SOPHISTICATED INVESTOR APPLICATION/CERTIFICATION

To: First Corporate Pty Ltd

Please:

  • Complete Section 1
  • Either Complete Section 2 - and have your accountant sign it OR complete Section 2 for professional Investors
  • Sign and date Section 3

Section One

Investors Details
Title Dr Mr Mrs Ms Miss
Name
Address
Phone Business
Private
Fax Business

Email
(Please note email will be the usual form of communication)

I acknowledge that:

  1. this Certificate is given to First Corporate Pty Ltd (First) to enable First to determine whether it is able to make certain offers of securities to me in compliance with Corporations Law.
  2. Offers of securities made to me by First may be made on the basis of this certificate.
  3. I may be required to observe certain selling restrictions in Australia in relation to securities offered to me as a registered Sophisticated Investor.
  4. I may only act as principal.
Dated
Signed

Section Two

Qualified Accountant's Certification
Title Dr Mr Mrs Ms Miss
Name
Address
Phone Business
Fax Business

I certify that the following is true and correct in every particular:

  1. I am a qualified accountant within the meaning of section 9 of the Corporation Law1.
  2. This certificate is given at the request of the investor described in Section 1 of this certificate ("Investor") in relation to potential offers by First of offers to subscribe for or acquire securities.
  3. This certificate is given to First for the purpose of section 708(8)(c) of the Corporations Law; and
  4. The Investor has:
    (i)  Net assets of at least $2,500,000; or
    (ii) A gross income for each of the last 2 financial years of at least $250,000 a year.
Signed
Name of Qualified Accountant
Dated

1"Qualified accountant" means a member of a professional body that is approved by ASIC in writing for the purpose of the definition. ASIC has indicated that it will approve any member of:

  1. The Australian Society of Certified Practicing Accountants ("ASPCA"), who is entitled to use the post-nominals "CPA" or "FCPA", and is subject to and complies with the ICAA's continuing professional development requirements;
  2. The Institute of Chartered Accountants in Australia ("the ICAA"), who is entitled to use the post-nominals of "CA", "ACA" or "FCA", and is subject to and complies with the ICAA's continuing professional education requirements; or
  3. The National Institute of Accountants ("the NIA"), who is entitled to use the post-nominals "MNIA" or "FNIA", and it subject to and complies with NIA's continuing professional education requirements.

Section Three

Professional Investor Category
I certify that I am (tick whichever box is applicable):
A person who controls at least $10 million (including any amount held by an associate or under a trust that the person manages) for the purpose of investment in securities; or
A regulated superannuation fund, an approved deposit fund, a pooled superannuation trust, or a public sector superannuation scheme within the meaning of the Superannuation Industry (Supervision) Act 1993 if the fund, trust or scheme has net assets of at least $10 million.
Details of the Managed Fund or Superannuation Fund/Trust/Scheme
Name
Address
Phone Business
Fax Business
A person who is licensed or exempt dealer and is acting as principal.
License Number
NOTE: First may require independent verification of your professional investors status.