name of Banking Institution: Address: Transit Number: Account Number: Account Name: FOR OFFICE USE ONLY Price per Preferred Share: $ Number of Preferred Shares: _ Register the Preferred Shares (if different from above) as follows: Name Account reference, if applicable Address (including postal code) ACCEPTAN...
Disclosed Beneficial Purchaser Information. If the Subscriber is signing as agent for a principal and is not deemed to be purchasing as principal pursuant to NI 45-106 (as defined herein) by virtue of being either (i) a trust company or trust corporation acting on behalf of a fully managed account managed by the trust company or otherwise or, (ii) a person acting on behalf of a fully managed account managed by it, and in each case satisfying the criteria set forth in NI 45-106, complete the following and ensure that Schedule A is completed in respect of such principal: (Full Name of Principal) (Principal’s Residential Address) (Telephone Number (including area code)) (Email address) Register the Preferred Shares (if different from above) as follows: Name Account reference, if applicable Address (including postal code) Deliver the Preferred Shares (if different from address given) as follows: Name Account reference, if applicable Contact Name Address (including postal code) Telephone Number (including area code)
Disclosed Beneficial Purchaser Information. If the shareholder is signing as agent for a principal and is not a trust company or trust corporation purchasing as trustee or agent for accounts fully managed by it or a person acting on behalf of a fully managed account managed by it, complete the following: ____________________________________________ (Name of Principal) ____________________________________________ (Principal’s Address, Telephone Number and E-mail Address) Register the Consideration Shares as set forth below: __________________________________________ (Name) __________________________________________ (Account reference, if applicable) __________________________________________ (Address) __________________________________________ Deliver the Consideration Shares as set forth below: ____________________________________________ (Name) ____________________________________________ (Account reference, if applicable) ____________________________________________ (Contact Name) ____________________________________________ (Address) ____________________________________________
Disclosed Beneficial Purchaser Information. Official Title or Capacity (please print) If the Subscriber is signing as agent for a principal and is not deemed to be purchasing as principal pursuant to NI 45-106 (as defined herein) by virtue of being either (i) a trust company or trust corporation acting on behalf of a fully managed account managed by the trust company or trust corporation or, (ii) a person acting on behalf of a fully managed account managed by it, and in each case satisfying the criteria set forth in NI 45-106, complete the following and ensure that, if applicable, Schedule A, Schedule B and/or Schedule C and in any event, Schedule D, is completed in respect of such principal: Name of Signatory (please print name of individual whose signature appears above if different than name of Subscriber) Subscriber's Address (including postal code) Telephone Number (including area code) (Name of Principal)
Disclosed Beneficial Purchaser Information. (If the Subscriber is a corporation or other entity, print the title of the individual who signed above) if the Subscriber is signing as agent for a principal pursuant to paragraph 3(g) (the Disclosed Beneficial Purchaser), complete the following and ensure that Exhibit 1 (and Exhibit 2, if applicable) is completed on behalf of such Disclosed Beneficial Purchaser (Subscriber’s Residential Address) (Name of Disclosed Beneficial Purchaser) (Telephone Number) (Disclosed Beneficial Purchaser’s Residential Address, Telephone Number and E-mail Address) (E-Mail Address) Deliver the Shares as set forth below: Register the Shares as set forth below: (Name) (Name) (Address) (Account reference, if applicable) (Contact Name and Telephone Number) (Address)
Disclosed Beneficial Purchaser Information. If the Subscriber is signing as agent for a principal and is not deemed to be purchasing as principal pursuant to applicable securities legislation, complete the following and ensure that the Schedules and Exhibits, as applicable, are completed in respect of such principal: This is the first page of an agreement comprised of 12 pages (excluding Schedules hereto).
