Please resolve the following issues before proceeding
Click on an issue to go directly to the related section of the form.
errors found:
warnings found:

Submission Received

Private Placement Purchase Direction
Thank you for your submission. Please make sure to download a copy for your records.

Summary

Your Reference Code is:
Please quote your reference code when inquiring about your submission.

For your records

OR

Check your email

We've sent a copy of your submission to your email address ().If you didn't receive it or would like another copy, just select one of the options below.
OR

Submission Cancelled

Private Placement Purchase Direction

Important Information

Private Placement Purchase Direction
Fields marked with * are required
Private Placement Purchase Direction
To complete this Direction you will need: Full name each investment as it appears on purchase documents Type of Investment Amount being invested Investment Sponsor/Issuer contact information Your review and execution of the necessary investment’s purchase documents
IMPORTANT INFORMATION
To help ensure that your investment is properly registered to your account at Millennium (“Account”) submit the investment’s purchase documents listing the owner as Millennium Trust Company, LLC (“Millennium”) as Custodian for your Account: Millennium Trust Company, LLC Custodian FBO (Account Owner’s Name) Tax-deferred accounts, such as IRAs, must be registered with Millennium’s Tax ID: #36-4400066. Employer retirement plans using their own plan and taxable accounts must be registered with their TIN or social security number. For all initial purchases, signed purchase documents will need to be submitted. You will be able to upload this and any other supporting documentation through the portal at the end of this process or you may submit manually by mail, fax or e-mail. For additional purchases, please check with the investment sponsor to see if any additional documentation is required.
Before Millennium will execute your directed transaction, it is your sole responsibility to: (i) provide complete answers to any and all suitability questions posed by the Investment Sponsor/Issuer for purposes of determining your Account’s eligibility to participate in a purchase; (ii) review and execute the purchase documents together with all other required or related documents necessary to complete the transaction directed herein; and (iii) deliver the documents to Millennium for execution as purchaser by Millennium as custodian of your Account. In order for Millennium to custody an Alternative Investment, we must first perform an Operational Assessment to determine that the investment is administratively feasible for an account and to ensure proper custody. Millennium may contact you requesting additional documentation if this has not been performed already.
View our Pre-Custody Process – Required Documentation for Alternative Investments fact sheet for more details.

Personal Information

Private Placement Purchase Direction
Fields marked with * are required

If the co-owner is an entity, please contact client service for assistance.
Personal Trust Administrator
Please wait...
An active Alternative Investment account is required to submit a Private Placement Purchase Direction.

The online Private Placement Purchase Direction is not available for entities and 401(k) plans. Please click here for the paper version of this form.
If you still need to open an account, click here to be redirected to the online Account Open Application
If you recently submitted an application to open an account, please wait until you receive the Welcome email before filling out the Purchase Direction
If you have any questions, please contact client service.
Preferred Contact Details
Optional Contact Details

Phone

Address

Residential Address
Your legal Residential Address cannot be a P.O. Box, Mail Drop or c/o address. Provide the address used for tax reporting.
Mailing Address
Please note:
This address will be saved and stored for reference as your primary address of record. All mail correspondence will be sent to this address.

FedEx cannot be sent to a PO Box address.
Verifying Address... Please wait.
Which Address? *
Alternate Address

Alternate Address

Verifying Address... Please wait.
Which Address? *
What is your marital status? *
Are you a US citizen? *
Foreign Documentation Required
Foreign citizens or other non-U.S. persons are required to submit a completed IRS Form W-8 and a clear copy of an unexpired government issued identification card.
Cannot continue!
We are not able open an account based on the Country of Citizenship that you have selected.

:

Preferred Contact Details
Optional Contact Details

Phone

Address

Residential Address
Your legal Residential Address cannot be a P.O. Box, Mail Drop or c/o address. Provide the address used for tax reporting.
Mailing Address
Please note:
This address will be saved and stored for reference as your primary address of record. All mail correspondence will be sent to this address.

