SEC Accredited Investor Qualification

Types of Investments Preferred
	Early Stage
	Private Placements in Private Company
	PIPES (Private Investment in Public Entity)
	Hedge Funds
Personal Information
First Name:
Last Name:
E-Mail Address:
Address:
City:
State:
Zip Code:
Country:
Phone:
Fax:
AIM Screen Name:
Capital to Invest:	$10k - $100k $100k - $250k $250k - $500k $500k - $1M $1M - $3M $3M - $5M $5M - $10M $10M - $20M $20M - $50M
How did you find this page?:	Google YouTube Facebook Other
Certification of Accreditation
I hereby acknowledge and certify that I am an Accredited Investor as defined by the United States Securities and Exchange Commission, Regulation D, Rule 501 promulgated under the Securities Act of 1933, as amended; that I have knowledge and experience in financial and business matters; and that I am capable of evaluating the merits and risks of private equity investments. For the definition of "accredited investor," please click on the underlined words in the preceding sentence and/or visit the Securities and Exchange Commission's web site at www.sec.gov. I certify that the information presented in this application is true to the best of my knowledge and agree to provide additional information as necessary to verify any of the information included herein. Initial Here:
Verification Code
Enter the code shown into the box below - this is done to prevent automated scripts from completing the form:
Verification Code: