Intake Questionnaire

Debt/ Bond offerings

Information and ideas for convertible notes, non-convertible unsecured loans, secured loans or bonds offerings.
What is the minimum amount the Issuer will raise before breaking impounds?
Skip if not acquiring an asset or other conditions on raising capital.
Annual interest rate paid to Investor
defined as annual percentage (%)
How will interest be calculated?

simple non-compoundingcompounding each payment periodcompounding monthlyOther - please clarify in Additional Notes
Is the loan convertible into equity interests?
If convertible, how will the conversion be effectuated?

Company's ownership ledger - this can be this can be uploaded separately.

	Name (beneficial owner)	Shares/ Units owned	Ownership % of the Issuer
1.
2.
3.
4.
5.

When are payments going to be made?

Monthly interest-only until maturity dateMonthly amortized payments until maturity dateNo payments until maturity dateOther - please clarify in Additional Notes
When do you expect the debt/notes issued to mature? I.e., the repayment date.*
Investor repayment date
Additional Notes
Additional information that should be considered

Existing Company

This includes background information for any Issuers that are currently in existence and operating.
As of this date, does the company have any transactions, assets, or bank accounts to consider?
Does the Company already have an Operating Agreement/Bylaws?
Besides the state of formation, what other states or countries does the Business operate or plan to operate in?

All StatesInternationalState that real estate is locatedOther - please clarify in Additional Notes
Date of Organization of Company

MonthDayYear
Date
Upload formation documents (may be called Articles of Organization, Certificate of Formation, or Articles of Incorporation) and governing documents (bylaws, operating agreements, company agreements, partnership agreement, or other resolutions).

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Has the Issuer issued any securities prior to the proposed offering?

NoYes equity interestsYes debt investments (promissory notes/ bonds/ debentures)Yes derivatives (options/ warrants/ SAFE agreements/ etc.)Yes but I need to clarify in Additional Notes
List of all current or anticipated litigation or proceedings against Issuer.
If stock is publicly traded, state the range of high and low bid information for the equity for each full quarterly period within the two most recent fiscal years and any subsequent interim period up to this date.
Description of Issuers real estate or other material assets
Please upload any additional information, such as material contracts, business plans, or other materials that will assist in the review and structure of the offering:

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Has there been prior securities issued or other ownership transfers prior to the planned offering?
Additional Notes

Regulation A+ Offering Information

Information and ideas for investment offerings qualified with SEC. Please note that additional information, including additional questionnaires, will be required prior to submission to SEC.
Substantial additional information is generally needed for a Regulation A qualified. Additional questionnaires will be sent to you through the structuring process.

Additionally, broker-dealers, SEC, and other regulatory institutions may require additional due diligence. The following link is an informational request guide. We will review and determine disclosure requirements through the consultative process.

Due Diligence Checklist

Please note that you are not anticipated to have complete information. These questionnaires and checklists are primarily for guides working towards forming.

IPO (Initial Public Offering) Information

Information and ideas for investment offerings registered with the SEC. Please take notice that additional information, including additional questionnaires, will be required prior to submission to SEC.
Substantial additional information is generally needed for a Registered Offering, uplisting, or other fully registered investment processes with the SEC. Additional questionnaires will be sent to you through the structuring process.

Additionally, broker-dealers, SEC, and other regulatory institutions may require additional due diligence. The following link is an informational request guide. We will review and determine disclosure requirements through the consultative process.

Due Diligence Checklist

Please note that you are not anticipated to have complete information. These questionnaires and checklists are primarily for guides working towards forming your offering documentation.

Regulation CF Offering Information

Information and ideas for investment offerings placed through crowdfunding portals. Please take notice that additional information, including additional questionnaires, will be required prior to submission to SEC.
Substantial additional information is generally needed for a Regulation CF offering. The following linked questionnaire includes additional considerations and information needed before the offerings are filed with the SEC. However, speaking with your attorney before taking the time to complete it is advisable.

Additionally, broker-dealers, crowdfunding portals, and other regulatory institutions may require additional due diligence. The following link is an informational request guide. We will review and determine disclosure requirements through the consultative process.

Due Diligence Checklist

Please note that you are not anticipated to have complete information. These questionnaires and checklists are primarily guides to complete the structuring of your offering.

Financial Statement Requirements

If you are raising more than $1,235,000, you must receive audited financials from a third-party CPA.