FedEx cannot be sent to a PO Box address.
Verifying Address... Please wait.
Which Address? *
Are you a US citizen? *
Foreign Documentation Required
Foreign citizens or other non-U.S. persons are required to submit a completed IRS Form W-8 and a clear copy of an unexpired government issued identification card.
Cannot continue!
We are not able open an account based on the Country of Citizenship that you have selected.

Investment Information

Private Placement Purchase Direction
Fields marked with * are required

Investment Search

Investment Name should match the name as it appears on the purchase/subscription documents.

Investment Platform

A website that lists investment offerings and enables an online investment process.
Is your offering listed on an investment platform?

Investment Sponsor

Private Placement Purchase Direction
Fields marked with * are required

Sponsor/Issuer

Preferred Contact Details
Preferred Contact Details
Preferred Contact Details
Address
Verifying Address... Please wait.
Which Address? *
Other Information

Investment Details

Private Placement Purchase Direction
Fields marked with * are required

Investment Details

Amount to be sent to Issuer/Sponsor
Do you have a Capital Commitment?
(Capital Commitment is your obligation to pay capital to the fund.)
Indicate if this is your initial Purchase or an Additional Purchase
Type of Investment

Purchase Funding Instruction

Private Placement Purchase Direction
Fields marked with * are required

Ownership Information

Are you an officer or director of the offering entity or any affiliates thereof, or are you related to any officer or director of the offering entity or any affiliates thereof?
Is your ownership of this entity (combined with any family member or disqualified person) less than 50%?

Investment Delivery

Private Placement Purchase Direction
Fields marked with * are required

Investment Delivery

Millennium shall have no liability or responsibility for the failure of the U.S Postal Service or any third party courier to deliver documents in a timely manner.
How do you wish to have the investment documents delivered to your Investment Sponsor?

Identity Verification

Private Placement Purchase Direction
Fields marked with * are required

Identity Verification

Confirmation
The information that you provided will allow us to verify your identity. Learn more about identifying documents.

After you confirm your identity, the following data cannot be changed for this request - name, address, social security number, and date of birth.
Do you confirm that the details you have entered are correct?

Identity Verification

Private Placement Purchase Direction
Fields marked with * are required

Verification

Verifying your identity now...
Additional verification is required.
To help verify your identity we’ve compiled a series of questions that only you should be able to answer. You will have 3 minutes to complete them.
Working...
Successfully Verified
Documents Needed
Placeholder

Verifying Additional Signer

Verifying Additional Signer Now...
Successfully Verified
We need some documentation
Client currently running CIP
Please click 'Reload' once the client has completed CIP

Account Selection

Private Placement Purchase Direction
Fields marked with * are required

Account Details

Please wait...
Please select your account type.

Account Confirmation

The account noted above is the account I wish to proceed with.

Confirm and Esign

Private Placement Purchase Direction
Fields marked with * are required

Review & Confirm

Confirm Data
Please review the information below and then check the box at the end confirming the accuracy of your data.

Confirmation

Attachment

Private Placement Purchase Direction
Fields marked with * are required

Attachment

The following documents are required to complete the purchase of your investment. Please select a delivery method before clicking next to complete this request.
The following documents may be required to complete the purchase of your investment. Please select a delivery method before clicking next to complete this request. If documents are not required for your additional purchase, please select "I will deliver later."
Purchase/Subscription Documents
Purchase/Subscription Documents
File:
I will deliver later

Agreement and Esign

Private Placement Purchase Direction
Fields marked with * are required

Agreement

Private Placement Purchase Direction Agreement
I direct Millennium to execute the purchase of the previously described investment in my Account, and in doing so I hereby agree to the terms below and make the following representations and warranties:

eSignature

Additional Investment

Would you like to submit another Private Placement Purchase Direction?
Your session will expire in minutes. Please click on continue to keep your session active.