User Basic Information for account opening

The purpose of this Statement is to obtain information relating to whether you are an accredited investor as defined in Securities and Exchange Regulation D as well as your knowledge and experience in financial and business matters and to your ability to bear the economic risks of an investment in a private placement offering.

I certify that I/we qualify as an Accredited Investor under the following category as defined in Regulation D:

A natural person whose individual net worth, or joint net worth with that person's spouse, at the time of his purchase exceeds $1,000,000, excluding the value of the person’s primary residence, but including any excess liability between the value of the residence and the amount of any obligation(s).A natural person who had an individual income in excess of $200,000 in each of the two most recent years or joint income with that person's spouse in excess of $300,000 in each of those years and has a reasonable expectation of reaching the same income level in the current year.A director, executive officer, or general partner of the issuer of the securities being offered or sold, or any director, executive officer, or general partner of a general partner of that issuer.A natural person holding in good standing one or more professional certification or designations or credentials from an accredited educational institution that the Commission has designated as qualifying an individual for accredited investor status.A natural person who is a “knowledgeable employee” As defined in Rule 3c-5(a)(4) under the Investment Company Act of 1940 (17 CFR 270. 3c-5(a)(4)), of the issuer of the securities being offered or sold where the issuer would be an investment company, as defined in Section 3 of such act, but for the exclusion provided by either sections 3(c)(1) or Section 3(c)(7) of such act.

ADELPHI STOCK BROKERS INC.ACCREDITED INVESTOR QUESTIONNAIRE

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