Name of Investor Person/Entity *
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I/We am/are aware that a prospectus and investment statement or a product disclosure statement (or any information usually given by an issuer in respect of the issue of financial products) will not be provided for this investment and I/we confirm that I/we are, for the purposes of the Financial Markets Conduct Act 2013 (the Act) and the Financial Markets Conduct Regulations 2014:
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An investment business (as defined in Schedule 1, clause 37 of the Act);
A person that meets the investment activity criteria (as defined in Schedule 1, clause 38 of the Act) for instance because I/we own (now or in the last two years) a portfolio of specified financial products valued at not less than $1 million;
A large person (as defined in Schedule 1, clause 39 of the Act) for instance because I am a person who as at the last day of the two most recently completed financial years held either personally or in entities controlled by me/us, net assets exceeding $5 million;
An eligible investor (as defined in Schedule 1, clause 41 of the Act) and can provide to you a certificate from an authorised financial adviser, chartered accountant or lawyer certifying the same;
A wholesale investor because I/We am/are investing $750,000 or more;
Have an annual gross income of at least $200,000 for each of the two most recently completed income years;
A close business associate of or a director or senior manager of the offeror (as defined in Schedule 1, clause 4 of the Act);
A relative of the offeror or of a director of the offeror (as defined in Schedule 1, clause 5 of the Act);
An entity controlled by a person who meets one of the criteria above (as defined in Schedule 1, clause 9 of the Act).