Avestor Attorney Authorization Form

Avestor Attorney Authorization form

Please fill out as accurately as possible
This authorization is entered into on the date below (the “Effective Date”) between Avestor, Inc. with a place of business at 515 NW Saltzman Rd., #674, Portland, OR 97229 (“Company”), and the Customer listed below (“Sponsor”).
Date*

MonthDayYear
Date
The following questions pertain to “Bad Actor Events” under Rule 506(d) of the Securities Act of 1933, which may trigger disqualification of an offering. Thus, it is important that all fund executives carefully consider and answer each question.
Name*

First NameLast Name
Email*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Avestor Attorney Authorization form