Home Join Now Learn More Sign in
Home | Admin | Sign Out 
Find a Form 

Access thousands of free legal and business forms contributed by leading lawyers and other professionals

Search by key words (e.g., "Sales Contract")
Advanced search

 
Promote Your Business  
  • Contribute a legal or business form and network with thousands of potential clients, businesses, and professionals

    Upload a Form Add Your Executive Profile
Promote Your Business 
  • Contribute a legal or business form and network with thousands of potential clients, businesses, and professionals

    Upload a Form Add Your Executive Profile
Promote your business  
  • Contribute a legal or business form and network with thousands of potential clients, businesses, and professionals

    Upload a Form Add Your Executive Profile
Add your free profile  
  • Contribute a legal or business form and network with thousands of potential clients, businesses, and professionals

    Upload a Form Add Your Executive Profile
 
Connect

Terms Of Use

Submissions to this site, including any legal or business forms, posts, responses to questions or other communications by contributors are not intended as and should not be construed as legal advice. You are strongly encouraged to consult competent legal council before engaging in any action based upon content contained on this site.

These downloadable forms are only for personal use. Retransmission, redistribution, or any other commercial use is prohibited. This includes reposting forms from this site to another site offering free legal or other document forms for download.

Please note that the donator may have included different usage terms regarding this form, and you agree to abide by these terms. It is highly recommended that you have a licensed attorney review any legal documents for which you are searching in order to make sure that your needs are being properly and completely satisfied.

Your use of this site constitutes your acceptance of our terms of use and your agreement to hold this site, its officers, employees and any contributors to this site harmless for any damage you might incur from your use of any submissions contained on this site. If you do not agree to the above terms, please do not proceed.

These forms are provided to assist business owners and others in understanding important points to consider in different transactions. They are offered with the understanding that no legal advice, accounting, or other professional service is being offered by these documents or on this website. Laws vary in the different states. Agreements acceptable in one state may not be enforced the same way under the laws of another state. Also, agreements should relate specifically to the particular facts of each situation. Therefore, it is important to consult legal counsel whenever utilizing these forms. The Forms are not a substitute for legal advice YourFreeLegalForms.com is not engaged in recommending or referring members on the site or making claims about the competence, character or qualifications of its participating members.
Close

Thank you for using
Yourfreelegalforms.com


Your online source for 100% free legal and business forms.
Have a form to contribute?
Contribute a legal or business form, checklist or article and have your profile displayed on the same page as the form for free, powerfull, targeted marketing to those searching for legal forms and advice.

Advertise your business to thousands for free – Contribute a form
Form #966

Investor Questionnaire

Average user rating:  
Not Yet Rated
Rate it

Investor Questionnaire - free form to use

Need this form customized? Download This Form Printer Friendly Version

INVESTOR QUESTIONNAIRE

 

Name of Subscriber: ________________________________________________

The offer and sale of limited partnership interests (the ''Interests'') in _____________________________________________________ (the ''Partnership''), are not being registered under the Securities Act of 1933, as amended (the ''Act'') or qualified under state securities laws, in reliance upon exemptions from such registration and qualification requirements for transactions not involving any public offering. Information supplied through this Questionnaire will be used to ensure compliance with the requirements of such exemptions.

 

The undersigned Subscriber represents and warrants to the Partnership and the General Partner that:

 

(a) The information contained herein is complete and accurate and may be relied upon by the Partnership and the General Partners; and

 

(b) Subscriber will notify the General Partner immediately of any material change in any of such information occurring prior to the acceptance or rejection of the Subscriber's subscription for an Interest.

 

INSTRUCTIONS:

 

Part I of this Questionnaire concerns investors who are "accredited," as that term is defined and construed pursuant to Regulation D under the Securities Act of 1933. If you qualify under any of the categories listed in Part I, you are not required to fill out Part II of this Questionnaire. If you do not qualify under any of the categories listed in Part I, you must fill out Part II.

 

IF THE INVESTOR IS A PARTNERSHIP, PLEASE ATTACH AN EXECUTED COPY OF THE PARTNERSHIP AGREEMENT AND ALL AMENDMENTS THERETO.

