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*

I confirm that I have read and understand the foregoing

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 securities.*

YesNo, I am ineligible to invest in private securities.I don't know (consult with your financial adviser or attorney)
Is the Investor a "qualified client" within the meaning of the Investment Company Act of 1940?*

YesNoI don't know (consult with your financial adviser or attorney)
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.*

YesNoI don't know (consult with your financial adviser or attorney)
Net Worth Excluding Primary Residence (check all that apply)*

over $500,000over $1,000,000over $5,000,000over $10,000,000over $25,000,000over $50,000,000over $100,000,000
Cumulative Value of owned Investments (check all that apply)*

over $500,000over $1,000,000over $5,000,000over $10,000,000over $25,000,000over $50,000,000over $100,000,000
Primary Residence*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is the Client planning to permanently retire within the next five years?*

YesNoI don't know
Investment Objectives (check all that apply)*

generate incomeliquidate assetspreserve capitalgrowthaccumulate assets for heirsNONE OF THE ABOVEOther
Primary Purpose of Investment Activities*

Personal, family, or household purposes such as retirement, educations, personal savings etc.Non-personal, business, commercial, charitable, institutional or other purposes
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)

less than $100,000 per yearover $100,000 per yearover $250,000 per yearover $350,000 per yearover $1,000,000 per year
Previous Investment Types (check all that apply)

Corporate BondsMunicipal BondsHedge FundsPublic EquityPrivate EquityOptions TradingAnnuitiesFutures/CommoditiesMutual FundsREITsEarly stage venture capitalLate-stage, Pre-IPO equity
Client's years of experience buying and selling securities
Client Sophistication (check all that apply)*

Client has founded or managed a private companyClient has experience evaluating company financial statementsClient has the business acumen to evaluate the merits and risks of an investmentClient has owned a controlling interest in a private companyClient possesses a professional license (attorney, CPA, FINRA, etc.)Client consults with a professional adviser for financial decisionsClient is a member of a group or club that emphasizes private investments
Client has invested in private equity/debt securities within the past five years.*

YesNo
Client can make investments with little to no need for liquidity in the foreseeable future.*

YesNo
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.*

YesNo
The Client is capable of evaluating investment risks independently; and will exercise independent judgement in evaluating any recommendation.*

YesNo
Additional Commentary
Attestation
Please confirm one of the following options . . .*

I attest that I am Investor indicated on this form or I have the authority to complete the form on behalf of the Investor. I have completed this form truthfully and accurately, to the best of my knowledge. I have refused to provide any missing information.I attest that I am the Rainmaker Securities Agent indicated on this form or I have the authority to complete the form on behalf of the Rainmaker Securities Agent. I have asked the investor for all of the information input into this form. I have completed this form truthfully and accurately, to the best of my knowledge.
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Investor Qualification Form for Natural Persons

Investor Profile

Attestation