EX-99
Investors Real Estate Trust
SUBSCRIPTION AGREEMENT
AMOUNT $_________________ NUMBER OF COMMON SHARES ___________
OWNERSHIP Name(s)
REGISTRATION: -----------------------------------------------------
(investor(s) names)
Address
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City State Zip
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Social Security Number ____-____-____ or Tax I.D.# ___-_____
Date of Birth ____/____/____
Social Security Number ____-____-____ or Tax I.D.# ___-_____
Date of Birth ____/____/____
Under penalties of perjury, the undersigned certified (1) that the number
shown as his taxpayer identification number is his correct taxpayer
identification number and (2) that he is not subject to back up withholding
either because he has not been notified that he is subject to backup
withholding as a result of a failure to report all interest and dividends or
because the Internal Revenue Service has notified him that he is no longer
subject to backup withholding.
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MAILING ADDRESS Name(s)
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FOR CORRESPONDENCE
AND CASH Address
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DISTRIBUTIONS City State Zip
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(If different
from above)
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TITLE TO ____Individual ____Tenants in Common ____IRA ____Partnership
BE HELD: ____Joint Tenants/ ____Corporation ____Trust ____Pension Plan
Rights of Survivorship ____Marital Property _____Custodian
____Profit Sharing
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SIGNATURES: I hereby certify as follows: That a copy of the Prospectus,
including the Subscription Agreement attached thereto, as amended
and/or supplemented to date, has been delivered to me, and I
acknowledge that such Prospectus was received.
Executed this ___ day of _________, 199___, at _____________(city)
____ (state).
Signature (investor's, otherwise Trustee of XXX, Pension Plan,
etc.) _____________________________________
Additional Signature (if joint tenant) _________________________
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The undersigned hereby represents that it has reasonable grounds to believe
on the basis of information obtained from the above-named investor concerning
his-her investment objectives, other investments, financial situation and
needs, and any other information known by it that:
A. The above-named investor is or will be in a financial position appropriate
to enable him-her to realize, to a significant extent, the benefits
discussed in the Prospectus;
B. The above-named investor has a fair market net worth sufficient to sustain
the risks inherent in the Shares, including loss of investment and lack of
liquidity; and
C. The Shares are otherwise suitable for the above-named investor. I further
represent that prior to executing this purchase transaction, I informed the
above-named investor of all pertinent facts relating to the liquidity of
the Shares.
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SOLICITING Firm
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DEALER
ENDORSEMENT: Registered Representative _____________________ Phone ___________
Address
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Dealer Authorized Signature
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NOTE: Checks to be made payable to: INVESTORS REAL ESTATE TRUST,
00 XXXXX XXXX XX., XXXXX, XX 00000
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Accepted by: INVESTORS REAL ESTATE TRUST
By: XXXXX-XXXXX & ASSOCIATES Date _________________
(Advisor)
231 Page 232 of 233
