If an investment opportunity became available within the next thirty to sixty days that interested you, would you have funds available for investment in (please check appropriate box or boxes):
(a) my individual net worth, along with the net worth of my spouse, exceeds $1,000,000, excluding the value of my personal residence and excluding from my liabilities the mortgages on my personal residence, provided the mortgages to not exceed the value of my personal residence; or
(b) an individual income of at least $200,000.00 over the past two years which is expected to continue in the current year, or $300,000 with your spouse?
(Ex. background, goals, whatever you think is relevant for me to know.)
Date Format: MM slash DD slash YYYY
I confirm, by typing my name in below and electronically submitting this form, that the information supplied herein is current and accurate. I agree to sign a printed copy if asked to do so by the recipient.