Common use of TO BE COMPLETED BY THE REGISTRANT Clause in Contracts

TO BE COMPLETED BY THE REGISTRANT. 2. Registrant information [Instruction: this section must only be completed if a subscriber has received advice from a portfolio manager, investment dealer or exempt market dealer concerning his or her investment.] First and last name of registrant (please print): Registered as: [Instruction: indicate whether registered as a dealing representative or advising representative] Telephone: Email: Name of firm: [Instruction: indicate whether registered as an exempt market dealer, investment dealer or portfolio manager.] Date: Complete this form if you are: • A Subscriber in Manitoba, Xxxxxx Xxxxxx Island, Yukon, Northwest Territories or Nunavut • Relying on the Offering Memorandum Exemption; and • Purchasing Units for Greater than $10,000 APPENDIX II ELIGIBLE INVESTOR QUESTIONNAIRE The undersigned, as a purchaser of units (the “Units”) of Capital Direct I Income Trust (the “Trust”), has represented to the Trust and Capital Direct Management Ltd. (the “Manager”) that the undersigned is an “eligible investor” as defined in section 1.1 of National Instrument 45-106 – Prospectus Exemptions. The undersigned has indicated below the categories which it, he or she satisfies to qualify as an “eligible investor”. The undersigned understands that each of the Trust and the Manager is relying on this information in determining to sell securities to the undersigned in a manner exempt from the prospectus requirements of applicable securities laws and the Trust or the Manager may require additional information or action to be taken by the undersigned to verify the undersigned’s eligibility for this exemption. ELIGIBLE INVESTOR STATUS The undersigned represents and warrants that it, he or she is [check each applicable item]: □

Appears in 2 contracts

Samples: www.incometrustone.com, www.incometrustone.com

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TO BE COMPLETED BY THE REGISTRANT. 2. Registrant information [Instruction: this section must only be completed if a subscriber has received advice from a portfolio manager, investment dealer or exempt market dealer concerning his or her investment.] First and last name of registrant (please print): Registered as: [Instruction: indicate whether registered as a dealing representative or advising representative] Telephone: Email: Name of firm: [Instruction: indicate whether registered as an exempt market dealer, investment dealer or portfolio manager.] Date: Complete this form if you are: A Subscriber in Manitoba, Xxxxxx Xxxxxx Island, Yukon, Northwest Territories or Nunavut • Manitoba  Relying on the Offering Memorandum Exemption; and Purchasing Units for Greater than $10,000 APPENDIX II ELIGIBLE INVESTOR QUESTIONNAIRE The undersigned, as a purchaser of units (the “Units”) of Capital Direct I Income Trust (the “Trust”), has represented to the Trust and Capital Direct Management Ltd. (the “Manager”) that the undersigned is an “eligible investor” as defined in section 1.1 of National Instrument 45-106 – Prospectus Exemptions. The undersigned has indicated below the categories which it, he or she satisfies to qualify as an “eligible investor”. The undersigned understands that each of the Trust and the Manager is relying on this information in determining to sell securities to the undersigned in a manner exempt from the prospectus requirements of applicable securities laws and the Trust or the Manager may require additional information or action to be taken by the undersigned to verify the undersigned’s eligibility for this exemption. ELIGIBLE INVESTOR STATUS The undersigned represents and warrants that it, he or she is [check each applicable item]: □:

