Transfer Form for Secondary Sales

Transcription

1 Return via Standard Mail CB Richard Ellis Realty Trust PO Box Kansas City, MO Return via Overnight Delivery CB Richard Ellis Realty Trust 430 W. 7th Street, Suite Kansas City, MO CNL Client Services Toll-Free Fax Transfer Form for Secondary Sales one Please print name(s) in which shares are currently registered. * This form must be used to change a social security number or TIN number under most circumstances. Current Investor (Transferor) Information Investor Name/Trustee Co-Investor Name/Trustee (if applicable) Street Address (required) Social Security Number/TIN* Social Security Number/TIN* Address Phone Number If the transfer is due to a death, please enclose a copy of the death certificate. If there is an executor of the estate, please enclose a copy of the Letters of Administration or court appointment of the executor dated within 90 days of the submission of the transfer forms. If the transfer is due to a divorce, please enclose a copy of the divorce decree. CB Richard Ellis Realty Trust may reject any request for transfer of shares, in whole or in part, in its sole discretion. two Investment Important Notice: The issuer has elected the first-in, first-out (FIFO) method as the default for calculating cost basis for covered shares as defined in the fund s offering documents. If you have questions or wish to change the cost basis method, please go to the Company website and download the investor change form. This transfer is for the amount of shares. three If this account involves a custodian, please forward the transfer forms to the custodian for its signature and Medallion stamp guarantee with instructions to return the forms to the transfer agent, Boston Financial Data Services. We must have the original signature(s) of the registered owner(s)/investor(s). Power of Attorney given to secondary market makers will not be accepted. Current Investor (Transferor) Signatures By executing this Transfer Form, the Transferor represents that the transfer is made in accordance with all applicable federal and state securities laws and regulations. The signature(s) to this Transfer Form must correspond with the name(s) in which you hold the shares, in every particular, without alteration or any change whatsoever. Signature of Current Investor - OR - Executor of Estate Signature of Co-Investor Medallion Stamp Signature Guarantee Co-Investor Medallion Stamp Signature Guarantee Revised 10/10/2011 Page 1 of 6

2 four Please print name(s) in which shares are to be registered. If applicable, please enclose a copy of the trust agreement, articles of incorporation, or other information pertinent to your type of entity. New Investor (Transferee) Information Investor Name/Trustee Social Security Number/TIN Co-Investor Name/Trustee (if applicable) Social Security Number/TIN Street Address (required) Address Phone Number Select one. Citizenship q U.S. citizen q Resident Alien q U.S. citizen residing outside the U.S., Country q Foreign Resident, Country Select one. Backup Withholding: Subject to backup withholding? q YES q NO For Custodial Accounts Only Name TIN Address Custodian/Brokerage Account Number five New Investor (Transferee) Form of Ownership Select only one type of account: Non-Custodial Single Signature Custodial Custodian Signature Required q Individual Other q Individual with Transfer on Death* Non-Custodial Multiple Signatures q Joint Tenant with Rights of Survivorship q Joint Tenants with Transfer on Death* Non-Custodial Trust q Taxable Trust q Tax Exempt Trust Name of Trust q Corporation q Partnership q Non-Profit Organization q Profit Sharing Plan q Pension Plan q Estate Name of Corporation/Plan Name/Estate/Other q Community Property * Fill out Transfer on Death form to effect designation. Transfer on Death form available on q Traditional IRA q ROTH IRA q SEP/IRA q Rollover IRA q Beneficial IRA Beneficial IRA Decedant Name Other Custodian Signature Required q Uniform Gift to Minors Act, State of DOB of Minor q Uniform Transfers to Minors Act, State of DOB of Minor Page 2 of 6 Revised 10/10/2011

3 six Select only one option. Complete this section only to enroll in the Reinvestment Plan or to direct distribution payments to a party other than the one indicated in Section 4. * See prospectus for more details. IRA accounts may not direct distributions without the custodian s approval. Distributions q Reinvestment Plan* q Direct Deposit (non-custodian investors only) I authorize Boston Financial Data Services or its Agent (together, BFDS ) to deposit my distribution to my checking or savings account. This authority will remain in force until I notify BFDS in writing to cancel it. In the event that BFDS deposits funds erroneously into my account, they are authorized to debit my account for an amount not to exceed the amount of the erroneous deposit. Financial Institution Address Select One Account Type. q Checking (please include a voided check) q Savings q Brokerage or other Account Number Bank ABA Routing Number seven Medallion Signature Guarantee Stamp Medallion Signature Guarantee Stamp New Investor (Transferee) Signatures A. Substitute IRS Form W-9 Certification: The investor signing below, under penalties of perjury, certifies that (i) the number shown on this subscription agreement is its correct taxpayer identification number (or it is waiting for a number to be issued to it) and (ii) it is not subject to backup withholding either because (A) it is exempt from backup withholding, (B) it has not been notified by the Internal Revenue Service ( IRS ) that it is subject to backup withholding as a result of a failure to report all interest or dividends, or (C) the IRS has notified it that it is no longer subject to backup withholding, and (iii) it is a U.S. person for federal tax purposes (including a U.S. resident alien). YOU MUST CROSS OUT CLAUSE (ii) IN THIS CERTIFICATION AND THE SUBJECT TO BACKUP WITHHOLDING BOX SHOULD BE CHECKED IN SECTION FOUR IF THE INVESTOR HAS BEEN NOTIFIED BY THE IRS THAT IT IS CURRENTLY SUBJECT TO BACKUP WITHHOLDING BECAUSE IT HAS FAILED TO REPORT ALL INTEREST AND DIVIDENDS ON ITS TAX RETURN. The Internal Revenue Service does not require your consent to any provision of this document other than this certification, which is required to avoid backup withholding.. B. Taxpayer Securities Laws Confirmation (required): By executing this transferee form, the transferee represents that the transfer is made in accordance with all applicable federal and state securities laws and regulations. Signature of New Investor Signature of Co-New Investor eight Broker-Dealer Information Broker-Dealer FINRA Firm Name Registered Representative Rep Mailing Address Phone Fax Revised 10/10/2011 Page 3 of 6

