IRREVOCABLE TRUSTS. If the trust is an irrevocable trust, please answer the following questions: Please provide the name of each trustee: Trustee Name: ________________________________________ Trustee Name: ________________________________________ Does the trust have assets greater than $5 million? Yes o No o Do you have such knowledge and experience in financial and business matters as to be capable of evaluating the merits and risks of an investment in the Company? Yes o No o Indicate how often you invest in: Marketable Securities Often o Occasionally o Seldom o Never o Restricted Securities Often o Occasionally o Seldom o Never o Venture Capital Companies Often o Occasionally o Seldom o Never o The undersigned has been informed of the significance to the Company of the foregoing representations and answers contained in this Confidential Purchaser Questionnaire and such representations and answers have been provided with the understanding that the Company and the Selling Agent will rely on them. Individual Date: ________________________ _______________________________ Name of Individual (Please type or print) _______________________________ Signature of Individual _______________________________ Name of Joint Owner (Please type or print) _______________________________ Signature (Joint Owner) Partnership, Corporation or Other Entity Date: ________________________ _______________________________ Print or Type Entity Name By: Name:_______________________ Print or Type Name Title: ___________________________ _________________________________ Signature Title: ____________________________ _________________________________
IRREVOCABLE TRUSTS. If the trust is an irrevocable trust, please answer the following questions: Please provide the name of each trustee: Trustee Name: Trustee Name: Does the trust have assets greater than $5 million? YES NO Do you have such knowledge and experience in financial and business matters as to be capable of evaluating the merits and risks of an investment in the Company? YES NO Indicate how often you invest in:
IRREVOCABLE TRUSTS. If the trust is an irrevocable trust, please answer the following questions: Please provide the name of each trustee: Trustee Name: ________________________________________ Trustee Name: ________________________________________ Does the trust have assets greater than $5 million? Yes ☐ No ☐ Do you have such knowledge and experience in financial and business matters as to be capable of evaluating the merits and risks of an investment in the Company? Yes ☐ No ☐ Indicate how often you invest in: Marketable Securities Often ☐ Occasionally ☐ Seldom ☐ Never ☐ Restricted Securities Often ☐ Occasionally ☐ Seldom ☐ Never ☐ Venture Capital Companies Often ☐ Occasionally ☐ Seldom ☐ Never ☐
IRREVOCABLE TRUSTS. If the trust is an irrevocable trust, please answer the following questions: Please provide the name of each trustee: Trustee Name: ________________________________________ Trustee Name: ________________________________________ Does the trust have assets greater than $5 million? Yes o No o Do you have such knowledge and experience in financial and business matters as to be capable of evaluating the merits and risks of an investment in the Company? Yes o No o Indicate how often you invest in: Marketable Securities Often o Occasionally o Seldom o Never o Restricted Securities Often o Occasionally o Seldom o Never o Venture Capital Companies Often o Occasionally o Seldom o Never o The undersigned has been informed of the significance to the Company of the foregoing representations and answers contained in this Confidential Purchaser Questionnaire and such representations and answers have been provided with the understanding that the Company and the Selling Agent will rely on them. Individual Date: ________________________ _______________________________ Name of Individual (Please type or print) _______________________________ Signature of Individual _______________________________ Name of Joint Owner (Please type or print) _______________________________ Signature (Joint Owner) Partnership, Corporation or Other Entity Date: ________________________ _______________________________ Print or Type Entity Name By: Name:_______________________ Print or Type Name Title: ___________________________ _________________________________ Signature Title: ____________________________ _________________________________ Signature (other authorized signatory) Annex B Certificate of Subscriber In addition to the covenants, representations and warranties contained in the Securities Purchase Agreement, to which this Annex B – Certificate of Subscriber is attached, the undersigned Purchaser (or the Purchaser on behalf of one or more beneficial purchasers for whom the Purchaser is purchasing as principal) covenants, represents and warrants to the Company that the Purchaser (or one or more beneficial purchasers for whom the Purchaser is purchasing as principal) is resident in British Columbia, Alberta, Manitoba, Quebec, Newfoundland and Labrador, or Ontario and either (i) qualifies under Category 1 – Accredited Investor as an “accredited investor” as defined in NI 45-106 and has checked the appropriate box below, or (ii) qualifies under Category 2 – Minimum $150,000 Investment, and h...
