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FIRST NAME*

LAST NAME*

EMAIL*

PHONE*

CITY*

STATE*

PLEASE CONFIRM YOUR STATUS AS AN ACCREDITED INVESTOR BY CHECKING ALL THAT APPLY.*

Income - My annual income exceeded $200,000 (or $300,000 together with a spouse) in each of the prior two years, and I reasonably expect to earn the same or greater for the current year.

Net Worth ($1M - $5M) - My net worth is over $1 million, either alone or together with a spouse, excluding the value of my primary residence.

Qualified Purchaser ($5M+ net worth) - I invest as a person or family business with at least $5 million in investable assets OR as an entity or investment company with $25 million in investable assets.

Entity Accredited Investor - I invest on behalf of an entity with at least $5 million in total assets or an entity in which all equity owners are accredited investors (e.g., an LLC or trust).

None of the above describes my financial status or I am unsure.

WHAT TYPE OF INVESTMENTS ARE YOU OPEN TO CONSIDERING?*

Income Investments

Collateral-Backed Debt Investments

Gross Revenue Royalty Investments

Real Estate Investments

Alternative Investments

Private Equity Sponsors & Funds

Equity Investments into Revenue Positive Companies with $500K+ in revenue

Equity Investments into Profitable Operating Businesses

WHAT IS THE MAXIMUM NUMBER OF YEARS YOU ARE COMFORTABLE BEING ILLIQUID IN ANY INVESTMENT?*

1 Year

3 Years

5 Years

7 Years

10+ Years

WHAT IS THE HIGHEST MINIMUM INVESTMENT YOU ARE COMFORTABLE?*

$25,000

$50,000

$75,000

$100,000

$150,000

$250,000

$500,000

$1,000,000+

WHAT ARE YOUR INVESTMENT GOALS?*

Growth

Preservation

Cash Flow

HOW DID YOU HEAR ABOUT US?*

PLEASE VERIFY YOUR REQUEST*

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