Centurion REIT Subscription Agreement
Eligible Investor
New Account
Yes
No
Prepare Date - Year
Prepare Date - Short Year
Prepare Date - Month
Prepare Date - Day
Name of DR.
DR's Tel. Number
Please enter a valid phone number.
DR's Email Address
example@example.com
Client Type
Individual
Corporation
Client's Last Name
Client's First Name
Client's Birthday
Client's Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Client's Tel. Number
Please enter a valid phone number.
Client's Email Address
example@example.com
Client's SIN Number
Investment Amount
Investment Type
Please Select
Open
TFSA
RRSP
RESP
Purchase Option
Plan A----Deferred Sales Charge
Plan B----Low Load
Plan C----Front Load
Individual Checklist
KYC Form
Signed Sub. Agreement
ID
Risk Acknowledgement Form
LOD
Cheque payable to issuer
Corporation Checklist
Certificate of Incorporation, Notice of Articles
Trust Declaration
Resolution of Officers and Directors
ID of Signing Authority
OM Date
-
Month
-
Day
Year
Date
Distribution Option
ALL CASH
DRIP
Name of Witness
Eligible Investor Status
Net Assets exceed $400,000 or Individual income exceeds $75,000 or Family income exceeds $ 125,000
Full Name
Client's Tax Residence
Tax resident of Canada
Tax resident of US
Tax resident of other country
Jurisdiction of Tax Residence
Reason for no TIN
Dealer Name
Commission
Preview PDF
Submit
Should be Empty: