Use this template to prepare an 
Accredited Investors Checklist and Representation Letter for a private offering of securities in Canada.
- The checklist sets out all of the classifications of investors which are defined as "accredited investors" by National Instrument 45-106.
 
- Any person, corporation or entity subscribing for the securities must complete the form and return it to the issuer.
 
- The subscriber must also make certain representations to the issuer regarding whether he/she is a Canadian resident, and on what basis he/she is purchasing the securities.
 
This 
Canada Accredited Investors Checklist and Representation Letter template is available in MS Word format, and can be easily edited to meet your needs.