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For Investors

The information given below will be kept strictly confidential. It will only be used to update you on possible investment opportunities, if you qualify financially to review such information.

This is not an offer of securities. The actual investment offering will be made only through a Private Placement Memorandum.

After you complete this questionnaire, we will contact you. Thank you for your interest.

First Name:
Last Name:
Email Address:
Address:
City/Town:
State:
Zip Code:
Phone Number: - -
Approximate Assets Available to Invest:

Your Investment Profile: Conservative    Moderate    Aggressive

At least one of the following questions must be answered in the affirmative to qualify as a purchaser:

I have had an individual income in excess of $200,000 in each of the two most recent years and reasonably expect an individual income in excess of $200,000 in the current year.
My spouse and I have had joint income in the excess of $300,000 in each of the two most recent past years and we reasonably expect joint income of $300,000 or more in the current year.
I have an individual net worth or joint net worth with my spouse in excess of $1,000,000.
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