IRREVOCABLE TRUSTS. If the trust is an irrevocable trust, please answer the following questions: Please provide the name of each trustee: Trustee Name: Trustee Name: Does the trust have assets greater than $5 million? Yes □ No □ Do you have such knowledge and experience in financial and business matters as to be capable of evaluating the merits and risks of an investment in the Company? Yes □ No □ Indicate how often you invest in: Marketable Securities Often □ Occasionally □ Seldom □ Never □ Restricted Securities Often □ Occasionally □ Seldom □ Never □ Venture Capital Companies Often □ Occasionally □ Seldom □ Never □ The undersigned has been informed of the significance to the Company of the foregoing representations and answers contained in this Confidential Purchaser Questionnaire and such representations and answers have been provided with the understanding that the Company and the Selling Agent will rely on them. Individual Date: Name of Individual (Please type or print) Signature of Individual Name of Joint Owner (Please type or print) Signature (Joint Owner) Partnership, Corporation or Other Entity Date: Print or Type Entity Name By: Name: Print or Type Name Title: Signature Title:
IRREVOCABLE TRUSTS. If the trust is an irrevocable trust, please answer the following questions about the trust and the trustee:
IRREVOCABLE TRUSTS. If the trust is an irrevocable trust, please answer the following questions: Please provide the name of each trustee: Trustee Name: ________________________________________ Trustee Name: ________________________________________ Does the trust have assets greater than $5 million? Yes o No o Do you have such knowledge and experience in financial and business matters as to be capable of evaluating the merits and risks of an investment in the Company? Yes o No o Indicate how often you invest in: Marketable Securities Often o Occasionally o Seldom o Never o Restricted Securities Often o Occasionally o Seldom o Never o Venture Capital Companies Often o Occasionally o Seldom o Never o The undersigned has been informed of the significance to the Company of the foregoing representations and answers contained in this Confidential Purchaser Questionnaire and such representations and answers have been provided with the understanding that the Company and the Selling Agent will rely on them.
IRREVOCABLE TRUSTS. An Irrevocable Trust is simply a type of Trust that can not be changed after the agreement has been signed. Irrevocable Trusts can take on many forms and be used to accomplish a variety of estate planning goals such as to protect assets and to reduce estate taxes upon death. Irrevocable Trusts are commonly used to remove the value of property from a person's estate so that the property can not be taxed when the person dies. The following guidelines apply to irrevocable Trusts:
IRREVOCABLE TRUSTS. If the trust is an irrevocable trust, please answer the following questions: Please provide the name of each trustee: Trustee Name: ____________________________________________________________ Trustee Name: ___________________________________________________________
IRREVOCABLE TRUSTS. If the trust is an irrevocable trust, please answer the following questions: Please provide the name of each trustee: Trustee Name: _______________________________________________________________ Trustee Name: _______________________________________________________________ Does the trust have assets greater than $5 million? Yes ☐ No ☐ Indicate how often you invest in: Marketable Securities Often ☐ Occasionally ☐ Seldom ☐ Never ☐ Restricted Securities Often ☐ Occasionally ☐ Seldom ☐ Never ☐ Venture Capital Companies Often ☐ Occasionally ☐ Seldom ☐ Never ☐ This completes the questions applicable to Trust Investors. Please sign below. The undersigned has been informed of the significance of the foregoing representations and answers contained in this Confidential Purchaser Questionnaire and such representations and answers have been provided with the understanding that the Company, will rely on them. Individual By: Name of Individual (Please type or print) Signature of Individual Name of Joint Owner (Please type or print) Signature (Joint Owner) Partnership, Corporation or Other Entity By: Print or Type Entity Name By: Name Title: Signature (other authorized signatory, if any) DISCLOSURE SCHEDULES Schedule 5(e) No Violation or Conflict