Disclosed Beneficial Purchaser Information. If the Subscriber is signing as agent for a principal and is not deemed to be purchasing as principal pursuant to NI 45-106 (as defined herein) by virtue of being either (i) a trust company or trust corporation acting on behalf of a fully managed account managed by the trust company or trust corporation or, (ii) a person acting on behalf of a fully managed account managed by it, and in each case satisfying the criteria set forth in NI 45-106, complete the following and ensure that, if applicable, Schedule A and/or Schedule B and in any event, Schedules C and D, are completed in respect of such principal: (Name of Principal) (Principal's address) (Telephone Number) (E-mail Address) Principal's Social Insurance No. or Federal Business No. Register the FT Units (if different from address given above) as follows: Name Account reference, if applicable Address (including postal code) Deliver the FT Units (if different from address given above) as follows: Name Account reference, if applicable Contact Name Address (including postal code) Telephone Number (including area code)
Disclosed Beneficial Purchaser Information. By: If the Subscriber is signing as agent for a principal and is not deemed to be purchasing as principal pursuant to NI 45-106 (as defined herein) by virtue of being either (i) a trust company or trust corporation acting on behalf of a fully managed account managed by the trust company or trust corporation or, (ii) a person acting on behalf of a fully managed account managed by it, and in each case satisfying the criteria set forth in NI 45- 106, complete the following and ensure that, if applicable, Schedule A, Schedule B and/or Schedule C and in any event, Schedule D, is completed in respect of such principal: Signature of Subscriber or its Authorized Representative Official Title or Capacity (please print) Name of Signatory (please print name of individual whose signature appears above if different than name of Subscriber) Subscriber's Address (including postal code) (Name of Principal) (Principal's address) Telephone Number (including area code) e-mail Address (Telephone Number) (E-mail Address) Deliver the Common Shares and Warrants (if different from address above) as follows: Register the Common Shares and Warrants (if different from address above) as follows: Name Name Account reference, if applicable Account reference, if applicable Contact Name Address (including postal code) Address (including postal code) Telephone Number (including area code)
Disclosed Beneficial Purchaser Information. If the Subscriber is signing as agent for a principal pursuant to paragraph 3(g)(i) (the “Disclosed Beneficial Purchaser”), complete the following and ensure that either Exhibit 1 is completed on behalf of such Disclosed Beneficial Purchaser or initial the applicable paragraph of subsection 3(f)(ii) on behalf of such Disclosed Beneficial Purchaser (and ensure that Exhibits 2, 3 and 4 if applicable, are completed on behalf of such Disclosed Beneficial Purchaser): (Name of Disclosed Beneficial Purchaser) (Disclosed Beneficial Purchaser’s Residential Address, Telephone Number and E-mail Address) Deliver the Shares as set forth below: TO THE REGISTERED OFFICE OF THE CORPORATION (SUBSCRIBERS MUST ALSO COMPLETE THE SECOND FACE PAGE) The Subscriber represents that the Subscriber (or the Disclosed Beneficial Purchaser, if applicable) is or is not (check one) an insider of the Corporation (as defined in Exhibit 1). The Subscriber represents that the Subscriber (or the Disclosed Beneficial Purchaser, if applicable) is or is not (check one) a registrant (as defined in Exhibit 1). If the Subscriber is an insider of the Corporation or a registrant, the number and type of securities of the Corporation owned by the Subscriber prior to the Offering (as defined herein) is:
Disclosed Beneficial Purchaser Information. If the Subscriber is signing as agent for a principal pursuant to paragraph 3(g)(i) (the “Disclosed Beneficial Purchaser”), complete the following and ensure that Appendix A to Exhibit 1 is completed on behalf of such Disclosed Beneficial Purchaser: (Name of Disclosed Beneficial Purchaser) (Disclosed Beneficial Purchaser’s Residential Address, Telephone Number and E-mail Address) Register the Preferred Shares as set forth below: Deliver the Preferred Shares as set forth below: BPY Limited (Name) (Account reference, if applicable) Wessex House 3rd Floor, 00 Xxxx Xxxxxx (Address) Xxxxxxxx, XX 00, Bermuda BPY Limited (Name) (Account reference, if applicable) Xxxxxx Xxxxx (Contact Name) 000 Xxxxxxxx Xx Xxxx (Xxxxxxx) Xxxxxxx, Xxxxxxx, Xxxxxx, X0X 0X0 (SUBSCRIBERS MUST ALSO COMPLETE THE SECOND FACE PAGE)
