Declaration Of Accredited / Expert / Institutional Investor Status Page 2
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3ACCREDITED INVESTOR QUALIFICATION
& VERIFICATION REQUIREMENTS
FOR REG D, RULE 506(c) OFFERINGS
Roll-Over Accredited – Those people who were treated as Accredited Investors under a prior
506 offering by the same issuer are deemed to be Accredited Investors in future 506(c)
offerings, provided that such Investor certifies that they are still an Accredited Investor.
2.
Legal Entity Qualification
We are an Accredited Investor by virtue of the fact that we meet one of the following criteria. Please
check the applicable box and provide the requested documents:
We are a charitable organization, corporation, or partnership with assets exceeding Five Million
Dollars ($5,000,000). Please provide:
A copy of the formation Certificate and Agreement, and a company resolution or other
document authorizing the investment signed by the requisite parties identified in the
Agreement; and
Documentation that the company has over Five Million Dollars ($5,000,000) in Assets such
as a bank statement, or financial statement showing its assets and liabilities.
We are a business in which all of the equity owners are Accredited Investors. Please provide:
A copy of the formation Certificate and Agreement, and a company resolution or other
document from the entity authorizing the investment signed by the requisite parties
identified in the Agreement; and
Documentation from each of the equity owners demonstrating that all of the equity owners
are Accredited Investors or a statement to that effect from a CPA, attorney or registered
investment advisor who has examined their qualifications within the last ninety (90) days.
We are a trust with assets in excess of Five Million Dollars ($5,000,000) that was not formed to
acquire these Securities. Please provide:
A copy of the trust, agency or other agreement and a document authorizing the investment
signed by the requisite parties identified in the Agreement, and
Documentation that the trust qualifies as an Accredited Investor because: a) it has over Five
Million Dollars ($5,000,000) in Assets, and b) that it was not formed to acquire the Interests.
We are a bank, insurance company, registered investment company, business development
company, or small business investment company. Please provide:
Documentation proving our designation as such, and
A document signed by the requisite Persons authorizing the investment.
We are an employee benefit plan, within the meaning of the Employee Retirement Income
Security Act, if a bank, insurance company, or registered investment adviser makes the
investment decisions, or if the plan has total assets in excess of Five Million Dollars ($5,000,000),
in which case:
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