Investor Qualification Form for Natural Persons

Investor Qualification Form for Natural Persons
Please Read Instructions
1. This form may be completed by the Investor or by a Rainmaker Securities Agent on behalf of the Investor.
2. This form is for investors that are natural persons. Investors transacting as legal entities should use the corresponding form legal entity investors located here https://www.rainmakersecurities.com/investor-qualification-form-for-entity-persons.
3. If you need help, please contact your Rainmaker Securities Agent to complete the form.
USA PATRIOT Act and SEC Regulations

Rainmaker Securities, LLC is a FINRA registered broker-dealer. Broker-dealers are required to collect certain personal information about all clients in order to comply with the USA Patriot Act to help prevent the financing of terrorism. We are also required by the SEC and FINRA to collect certain personal information to ensure we understand the financial circumstances and investment goals of our clients. We are also required by law to conduct an independent background investigation of every client.

Your Personal Information is Secure

The information entered in this form is protected by 256 bit SSL (Secure Socket Layer) connection that uses a SHA256 Certificate. This is the same level of protection used by online banking or e-commerce providers. Once submitted, the information is stored in cloud storage that is maintained with AES 256-bit encryption. Our emails are protected in transit by TLS (Transport Layer Security).

Your Personal Information is Private

Our full privacy policy is available here:

https://www.rainmakersecurities.com/privacy-policy
ACKNOWLEDGEMENT

Investor Profile
Who is the referring Rainmaker Securities Agent?

First NameLast Name
(Optional) If you know the email of the Rainmaker Securities Agent and would like them to be notified that you have completed this form, you may enter their email address here.
example@example.com
Name of Natural Person Investor

First NameLast Name
Investor Phone Number

Area CodePhone Number
Investor Email
example@example.com
Is the Investor is an "accredited investor" within the meaning of Rule 501 of the Securities Act of 1933? In general, only accredited investors may purchase private placement securities.
Is the Investor a "qualified client" within the meaning of the Investment Company Act of 1940?
Is the Investor a "qualified purchaser" within the meaning of the Investment Company Act of 1940? Only qualified purchasers may invest in securities offerings of issuers that are exempt from registration as an investment company under the 3(c)(7) exemption.
Net Worth Excluding Primary Residence (check all that apply)
Net Worth Excluding Primary Residence (check all that apply)
Cumulative Value of owned Investments
Cumulative Value of owned Investments (check all that apply)
Primary Residence

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Is the Client planning to permanently retire within the next five years?
Investment Objectives (check all that apply)

Other
Primary Purpose of Investment Activities
Tax ID Number
Date of Birth

MonthDayYear
Date
Occupation
or type NONE
Name of Employer
or type NONE
Address of Employer

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Annual Income (check all that apply)
Previous Investment Types (check all that apply)
Client's years of experience buying and selling securities
Client Sophistication (check all that apply)
Client has invested in private equity/debt securities within the past five years.
Client can make investments with little to no need for liquidity in the foreseeable future.
Client has the risk tolerance to invest in private securities and understands that certain private securities carry significant risk, including the risk of loss of the entire investment.
The Client is capable of evaluating investment risks independently; and will exercise independent judgement in evaluating any transaction or recommendation.
Additional Commentary
Attestation
Please confirm one of the following options . . .
Should be Empty: