I am, We are: *

An individual (natural person)

A couple, filing and investing together

A business entity, non-profit organization, trust, or family office

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Investor Information *

Please select one or more of the following to establish yourself as an accredited investor.

My current net worth is over $1,000,000.00 (US Dollars), exclusive of my primary residence.

My current annual income exceeds $200,000.00 (US Dollars), and I expect it to be equal to, or greater than, this amount next year.

[For joint-filing couples] Our current net worth is greater than $1,500,000.00 (US Dollars), exclusive of our primary residence.

[For joint-filing couples] Our current annual income exceeds $300,000.00 (US Dollars), and we expect it to be equal to, or greater than, this amount next year.

[For Entities] The value of the business or charitable entity I am representing is greater than $5,000,000.00 (US Dollars), exclusive of any endowment funds prohibited from use, and not including funds received from business loans, government grants, or lines of credit.

Confirmation *

By checking the box below, I affirm and attest that I am an accredited investor, or the authorized representative of such, as defined by the Investment Company Act of 1940, the Securities Exchange Act of 1934, and/or any amendments thereto.

I confirm that the above statements are true and accurate for myself, or myself and my spouse.

I confirm that the above statements are true and accurate for the entity of which I am an authorized representative.