Investors Real Estate Trust EX-99
SUBSCRIPTION AGREEMENT
AMOUNT $__________________ NUMBER OF COMMON SHARES ________________
OWNERSHIP
Name(s)________________________________________________________________________
REGISTRATION: Address _______________________________________________________
City ________________________ State __________ Zip ____________
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 FOR CORRESPONDENCE AND CASH DISTRIBUTIONS
Name(s)________________________________________________________________________
Address________________________________________________________________________
City ____________________________________ State __________ Zip ____
(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 IRA, 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 DEALER ENDORSEMENT:
Firm _________________________________________________________________
Registered Representative ____________________________ Phone _________
ii-17 Page 136 of 143
Address ______________________________________________________________
Dealer Authorized Signature __________________________________________
NOTE: Checks to be made payable to:
INVESTORS REAL ESTATE TRUST, 00 XXXXX XXXX XX., XXXXX, ND 58701
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Accepted by: INVESTORS REAL ESTATE TRUST
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By: XXXXX-XXXXX & ASSOCIATES (Advisor) Date ___________
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