All fields below are required to create your subscription agreement.
Legal Entity Overview Tab
Entity Name: Please refer to this article.
General Partner Name: Only applicable if it's a Partnership. It will go into your Subscription Agreement and the DCR for a Distribution.
Partnership Name: Only applicable if it's a Partnership. It will go into your Subscription Agreement and the DCR for a Distribution.
Street Address (City, Province / State, Country, Postal Code): The address you can be contacted at. It will go into your Subscription Agreement, and Tax Forms.
Placeholders | addy Business Name (& Location) |
[ISSUER FULL LEGAL NAME] |
Entity Name (Overview Tab) |
[GENERAL PARTNER FULL LEGAL NAME] |
General Partner Name (Overview Tab) |
[ISSUER ADDRESS] |
Street Address (Overview Tab) |
[DESCRIPTION OF SECURITIES] |
Security Name (Properties > Overview Tab) |
[FULL NAME OF SUBSCRIBER] |
Populated with Investor Information |
[ADDRESS OF SUBSCRIBER] |
Populated with Investor Information |
[TELEPHONE ADDRESS] |
Populated with Investor Information |
[NUMBER OF SECURITIES] |
Populated with Investor Information |
[PRICE PER SECURITY] |
Populated with Investor Information |
[AGGREGATE SUBSCRIPTION PRICE] |
Populated with Investor Information |
[DATE OF OFFERING MEMORANDUM/OFFERING DOCUMENT] |
Populated by addy |
[SUBSCRIPTION DATE OF INDIVIDUAL] |
Populated with Investor Information |
[SIGNATURE OF AUTHORIZED SIGNATORY OF ISSUER] |
Populated During Countersigning |
[TITLE OF AUTHORIZED SIGNATORY OF ISSUER] |
Title (Directors, Officers, Signatories Tab) |
[REGISTRANT FULL LEGAL NAME] |
Populated by Dealer Rep |
[REGISTRANT TELEPHONE] |
Populated by Dealer Rep |
[REGISTRANT EMAIL] |
Populated by Dealer Rep |
[FUNDING PORTAL EMAIL ADDRESS] |
Populated by Dealer Rep |
[FUNDING PORTAL TELEPHONE NUMBER] |
Populated by Dealer Rep |
[CURRENCY] |
Country (Properties > Overview Tab) |
AMOUNT OF DEALER/FUNDING PORTAL FEE |
Dealer Fee (Percentage) (Raise Capital > Overview Tab) |
[MAXIMUM AMOUNT OF DEALER/FUNDING PORTAL FEE] |
Calculated Automatically based on Dealer fee percentage |
[MAXIMUM OFFERING AMOUNT] |
Maximum Offering Amount (Properties > Overview Tab) |
[ISSUER CONTACT PERSON AND ADDRESS] |
Contact Person Email & Street Address (Raise Capital Tab) |
[ISSUER CONTACT PERSON EMAIL] |
Contact Person Email (Raise Capital Tab) |
[DATE SUBSCRIBER FILLS OUT THIS FORM] |
Populated Automatically |
[SUBSCRIBER NAME] |
Populated with Investor Information |
[DATE OF SUBSCRIBER SIGNATURE] |
Populated with Investor Information |
[FIRST AND LAST NAME OF SALESPERSON OF THE AGENT] |
Populated by Dealer Rep |
[NUMBER OF SALESPERSON OF THE AGENT] |
Populated by Dealer Rep |
[EMAIL OF SALESPERSON OF THE AGENT] |
Populated by Dealer Rep |
[REGISTRATION NUMBER OF AGENT] |
Populated by Dealer Rep |
[ISSUER CONTACT PERSON EMAIL] |
Contact Person Email (Raise Capital Tab) |
[DESCRIPTION AND AGGREGATE AMOUNT OF SECURITIES] |
Populated with Investor Information |
[FULL NAME OF PURCHASER] |
Populated with Investor Information |
[DATE OF SIGNATURE ON FORM] |
Populated with Investor Information |
[Instruction: total consideration] |
Populated with Investor Information |
[Instruction: name of issuer] |
Entity Name (Overview Tab) |
[Instruction: amount of fee or commission] |
Calculated Automatically based on Dealer fee percentage |
[Instruction: name of person selling the securities] |
Populated by Dealer Rep |
[NAME OF PURCHASER] |
Populated with Investor Information |
[DATE OF SIGNATURE] |
Populated with Investor Information |
[SALESPERSON FULL LEGAL NAME] |
Populated by Dealer Rep |
[SALESPERSON TELEPHONE] |
Populated by Dealer Rep |
[SALESPERSON EMAIL] |
Populated by Dealer Rep |
[SALESPERSON FIRM NAME] |
Populated by Dealer Rep |
[name of issuer] |
Entity Name (Overview Tab) |