IF THE INVESTOR IS A CORPORATION, PLEASE ATTACH A COPY OF THE ARTICLES OF INCORPORATION AND A BOARD OF DIRECTORS RESOLUTION (CERTIFIED BY THE SECRETARY OF THE CORPORATION) AUTHORIZING THIS INVESTMENT.

IF THE INVESTOR IS A TRUST, PLEASE ATTACH A COPY OF THE TRUST AGREEMENT AND ALL AMENDMENTS THERETO.

 

PART I: ACCREDITED INVESTORS

 

1. FOR INDIVIDUAL INVESTORS ONLY:

 

Initial ________ a. I certify that I have an individual net worth, or my spouse and I have a combined net worth, in excess of $1,000,000. For purposes of this Questionnaire, ''net worth'' means the excess of total assets at fair market value, (including principal residence, home furnishing, and automobiles) over total liabilities.

or

 

Initial ________ b. I certify that I had individual income, exclusive of any income attributable to my spouse, of more than $200,000 in the two calendar years preceding the calendar year in which this Questionnaire is submitted, and I reasonably expect to have an individual income in excess of $200,000 during the current calendar year. or

 

Initial ________ c. I certify that my spouse and I had joint in come of more than $300,000 in the two calendar years preceding the calendar year in

which this Questionnaire is submitted, and reasonably expect to have joint income in excess of $300,000 during the current calendar year.

 

2. FOR CORPORATIONS. BUSINESS TRUSTS, OR PARTNERSHIPS:

 

Initial ________ d. Subscriber certifies that it was not formed for the specific purpose of acquiring the Interests and that Subscriber has total assets in excess of $5,000,000.

or

 

Initial ________ e. Subscriber certifies that all of its equity owners are accredited investors under either 1(a) above (i.e., $1,000,000 net worth) or 1(b) or 1(c) above (i.e., $200,000 individual or $300,000 joint income). Please list below the names of all equity owners and the manner in which they qualify* (check applicable category )

Check the Applicable Column

 

                                                                                                         $200,000 (individual)

                                                                         $1,000,000                 or $300,000  (joint)

       Names of All Equity Owners                       Net Worth                 Minimum Income

______________________________         _______________      _________________

______________________________         _______________      _________________

______________________________         _______________      _________________

______________________________         _______________      _________________

______________________________         _______________      _________________

 

3. FOR TRUSTS:

 

Initial ________ f. The undersigned financial institution certifies that it is (i) a bank, savings and loan association, or other regulated financial institution; (ii) acting in its fiduciary capacity as trustee;  and (iii) subscribing for the purchase of the Interests on behalf of the subscribing trust.

or

 

Initial ________ g. The undersigned certifies that the subscribing trust has total assets in excess of $5,000,000, and that the person making the investment decision on behalf of the trust has such knowledge and experience in financial and business matters that he is capable of evaluating the merits and risks of an investment in the Interests.

or

 

Initial ________ h. The undersigned certifies that it is a revocable

trust that may be amended or revoked at any time by the grantors thereof, and all of the grantors are accredited investors under either 1(a) above (i.e., $1,000,000 net worth) or 1(b) or 1(c) above (i.e., $200,000 individual or $300,000 joint income). Please list below the names of all grantors.

Check the Applicable Column

 

                                                                                                         $200,000 (individual)

                                                                         $1,000,000                 or $300,000  (joint)

       Names of All Grantors                                Net Worth                 Minimum Income

______________________________         _______________      _________________

______________________________         _______________      _________________

______________________________         _______________      _________________

______________________________         _______________      _________________

______________________________         _______________      _________________

 

FOR EMPLOYEE BENEFIT PLANS (INCLUDING KEOGH PLANS):

 

Initial ________ i. The undersigned is an employee benefit plan within the meaning of the Employee Retirement Income Security Act of 1974, as amended ("ERISA''), and the decision to invest in the Partnership was made by a plan fiduciary (as defined in Section 3 (21) of ERISA), which is either a bank, savings and loan association, insurance company, or registered investment adviser. Please state the name of such plan fiduciary: or

 

Initial ________ j. The undersigned is an employee benefit plan within the meaning of ERISA and has total assets in excess of $5,000,000.

or

1

 

Initial ________ k. The undersigned is an employee benefit plan within the meaning of ERISA, the plan is self directed, and the investment decision is being made by a plan

participant who is an accredited investor under either 1(a) above (i.e., $1,000,000 net worth) or 1(b) or 1(c) above (i.e., $200,000 individual or $300,000 joint income). Please list below the names of all such participants.

