Purchaser Representative Questionnaire
(Rule 506(b) Offering)

Summary

This template Purchaser Representative Questionnaire may be used by a company to collect and confirm information about a purchaser representative in an unregistered offering relying on Rule 506(b) of Regulation D (17 C.F.R. § 230.506(b)). This template includes practical guidance and drafting notes. Specifically, the answers to this questionnaire will assist the company in determining whether a non-accredited investor, together with its purchaser representative, meets the investor sophistication requirements of Rule 506(b) to participate in the offering. The document should be prepared by company counsel and distributed to any non-accredited investors that the company knows will or may require a purchaser representative. All completed questionnaires must be received by the company prior to the close of the offering. If the investor's status is uncertain (for example, if the investor may be an accredited investor or may meet the sophistication requirements without a purchaser representative), an investor and purchaser representative questionnaire should be completed instead. For a template investor and purchaser representative questionnaire, see Investor and Purchaser Representative Questionnaire (Start-Up). For more information on Rule 506(b) offerings, see Regulation D Offerings. For a full listing of key content covering Regulation D offerings, see Regulation D Resource Kit. For more information on private placements, see Private Placements Resource Kit.