Private Individual Subscription

After filling out this form you will receive an email with the Profit Participation Note (PPN) Subscription Agreement that you will have to sign electronically in order to complete your subscription for PPNs in Quantrom P2P Lending DAC. You will also receive a link to the Offering Memorandum dated 25 October 2018 with detailed information about the Profit Participation Note Program.

Private Individuals - Subscription form

Please enter your ultimate beneficiary details

Title*

First Name*

Last Name*

Social Security Number*

Address*

ZIP*

City*

Country*

Country of residence*

Email*

Mobile*

Phone

Please enter your banking information

Bank*

IBAN Number*

Bic code*

Enter the amount you want to subscribe

Amount you want to subscribe*

Source of income

Enter detailed information about source of income

Are you a Politically Exposed Person (PEP) self-declaration*

Yes

Please select one of the below KYC methods:

KYC method*

The Offering Memorandum has been prepared by Quantrom P2P Lending DAC and is being delivered to persons who have expressed an interest in investing the Profit Participation Note Program. It is for information purposes only and does not constitute an offer or solicitation to buy or sell securities. Tax information contained in the Offering Memorandum is for general guidance purposes only.

Prospective investors are advised to make their own independent commercial assessment of the information contained therein and seek appropriate independent professional advice before deciding to subscribe for PPNs.

An investment in the PPN Program should only be undertaken by investors who are able to bear the economic risk of the investment, and who can afford to sustain a total loss of their investment.

While all reasonable care has been taken in preparing the Offering Memorandum, the PPN Subscription Agreement and all related documents and information in respect of the PPN Program, no warranties or representations expressed or implied, are given by the company or its advisors in relation to the accuracy, fairness or completeness of the information contained therein. The company, its shareholders, directors, employees and advisors shall not be responsible or liable losses incurred by investors in the PPN Program.

I confirm that I have read the above terms and agree with them

Subscription Process

Please prepare the following documents:

a scanned copy of your passport and /or national ID-card with the social security number
a utility bill not more than 3 months old

These information will have to upload to our web-page before the Profit Participation Note Subscription Agreement can be signed.

Contact

client@quantrom.com