Appears in 1 contract

Samples: www.incometrustone.com

TO BE COMPLETED BY THE REGISTRANT. 2. Registrant information [Instruction: this section must only be completed if a subscriber has received advice from a portfolio manager, investment dealer or exempt market dealer concerning his or her investment.] First and last name of registrant (please print): Registered as: [Instruction: indicate whether registered as a dealing representative or advising representative] Telephone: Email: Name of firm: [Instruction: indicate whether registered as an exempt market dealer, investment dealer or portfolio manager.] Date: Complete this form if you are: • A Subscriber in Manitoba, Xxxxxx Xxxxxx Island, Yukon, Northwest Territories or Nunavut Manitoba • Relying on the Offering Memorandum Exemption; and • Purchasing Units for Greater than $10,000 APPENDIX II ELIGIBLE INVESTOR QUESTIONNAIRE The undersigned, as a purchaser of units (the “Units”) of Capital Direct I Income Trust (the “Trust”), has represented to the Trust and Capital Direct Management Ltd. (the “Manager”) that the undersigned is an “eligible investor” as defined in section 1.1 of National Instrument 45-106 – Prospectus Exemptions. The undersigned has indicated below the categories which it, he or she satisfies to qualify as an “eligible investor”. The undersigned understands that each of the Trust and the Manager is relying on this information in determining to sell securities to the undersigned in a manner exempt from the prospectus requirements of applicable securities laws and the Trust or the Manager may require additional information or action to be taken by the undersigned to verify the undersigned’s eligibility for this exemption. ELIGIBLE INVESTOR STATUS The undersigned represents and warrants that it, he or she is [check each applicable item]: □:

Appears in 1 contract

Samples: www.incometrustone.com

TO BE COMPLETED BY THE REGISTRANT. 2. Registrant information [Instruction: this section must only be completed if a subscriber has received advice from a portfolio manager, investment dealer or exempt market dealer concerning his or her investment.] First and last name of registrant (please print): Registered as: [Instruction: indicate whether registered as a dealing representative or advising representative] Telephone: Email: Name of firm: [Instruction: indicate whether registered as an exempt market dealer, investment dealer or portfolio manager.] Date: Complete this form if you are: A Subscriber in Manitoba, Xxxxxx Xxxxxx Island, Yukon, Northwest Territories or Nunavut Relying on the Offering Memorandum Exemption; and Purchasing Units for Greater than $10,000 APPENDIX II ELIGIBLE INVESTOR QUESTIONNAIRE The undersigned, as a purchaser of units (the “Units”) of Capital Direct I Income Trust (the “Trust”), has represented to the Trust and Capital Direct Management Ltd. (the “Manager”) that the undersigned is an “eligible investor” as defined in section 1.1 of National Instrument 45-106 – Prospectus Exemptions. The undersigned has indicated below the categories which it, he or she satisfies to qualify as an “eligible investor”. The undersigned understands that each of the Trust and the Manager is relying on this information in determining to sell securities to the undersigned in a manner exempt from the prospectus requirements of applicable securities laws and the Trust or the Manager may require additional information or action to be taken by the undersigned to verify the undersigned’s eligibility for this exemption. ELIGIBLE INVESTOR STATUS The undersigned represents and warrants that it, he or she is [check each applicable item]:

Appears in 1 contract

Samples: www.incometrustone.com

TO BE COMPLETED BY THE REGISTRANT. 2. Registrant information [Instruction: this section must only be completed if a subscriber has received advice from a portfolio manager, investment dealer or exempt market dealer concerning his or her investment.] First and last name of registrant (please print): Registered as: [Instruction: indicate whether registered as a dealing representative or advising representative] Telephone: Email: Name of firm: [Instruction: indicate whether registered as an exempt market dealer, investment dealer or portfolio manager.] Date: Complete this form This Form if you are: A Subscriber in Manitoba, Xxxxxx Xxxxxx Island, Yukon, Northwest Territories or Nunavut • Manitoba  Relying on the Offering Memorandum Exemption; and Purchasing Class C Units for Greater than $10,000 APPENDIX II ELIGIBLE INVESTOR QUESTIONNAIRE The undersigned, as a purchaser of units Class C Units (the “Class C Units”) of Capital Direct I Income Trust (the “Trust”), has represented to the Trust and Capital Direct Management Ltd. (the “Manager”) that the undersigned is an “eligible investor” as defined in section 1.1 of National Instrument 45-106 Prospectus and Registration Exemptions. The undersigned has indicated below the categories which it, he or she satisfies to qualify as an “eligible investor”. The undersigned understands that each of the Trust and the Manager is relying on this information in determining to sell securities to the undersigned in a manner exempt from the prospectus requirements of applicable securities laws and the Trust trust or the Manager may require additional information or action to be taken by the undersigned to verify the undersigned’s eligibility for this exemption. ELIGIBLE INVESTOR STATUS The undersigned represents and warrants that it, he or she is [check each applicable item]: □:

