OMB control number

Rule 147A(f)(1)(iii) Written Representation as to Purchaser Residency

OMB 3235-0757 · SEC.

OMB 3235-0757

Rule 147A is an exemption from registration under Securities Act Section 28. To qualify for the exemption, Rule 147A(f)(1)(iii) (17 CFR 230.147A) will require the issuer to obtain from the purchaser a written representation as to the purchaser's residency.

The latest form for Rule 147A(f)(1)(iii) Written Representation as to Purchaser Residency expires 2026-08-31 and can be found here.