Name *

First Name

Last Name

Phone *

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I certify that I meet the definition of an “accredited investor” as set forth in the Securities Act of 1933, as amended. *

Income: Have an income of over $200,000 individually or over $300,000 jointly with a spouse or domestic partner in each of the prior two years, and reasonably expect the same for the current year OR Net worth: Have an individual net worth, or joint net worth with a spouse, that exceeds $1 million at the time of the investment, excluding the value of their primary residence

YES

NO

Are you a qualified purchaser? *

A qualified purchaser (QP) is an individual or entity that has an investment portfolio worth at least $5 million. This status is based on the value of the portfolio, rather than the person's net worth, income, or credentials. For entities, the minimum portfolio value is $25 million. Investments can include stocks and bonds, but do not include a primary residence or business property

YES

NO

Do you represent a family office or multi-family office? *

YES

NO

Are you a representative of an institutional investor? *

YES

NO