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Accredited Investor Questionnaire
ADDITIONAL INFORMATION WHICH AN ISSUER MAY REQUIRE BEFORE ACCEPTING INVESTMENT FROM AN INVESTOR:
Certification that:
The Investor further certifies: In signing this Investor Questionnaire, they acknowledge they have received and carefully reviewed all of the following documentation:
Additionally, in making this investment, the Investor is able to bear the economic risk of this investment, the Investor acknowledges that this investment involves a high degree of risk, and the Investor should not be making this investment unless the Investor can afford to lose the amount invested in its entirety. The foregoing statements and documents attached hereto are true and accurate to my knowledge and belief, and the Investor is authorized to rely on the information in entering into the Investment as of the date completed below. SIGNATURE OF INVESTOR: If an Individual – Date:_____________ (Signature of Investor):_____________ (Printed or Typed Name):____________ If Co-owners – Date: ______________ (Signature of Co-Investor):___________ (Printed or Typed Name):____________ Type of ownership: ___co-tenants ___joint tenancy (married couples only) If an Entity: Date:__________________ (Name of Entity):___________________ (Type of Entity & State of formation):_______ By:___________________________ (Signature of official of Investor) Name:________________________ Title:_________________________ 2022-07-01T09:39:20-04:00Our Knowledge Base contains lots more information about investing in private placements. |