ACCREDITED INVESTOR FORM Your Name (required) Your Address (required) Your City/Town (required) Your ZipCode (required) Your Phone Number(required) Your Email (required) Any natural person who has earned income that exceeded $200,000 (or$300,000 together with a spouse) in each of the prior two years, and reasonably expects the same for the current year. Any natural person who has a net worth over $1 million, either alone or together with a spouse (excluding the value of the person’s primary residence). I hereby certify the above is true and correct By submitting this form I confirm that I am an accredited investor as defined by SEC guidelines. NOTE: THIS IS NOT AN OFFER TO SELL SECURITIES. THE PURPOSE OF THIS QUESTIONAIRE IS TO ESTABLISH A PRE-EXISTING RELATIONSHIP AND TO VERIFY THAT YOU ARE QUALIFIED TO INVEST IF WE HAVE ANY AVAILABLE OFFERINGS IN ACCORDANCE WITH THE LAW. THIS QUESTIONAIRE IS NOT IN CONTEMPLATION OF ANY SPECIFIC OFFERING.