4 nine The transfer agent collects this information in connection with its reporting obligations to the Securities and Exchange Commission. * The transferor (seller) is the entity that is the current owner. Current Investor (Transferor) Acknowledgement The undersigned transferor(s) (the Transferor ), in connection with the undersigned s request to transfer Shares (the Shares ) in CB Richard Ellis Realty Trust (the Company ), hereby represents and warrants to the Company that the following statements are true: 1. The Transferor* has completed all forms required by CB Richard Ellis Realty Trust 2. The Transferor acknowledges that the Shares were purchased for long-term investment. 3. The Transferor has agreed upon the requested transfer and agrees that neither the Company, Board of Directors, of affiliates of the Company shall be responsible for any loss incurred by Transferor as a result of such transfer. The request for this transfer has net sales proceeds to the seller of $ per Share or of the original purchase price. % 4. The Transferor has received no representations or warranties from the Company, the Board of Directors, or any affiliates, agents or representatives of the Company. 5. The Transferor agrees that the Transferee may revoke its agreement to transfer and shall be released from any obligation in connection therewith until such transfer is recorded on the books and records of the Company. IN WITNESS WHEREOF, the undersigned has executed this Acknowledgement as of the day of, 20 Signature (Title, if applicable) Signature of Joint Purchaser (if applicable) Page 4 of 6 Revised 10/10/2011

5 ten New Investor (Transferee) Acknowledgement The undersigned transferee (the Transferee ), in connection with the undersigned s submission to acquire Shares (the Shares ) in CB Richard Ellis Realty Trust (the Company ), hereby represents and warrants to the Company that the following statements are true: * The transferee (buyer) is the entity to which the shares are to be transferred. 1. The Transferee* has completed all forms required by the Company. 2. The Transferee has received a copy of the most recent annual report or Form 10-K and any subsequent reports or Form 10-Q or Form 8-K. 3. The Transferee is in a financial position appropriate to enable it to realize to a significant extent the benefits of the investment, has adequate means for providing for its current needs and personal contingencies, has sufficient net worth and income to sustain the risks inherent in the investment, including limited liquidity of the investment, and believes the investment is otherwise suitable. 4. The Transferee has received no representations or warranties from the Company, Board of Directors, or any affiliates, agents or representatives of the Company. 5. The Transferee agrees that the Transferor may revoke its agreement to transfer and shall be released from any obligation in connection therewith until such transfer is recorded on the books and records of the Company. IN WITNESS WHEREOF, the undersigned has executed this Acknowledgement as of the day of, 20 Signature of Transferee Signature of Joint Transferee (if applicable) Revised 10/10/2011 Page 5 of 6

6 eleven This form is to be completed and signed by the entity or person that is facilitating the transfer. Facilitator Acknowledgement The undersigned, in connection with its submission of the enclosed request for transfer of Shares (the Shares ) in CB Richard Ellis Realty Trust (the Company ) from (the Transferor ) to (the Transferee ), hereby represents and warrants to the Company that the following statements are true: 1. The Transferee has completed all forms required by the Company. 2. The Transferee has received a copy of the most recent annual report or Form 10-K and any subsequent reports or Form 10-Q or Form 8-K. 3. The Transferee is in a financial position appropriate to enable it to realize to a significant extent the benefits of the investment, has adequate means for providing for its current needs and personal contingencies, has sufficient net worth and income to sustain the risks inherent in the investment, including limited liquidity of the investment, and believes the investment is otherwise suitable. 4. Neither the undersigned nor the Transferee has relied on any representations or warranties from the Company, the Board of Directors, or any affiliates, agents or representatives of the Company. 5. The undersigned agrees that the Transferor may revoke its agreement to transfer and shall be released from any obligation in connection therewith until such transfer is recorded on the books and records of the Company. The undersigned has executed this Acknowledgement as of the day of, 20 Signature (Title, if applicable) Name of Organization Represented Page 6 of 6 Revised 10/10/2011