Please print out the pdf form provided or complete the electronic form below:
CERTIFICATE FOR THE PURCHASE OF INITIAL PUBLIC OFFERINGS OF EQUITY SECURITIES
Pursuant to FINRA Rule 5130 (the "New Issue Rule"), Stifel, Nicolaus & Company, Incorporated ("Stifel") may not sell or cause to be sold a new issue (all bolded terms are defined at the end of this document) to any account in which a restricted person holds a beneficial interest unless the account qualifies for a general exemption under the New Issue Rule.
In addition, pursuant to FINRA Rule 5131 (the "IPO Allocation Rule") firms may not, under certain circumstances, allocate shares of a new issue to any account in which an executive officer or director of a public company or a covered non-public company or a person materially supported by such executive officer or director (collectively, "Covered Persons") has a beneficial interest unless the account qualifies for a general exemption.
In addition, in connection with any new issue, you hereby represent that you will not act as a finder or in a fiduciary capacity to any managing underwriter of any new issue and that you shall notify Stifel immediately in the event that such representation ceases to be true and correct.
IN ORDER TO PURCHASE OR RECEIVE AN ALLOCATION OF AN EQUITY IPO, YOU MUST CERTIFY YOUR ELIGIBILITY BY CHECKING ONE BOX FROM SECTION "A" AND ONE BOX FROM SECTION "B" AND COMPLETING THE ACCOUNT INFORMATION BELOW. IF YOU CANNOT CERTIFY, THEN YOU ARE DEEMED TO BE INELIGIBLE AND SHOULD NOT COMPLETE OR SUBMIT THIS FORM.