If you are raising $124,000 to $1,235,000, you must receive reviewed financials from a third-party CPA. However, for issuers that have previously sold exempt securities and current offerings that have a target offering amount of more than $619,000 but not more than $1,235,000, financial statements of the issuer audited by a CPA are required.
Do you have a CPA for any financial statement requirements:

Auditing CPA for capital raises above $1235000Reviewing CPA for capital raises between $107000 and $1235000I need a referral for a CPAI have previously completed a raise under Reg CFOther - please clarify in Additional Notes
Additional Notes

New Start-Up Company

Information and ideas for the Issuer Entity for Business Start-Ups, Franchises, or SPVs.
Type of New Business

Acquire or merge with another businessStart-up businessOpening franchise - please name in Additional NotesSpecial Purpose Vehicle investmentOther - please clarify in Additional Notes
Describe Management Team
Identify Managers, Officers, Directors and Key Principals
Compensation Summary
Please describe any compensation paid to management or material employees including stock options and salary.
Describe your start-up business or acquisition plan

0/500
If SPV, what entity is it going to invest into?
Special Purpose Vehicles set up as a pass-through issuer to invest in target company.
Additional Notes
General information that should be considered

Real Estate Syndications
Type a Property/ Project

Multifamily ApartmentsSelf-StorageMobile Home ParksSingle-family homes or neighborhoods for rentCommercial - retail/ restaurant/ office/ medicalDevelopment - ground-up construction
Property Description and Transaction Notes
Please describe the property(ies).
What is the total Purchase Price for the property(ies)?
How many real estate investments/syndications have you operated in the past?
Management Fees

Information and ideas for management fees paid to the Manager of the Issuer Entity.
Acquisition Fee
Skip if none expected.
Disposition Fee
Skip if none is expected
Acquisition/ Disposition Fee basis of calculation
Generally based upon purchase price.
Asset Management Fee
Skip if none expected
Asset Management Fee basis of calculation
Generally based upon rental income.
Property Management Fee
Skip if 3rd party provider or none expected
Financing Fee
Skip if none expected.
Refinancing Fee
Skip if none expected.
Construction Fee
Skip if none expected
Development Fee
Skip if none is expected
If management loans funds to the company, what interest rate will be charged?
Any Other Fees or Additional Notes

Real Estate Funds
Will the Fund be investing in a certain type of real estate? (check all that apply)

MultifamilyDevelopment - constructionVacation RentalsFix n Flip OpportunitiesSingle Family Residential for rentOther - please clarify in Additional Notes
Describe the Geographic Region or target market of the investing activities
Please clarify your anticipated area of investments
How many real estate investments/syndications have you operated in the past?
Management Fees

Information and ideas for management fees paid to the Manager of the Issuer Entity.
Acquisition Fee
Skip if none expected.
Disposition Fee
Skip if none is expected
Acquisition/ Disposition Fee basis of calculation
Generally based upon purchase price.
Asset Management Fee
Skip if none expected
Asset Management Fee basis of calculation
Generally based upon rental income.
Property Management Fee
Skip if 3rd party provider or none expected
Financing Fee
Skip if none expected.
Refinancing Fee
Skip if none expected.
Construction Fee
Skip if none expected
Development Fee
Skip if none is expected
If management loans funds to the company, what interest rate will be charged?
Any other fees or Additional Notes

Cryptocurrency, NFT or Token considerations
What type of digital asset are you going to offer?

Crypto commodityTrading fundDigital currency w/ utilityTokenize real estate
Please upload any White Papers or other NFT written summaries regarding your business plan.

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Investment Funds

Including equity trading, crypto, fund-of-funds, et al.
Have you filed your company or contracted any of the following to represent your investment fund:

Exempt Reporting AdvisorRegistered Investment Advisor (RIA)Commodities-brokerBroker-dealerOther - please clarify in Additional Notes

Management Fees

	Type of Fee	Percentage or Fixed Fee (describe)	Recurring Annually?
1
2
3
4

Do you currently have assets under management (AUM) between all your prior funds.
Please describe any FINRA Series license that you may hold and if placed with any current broker-dealers or registered investment advisors.
Leave blank if not applicable.
Additional Notes

Limited Liability Company (LLC) Management

Information and ideas for the Manager of the Issuer Entity.
Proposed Manager Name
Skip if you don't have any idea.
If the Manager entity is already formed, what state was it organized in?
Skip if the Manager entity hasn't been formed.
Manager Entity Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Manager's Business Phone Number
Skip if the same as the Contact's phone number.

Manager's Control Parties

	Name	Position	Ownership %
1.
2.
3.
4.
5.

Additional Notes

General Partner (GP) Management

Information and ideas for the GP of the Issuer Entity.
Proposed GP Name
Skip if you don't have any idea.
If the GP entity is already formed, what state was it organized in?
Skip if the GP entity hasn't been formed.
GP Entity Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
GP's Business Phone Number
Skip if the same as the Contact's phone number.

GP's Control Parties

	Name	Position	Ownership %
1.
2.
3.
4.
5.

