Questions Regarding Investor Suitability for a Rule 506(b) Securities Offering

Per the SEC, to demonstrate a pre-existing relationship sufficient to invite an investor into a Regulation D, Rule 506(b) Offering:

Investor Name

Email

example@example.com

Phone #

Format: (000) 000-0000.

There must be a pre-existing relationship between the issuer and investor that is not built solely through a specific duration of time or a short-form accreditation questionnaire.
Rather, it can be established by adhering to specific policies and procedures both online and offline (where appropriate), which enable the issuer to evaluate the prospective

investor’s financial sophistication, circumstances, suitability, and his or her ability to understand the nature and risks of the Interests to be offered; and that the issuer actually followed this process to make such an evaluation.

3. The relationship must pre-date the offer.

4. You must have a record-keeping system to record compliance with Nos. 1-3 above.

Select all that apply and provide a brief summary.

What is your current net worth? 25 words or less .

Has your last 2 years’ income exceeded $200k/year if single or $300k/year if married? blanks 25 words or less

Do you expect your current income to continue into the future? . 25 words or less

What types of investments do you currently have? 25 words or less .

What is the value of your other investments? 25 words or less .

What kind of returns are you getting from your other investments? 25 words or less .

What experience do you have in Private Placements? 25 words or less .

What are your investment objectives? 25 words or less .

What is your investment time horizon? 25 words or less .

What liquidity needs do you have? 25 words or less .

How would you rate your risk tolerance? 25 words or less .

SAMPLE: This is a sample document and as such is not intended as legal or financial advice. The information is publicly available through various regulatory and and other authorities and

summarized here for your consideration. We highly recommend you consult with your legal and financial representatives before engaging in any transactions.