Appears in 1 contract

Samples: www.incometrustone.com

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TO BE COMPLETED BY THE REGISTRANT. 2. Registrant information [Instruction: this section must only be completed if a subscriber has received advice from a portfolio manager, investment dealer or exempt market dealer concerning his or her investment.] First and last name of registrant (please print): Registered as: [Instruction: indicate whether registered as a dealing representative or advising representative] Telephone: Email: Name of firm: [Instruction: indicate whether registered as an exempt market dealer, investment dealer or portfolio manager.] Date: Complete this form This Form if you are: • A Subscriber in Manitoba, Xxxxxx Xxxxxx Island, Yukon, Northwest Territories or Nunavut Manitoba • Relying on the Offering Memorandum Exemption; and • Purchasing Class C Units for Greater than $10,000 APPENDIX II ELIGIBLE INVESTOR QUESTIONNAIRE The undersigned, as a purchaser of units Class C Units (the “Class C Units”) of Capital Direct I Income Trust (the “Trust”), has represented to the Trust and Capital Direct Management Ltd. (the “Manager”) that the undersigned is an “eligible investor” as defined in section 1.1 of National Instrument 45-106 Prospectus and Registration Exemptions. The undersigned has indicated below the categories which it, he or she satisfies to qualify as an “eligible investor”. The undersigned understands that each of the Trust and the Manager is relying on this information in determining to sell securities to the undersigned in a manner exempt from the prospectus requirements of applicable securities laws and the Trust trust or the Manager may require additional information or action to be taken by the undersigned to verify the undersigned’s eligibility for this exemption. ELIGIBLE INVESTOR STATUS The undersigned represents and warrants that it, he or she is [check each applicable item]: □:

Appears in 1 contract

Samples: www.incometrustone.com

TO BE COMPLETED BY THE REGISTRANT. 2. Registrant information [Instruction: this section must only be completed if a subscriber has received advice from a portfolio manager, investment dealer or exempt market dealer concerning his or her investment.] First and last name of registrant (please print): Registered as: [Instruction: indicate whether registered as a dealing representative or advising representative] Telephone: Email: Name of firm: [Instruction: indicate whether registered as an exempt market dealer, investment dealer or portfolio manager.] Date: Complete this form if you are: • A Subscriber in Manitoba, Xxxxxx Xxxxxx Island, Yukon, Northwest Territories or Nunavut • Relying on the Offering Memorandum Exemption; and • Purchasing Units for Greater than $10,000 APPENDIX II ELIGIBLE INVESTOR QUESTIONNAIRE The undersigned, as a purchaser of units (the “Units”) of Capital Direct I Income Trust (the “Trust”), has represented to the Trust and Capital Direct Management Ltd. (the “Manager”) that the undersigned is an “eligible investor” as defined in section 1.1 of National Instrument 45-106 – Prospectus Exemptions. The undersigned has indicated below the categories which it, he or she satisfies to qualify as an “eligible investor”. The undersigned understands that each of the Trust and the Manager is relying on this information in determining to sell securities to the undersigned in a manner exempt from the prospectus requirements of applicable securities laws and the Trust or the Manager may require additional information or action to be taken by the undersigned to verify the undersigned’s eligibility for this exemption. ELIGIBLE INVESTOR STATUS The undersigned represents and warrants that it, he or she is [check each applicable item]:

Appears in 1 contract

Samples: www.incometrustone.com

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