To be completed by MJIC U.S. Securityholders who do not qualify as Accredited Investors. If you are an Accredited Investor, please fill out this form instead.
In addition to the covenants, representations and warranties contained in the Merger Agreement and the Representation Letter to which this Appendix is attached, the undersigned (the “MJIC U.S. Securityholder”) covenants, represents and warrants to Pubco (also referred to herein as the “Company”) that the MJIC U.S. Securityholder understands that the Securities have not been and will not be registered under the U.S. Securities Act and that the offer and sale of the Securities to the MJIC U.S. Securityholder contemplated by the Merger Agreement is intended to be a private offering pursuant to Rule 506(b) of Regulation D of the U.S. Securities Act and/or section 4(a)(2) thereunder.
Your answers will at all times be kept strictly confidential. However, by signing this suitability questionnaire (the “Questionnaire”) the MJIC U.S. Securityholder agrees that the Company may present this Questionnaire to such parties as may be appropriate if called upon to verify the information provided or to establish the availability of an exemption from registration of the private offering under the federal or state securities laws or if the contents are relevant to issue in any action, suit or proceeding to which the Company is a party or by which it is or may be bound. A false statement by the MJIC U.S. Securityholder may constitute a violation of law, for which a claim for damages may be made against the MJIC U.S. Securityholder. Otherwise, your answers to this Questionnaire will be kept strictly confidential.
Please complete the following questionnaire: