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Accredited Investor Questionnaire

Tell Us About Yourself:
(*Required Fields)

*Last Name : 
*Job Title : 
*Company/Organization : 
*Street Address : 
 
*City : 
Province : 
*Zip / Postal Code : 
*Work Telephone : 
Fax Number : 
*Email Address : 
Website : 

*Where did you hear about us?
Industry Contact  (please specify):




  (please specify):

*Please register me:


*Please categorize your institution

   If "Other", please specify

If you are a financial intermediary, what types of investors do you represent?
High Net Worth Individuals
Institutions
Other

If you represent an institution, what are the institution's assets under management?

*Do you or your institution invest in hedge funds?

No

  In order to proceed, you must:
1) Meet the Accredited Investor eligibility
2) Read and agree to the Terms and Conditions below
 

I hereby certify that I am an Accredited Investor within the meaning of the Rule 501(a) of Regulation D under the Securities Act of 1933, because (check below):

*If you are an Individual Investor:

I am a natural person whose individual net worth, or joint net worth with my spouse, exceeds $1,000,000.

I am a natural person whose individual income exceeded $200,000 in each of the last two calendar years, or had joint income with my spouse that exceeded $300,000 in each of those years, and has a reasonable expectation of reaching the same level in this calendar year.

None of the above categories are applicable for my individual use.

*If you represent an Institution:

Charitable Organizations, Business Trusts and Partnerships

I represent any organization described in section 501(c)(3) of the Internal Revenue Code, corporation or similar business trust, or partnership, which was not formed for the specific purpose of investing in any of the funds represented on this website, with total assets in excess of $5,000,000.

Personal Trusts

I represent a personal trust with total assets in excess of $5,000,000 which was not formed for the specific purpose of investing in any of the funds represented on this website, whose purchase is directed by a sophisticated person as defined in the Securities Act of 1933.

Employee Benefit Plans

I represent an employee benefit plan that satisfies at least one qualifying condition as set forth in Rule 501(a) of Regulation D.

Bank, Insurance Company, Small Business Investment Company or Organization Registered with the SEC

I represent an organization that is licensed, or subject to supervision by U.S. federal or state examining authorities as a “bank,” “savings and loan,” “insurance Company,” or “small business investment company,” or my organization is registered with the U.S. Securities and Exchange Commission.

Entity with 100% Accredited Investor Equity Owners

I represent an entity in which all of the equity owners are accredited investors

None of the above categories are applicable to the entity I represent.

 

Terms and Conditions

By accessing the requested information or password-protected area of this site, you agree not to invest in any posted hedge fund other than funds in which you or your affiliates are already invested, have already been solicited for or are already actively considering an investment in) for thirty days after the approval of your application.

Additionally, by accessing the requested information or password-protected area of this site, you agree to immediately contact FX Concepts if there is any change in your status as an Accredited Investor of Rule 501(a) of Regulation D under the Securities Act of 1933. For individuals such changes may include, for example, a Registered User’s net worth declining below $1,000,000, an expectation that income for the next twelve months may total less than $200,000, or an expectation that the Registered User’s combined income with his or her spouse may total less than $300,000 in the next twelve months. All Registered Users, including individuals and entities, should communicate with their legal advisors if they believe that their status as an accredited investor has changed. If a Registered User’s status as an accredited investor has changed, that Registered User agrees to immediately notify FX Concepts of this change.

*I have read and accept the Terms and Conditions
  (You must check this box to be able to submit this questionnaire)

 



 

 


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