Certificate of Rule 144A Qualified Institutional Buyer
This certificate is essential for institutional buyers involved in the private offering of securities under Rule 144A. It ensures compliance with the necessary regulations and provides necessary representations to facilitate investments. This document is a fundamental requirement for entities qualifying under Rule 144A.
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How do I fill this out?
To fill out this certificate, begin by confirming your status as a Qualified Institutional Buyer (QIB). Next, provide the total value of eligible securities you hold. Lastly, complete the personal and institutional details accurately before submission.

How to fill out the Certificate of Rule 144A Qualified Institutional Buyer?
1
Determine your status as a Qualified Institutional Buyer.
2
Enter the total dollar amount of eligible securities you own.
3
Fill in the required institutional information.
4
Review the certificate for accuracy.
5
Submit the completed certificate.
Who needs the Certificate of Rule 144A Qualified Institutional Buyer?
1
Institutional investors seeking to purchase securities under Rule 144A.
2
Registered investment advisers facilitating transactions for clients.
3
Investment companies looking to invest in eligible securities.
4
Insurance companies making separate account purchases.
5
Dealers registered under the Securities Exchange Act of 1934.
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What are the important dates for this form in 2024 and 2025?
Important dates for the use of the Rule 144A certificate generally depend on your investment schedule. Institutions should keep track of their fiscal year-end and establish deadlines for submission based on their investment cycles. Stay updated with your financial advisor for any specific deadlines pertaining to this form.

What is the purpose of this form?
The purpose of the Rule 144A certificate is to provide a formal declaration that the undersigned entity is a Qualified Institutional Buyer. This certification is crucial for facilitating the legal purchase of privately offered securities under Rule 144A of the Securities Act. It ensures that all parties comply with the necessary regulatory requirements to engage in such transactions.

Tell me about this form and its components and fields line-by-line.

- 1. Name of Institution: The official name of the entity completing the certificate.
- 2. Tax Identification Number: The institution’s unique tax identification number for legal recognition.
- 3. Address: The physical address of the institution.
- 4. City: The city where the institution is located.
- 5. Telephone #: The contact phone number for further communications.
- 6. Executive Officer Name/Signature: The name and signature of the executive officer certifying the form.
- 7. Title: The title or position of the executive officer.
- 8. E-mail address: Email address for any follow-up communications.
What happens if I fail to submit this form?
Failing to submit this form may result in the inability to participate in securities offerings under Rule 144A. Compliance with the certification is critical to ensure investment eligibility. Entities may also face legal ramifications for non-compliance with federal securities laws.
- Legal Ramifications: Failure to certify may lead to legal issues concerning compliance with the Securities Act.
- Investment Restrictions: Without proper certification, institutions could be barred from participating in Rule 144A transactions.
- Regulatory Compliance: Non-compliance may result in penalties from regulatory agencies.
How do I know when to use this form?

- 1. Investment in Private Offerings: Required for institutions participating in private securities offers.
- 2. Compliance Verification: Necessary to confirm status as a Qualified Institutional Buyer to regulatory authorities.
- 3. Facilitating Transactions: Helps facilitate transactions on behalf of clients or the institution.
Frequently Asked Questions
What is a Rule 144A certificate?
A Rule 144A certificate is a document that certifies an institution's status as a Qualified Institutional Buyer, allowing it to purchase privately offered securities.
How do I fill out the Rule 144A certificate?
To fill out the Rule 144A certificate, confirm your QIB status, specify your eligible securities' value, and complete the required personal and institutional information.
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What types of institutions can use this form?
The form can be used by various institutions, including investment advisors, registered investment companies, and insurance companies.
What happens if I don't submit this form?
Failure to submit this form may hinder your ability to purchase securities under Rule 144A.
Are there any important dates associated with this form?
Important dates typically vary by institution and investment cycles; consult your financial advisor for specific deadlines.
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