Risk Acknowledgment Form 45-106F4 | Canada

Investors who are family, friends or business associates of the issuer must complete this form 45-106F12 when buying shares under an exempt private placement offering.

• This form comprises amendments in Ontario that came into effect on May 5, 2015.
• The investor acknowledges that the investment is risky and that they may lose their entire investment.
• This form can only be used by investors who are:
  • a principal of the issuer,
  • a family member, business associate or close friend of a majority shareholder, or
  • a trust or estate of which all of the beneficiaries or a majority of the trustees or executors are one of the above.
• Available in PDF format.
• This free form is issued by the British Columbia Securities Commission.

Ontario investors can use this Share Subscription form to purchase securities being offered in a private placement of shares.

• The investor must be purchasing the shares for their own behalf and not for someone else.
• The form is only for Ontario residents.
• This form of Subscription should be used only by close friends or business associates of a principal or promoter of the issuing corporation.

The Ontario Investor Share Subscription is part of the required documentation for any private securities offering.

When doing a private placement of shares in Canada, an issuer provides certain documents to potential investors. One of those forms is the Share Subscription Agreement.

• An investor who wants to purchase shares under the offering must complete and send the Subscription Agreement to the issuing corporation.
• The rights, restrictions, privileges and conditions attaching to the shares are described, such as voting rights, rights to dividends, and rights on dissolution.
• This template contains provisions for both shares and share warrants.
• The subscriber acknowledges that because the securities are being purchased under a prospectus exemption, most of the civil remedies available under securities legislation is not available.
• Once you purchase the Canada Share Subscription Agreement for Private Placement, you can customize it with your specific details and use it as often as you need to.