Hedge Fund Subscription Procedure Page 12
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124. Your name and signature
By signing this form, you confirm that you have read this form and you understand the risks of making this investment as identified
in this form.
First and last name (please print):
Signature:
Date:
SECTION 5 TO BE COMPLETED BY THE SALESPERSON
5. Salesperson information
[Instruction: The salesperson is the person who meets with, or provides information to, the purchaser with respect to making this
investment. That could include a representative of the issuer or selling security holder, a registrant or a person who is exempt from
the registration requirement.]
First and last name of salesperson (please print):
Telephone:
Email:
Name of firm (if registered):
SECTION 6 TO BE COMPLETED BY THE ISSUER OR SELLING SECURITY HOLDER
6. For more information about this investment
Sprott Bridging Income RSP Fund
c/o Sprott Asset Management LP
Royal Bank Plaza, South Tower
200 Bay Street, Suite 2700
Toronto, Ontario M5J 2J1
Telephone: 1.888.362.7172 or 416.362.7172
Email:
For more information about prospectus exemptions, contact your local securities regulator. You can find contact information
at
The purchaser must sign this form. Each of the purchaser and the issuer must receive a copy of this form
signed by the purchaser. The issuer is required to keep a signed copy of this form for 8 years after the
distribution.
1950259-v1TORDMS
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