Accredited Investor Qualification Form
By submitting this form you certify the following:
Net Worth Certification
I am a natural person whose individual net worth, or joint net worth with my spouse, at this time exceeds $1,000,000, excluding my home.
I am a natural person who had an individual income in excess of $200,000 in each of the two most recent years or joint income with my spouse in excess of $300,000 in each of those years and I have a reasonable expectation of reaching the same income level in the current year.
Certification of Accredited Investor Status
I have read and understand the meaning of “accredited investor” as described below and certify that I met the requirement as defined in Regulation D of the Securities & Exchange Commission. I have read the link to the S.E.C. web site describing the applicable securities regulations and understand them clearly and take responsibility for meeting them.
Certification of Information Submitted
I certify that all the information submitted is true and correct.
I am interested in registering with S.E.C. compliant web sites to review investment opportunities open to accredited investors.
Securities offered through Merriman Capital, Inc. member FINRA/SIPC or other registered broker dealers at Cutting Edge Capital, Crowdfunder.com, Andrew Romans, Viviene Telio or Steven Kann and The California Stock Xchange or Cal-X Stars Business Acclerator, Inc. (Cal-X) are not legally affiliated. Risk Disclosure: Any investor who intends to utilize this website must be an accredited investor. Private investments involve a high degree of risk, can be highly illiquid, are not required to provide periodic pricing or valuation information to investors, and may involve complex tax structures and delays in distributing important tax information. Prior performance is not a guarantee of future results. Private investment performance can be volatile. An investor could lose all or a substantial amount of his or her investment. There is often no secondary market for an investor’s interest in private investments, and none is expected to develop. There may be restrictions on transferring interests in any private investment. Investors are encouraged to seek the advice of their legal counsel and CPA prior to investing. NO OFFER OR SOLICITATION: The contents of this website: (i) do not constitute an offer of securities or a solicitation of an offer to buy securities, and (ii) may not be relied upon in making an investment decision related to any investment offering by or Merriman Capital, Andrew Romans or another registered broker dealer. Use of this website does not constitute an offer by Cal-X or Merriman Capital of Andrew Romans or any other registered broker dealer to sell, solicit or make an offer to buy any investment interest in any business venture. Cal-X or Merriman Capital or Andrew Romans or any other registered broker dealer do not give or offer any business advice, investment advice, tax advice or legal advice to anyone using the website. Investment offerings and investment decisions may be made on the basis of a confidential private placement memorandum provided by the issuer only through registered broker dealer site or password protected accredited investor only portals such as HealthiosXchange.com, Crowdfunder.com, AngelList.co, Microventures.com, RockThePost.com, EarlyShares.com and Healthfundr.com . Cal-X or Merriman Capital or Andrew Romans or any other registered broker dealer or portal listed on this site does not warrant the accuracy or completeness of the information contained herein.
Leonhardt Venture’s and Cal-X Ensures Accredited Investor Verification When Required By Law With These Methods Followed Strictly:
The SEC has designated certain “safe harbor” methods that if followed definitely count as reasonable verification. The individual safe harbors for verification of accredited status are satisfied if the issuer does any one of the following:
● Obtains any IRS form that reports income including but not limited to Form W-2 (“Wage and Tax Statement”), Form 1099 (report of various types of income), Schedule K-1 of Form 1065 (“Partner’s Share of Income, Deductions, Credits, etc.”), or a copy of a filed Form 1040 (“U.S. Individual Income Tax Return”) for the two most recent years, along with obtaining a written representation from such person that he or she has a reasonable expectation of reaching the income level necessary to qualify as an accredited investor during the current year.
● Reviews one or more of the following types of documentation for assets and for liabilities, dated within the prior three months, and obtains a written representation from that person that all liabilities necessary to make a determination of net worth have been disclosed. For assets this is bank statements, brokerage statements and other statements of securities holdings, certificates of deposit, tax assessments and appraisal reports issued by independent third parties. For liabilities this is a consumer report (also known as a credit report) from at least one of the nationwide consumer reporting agencies and a written representation from such person that all liabilities necessary to make a determination of net worth have been disclosed.
● Obtains a written confirmation from a registered broker-dealer, an SEC-registered investment adviser, a licensed attorney, or a certified public accountant that such person or entity has taken reasonable steps to verify that the purchaser is an accredited investor within the prior three months and has determined that such purchaser is an accredited investor.