Additional Notes

Officer Searches & Background Information
Securities laws require that an entity raising capital by selling securities, such as the Issuer, conduct a “reasonable investigation” to determine whether certain individuals involved in the offering (“covered persons”) may be disqualified from participating in the investment offering. This investigation involves the Issuer requesting that potentially covered persons complete a questionnaire regarding potential disqualifying events and conducting a background check of publicly available information. Any possible “bad acts” disclosed in the questionnaire and/or background check may require further inquiry to determine whether such individual is disqualified from participating in the securities offering, or if disclosure of past events to investors is required. The importance of this information cannot be overstated.

Failure of an Issuer to exclude participation by persons disqualified under the securities rules, or to disclose prior bad acts as required, may result in the Issuer losing its exemption from registration and could results in civil or criminal liability.

We have a separate officer questionnaire for covered persons if:

1. All manager, director, officer, general partner, managing member, promoter, key principal, or sponsor for the Issuer of the contemplated securities offering.

2. All persons involved in raising capital, managing, or promoting the offering on behalf of the Issuer.

3. All persons that are or expect to be a 20%+ equity or voting interests holder in the Issuer.

Please list all persons that are covered persons under 1, 2, or 3 above:

	Name	Email	Why Covered?
1
2
3
4
5
6

Confirm that neither the Issuer nor any director, officer or underwriter is disqualified from Regulation A due to “bad boy” acts listed in rule 262 of the securities act of 1933:
Biography or resume of covered persons

Please upload or provide in separate written form.
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Additional Notes

Capital Use of Proceeds Information:

You can separately upload pro forma and budget information

Detailed use of offering proceeds- should detail as if 100%, 75%, 50%, and 25% of maximum offering amount is raised. May be separately uploaded.

	Category Description	100% Funded	75% Funded	50% Funded	25% Funded
1.
2.
3.
4.
5.
6.
7.

What percentage (%) capital remains as working capital reserves?
Percentage of capital as working capital reserves remaining after above allocations
From the date of first breaking impounds, estimated capital requirements and description for each phase of operations.

Complete the following as appropriate for expected offering expenses:

	Category of Service Provider	Name	Fee
Underwriters
Commissioned sales
Finder fees
Audit and CPA expense
Legal expense
Promoters
Blue-Sky compliance

Upload financial projections/ pro forma estimates

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Additional Notes on Use of Proceeds
For clarification as appropriate

File Uploads

Please upload the following files if you have them
Don’t worry about any items that you don't already have referenced below. This is simply information gathering for us to talk through as appropriate. We will not receive any of your information unless you Submit this form on the following page.

If you don't have documentation, please skip uploads and submit. You may have previously uploaded or emailed documentation through the onboarding process. If you have, skip uploads and submit.

For your Offering, to the extent that you have any of the following at hand, please upload:
- Governing documents, including bylaws, operating agreements, articles, and minutes for any entities that have already set up
- Financial projections- excel is preferred
- Marketing materials - business plan, pitch deck, or brochures
- Resume or Bio including at least the past 5 years of work history, companies and title, and education.
- Past Performance – any summaries of past transactions (whether successful or not) if you intend to include prior performance information
- Executive Summary – your intended investment operations, targets, plans, etc…
For Real Estate Syndications
- Transactional Documents - purchase agreements, LOIs, loan document forms, loan commitments, etc…
- Property Information - property marketing memo, market summary, etc...
- Material Agreements - property management agreements, selling agreements, vendor/services agreements, developer agreements, GC agreements, etc...
For Business Capitalizations
- Material Agreements - services contracts, employment agreements, contractor agreements, vendor agreements, selling agreements, etc...
If you are funding through a broker-dealer, RIA, or finders
- LOIs, term sheets, conditional commitments, or similar non-binding commitments to raise capital
- Selling agreements
- ADV if selling through RIA
Documents not previously sent that are currently available and appropriate to the transaction or investment

Skip if you don't have files right at hand. We can always email!
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Additional Notes
Should be Empty:

Contact Information

Issuer Entity Information

Resident Agent Information

Offering Information

Equity Offering Information

Debt/ Bond offerings

Tax Planning

Existing Company

Regulation A+ Offering Information

IPO (Initial Public Offering) Information

Regulation CF Offering Information

New Start-Up Company

Real Estate Syndications

Management Fees

Real Estate Funds

Management Fees

Mortgage/ Loan Fund Information

Management Fees

Cryptocurrency, NFT or Token considerations

Investment Funds

Limited Liability Company (LLC) Management

General Partner (GP) Management

Financing/ Debt Expectations

Officer Searches & Background Information

Capital Use of Proceeds Information:

Referrals Wanted

File Uploads