Check the Applicable Column

 

                                                                                                         $200,000 (individual)

                                                                         $1,000,000                 or $300,000  (joint)

       Names of All Participants                           Net Worth                 Minimum Income

______________________________         _______________      _________________

______________________________         _______________      _________________

______________________________         _______________      _________________

______________________________         _______________      _________________

______________________________         _______________      _________________

 

 

5. FOR INDIVIDUAL RETIREMENT ACCOUNTS:

 

Initial ________ 1. The undersigned hereby certifies that the beneficiary thereof is an accredited investor under either (a) above (i.e., $1,000,000 net worth) or (b) or (c) above (i.e., $200,000 individual or $300,000 joint income).

 

6. FOR 501(c)(3) ORGANIZATIONS:

 

Initial ________ m. The undersigned hereby certifies that it is an

organization described in section 501(c)(3) of the Internal Revenue Code of 1986, as amended, not formed for the specific purpose of acquiring the Interests, with total assets in excess of $5,000,000.

 

PART II: NON-ACCREDITED INVESTORS

 

1. Name of Person Making Investment Decision: ____________________________

 

Date of Birth: ________________                          U.S. Citizen: Yes ____  No ____

 

College:______________________________________________________________

Degree: _______________ Year: _________________

 

Graduate School: _______________________________________________________

Degree: _______________ Year: _________________

 

Social Security or Federal ID No(s): _______________________________________

____________________________________________________________________

 

2. Nature of Business: __________________________________________________

 

Position and Duties: ___________________________________________________

 

Please set forth other prior occupations or duties during the past five years:

___________________________________________________________________

___________________________________________________________________

 

Year of Anticipated Retirement: _______________________

 

3. Please list investments made during the past five years: ____________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

_________________________ (to include Year, Nature of Investment, Amount ($))

4. (a) I consider myself to have such knowledge and experience in financial and business matters to enable me to evaluate the merits and risks of an investment in the Company. Yes ____  No ____

 

(b) If the answer to 4(a) is ''yes,'' please set forth below (or in an attachment) the basis for your answer (e.g., investment or business experience, profession, past review of other investment offerings, etc.) ________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

 

(c) If the answer to 4(a) is ''no,'' please list the name, business address and telephone number of the person who is your purchaser representative ____________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

 

 

5. My income from all sources was, now is, or is expected to be:

 

            Year                                                              Gross Income

 

[19 _ (Two Years Ago)]                             $____________________

 (Actual)

 

[19 _ (One Year Ago)]                               $____________________

(Actual)

 

 

[19 _ (This Year )]                                     $____________________

(Estimated)

1

6. (a) My personal net worth (including the net worth of my spouse, if any) is now estimated at: $___________________________

 

(b) My personal net worth (exclusive of homes, home furnishings and automobiles) is now estimated at: $___________________________

 

(c) My estimated liquid assets equal: $___________________________

 

(d) My estimated non-liquid assets equal: $_______________________

 

Dated: _____________ 19______

 

Signature for Individual Subscriber

 

______________________________

Signature

 

______________________________

Print Name of Subscriber

 

_____________________________

Signature of joint Subscriber (if any)

 

_______________________________

Print Name of joint Subscriber (if any)

 

 

Signature For Partnership Trust, Corporation or Other Entity

 

______________________________

Print Name of Subscriber

 

______________________________

Signature

 

______________________________

Print Name of Signing

 

______________________________

Title

 

Contributed by
Anonymous3
 
Name of Firm Anonymous3
Total Forms Contributed 102
 

See All Anonymous3's Forms
 

Related Forms

PPM Stock Subscription Agreement
Successor Addendum Questionnaire
Last Will and Testament Questionnaire
PURCHASER REPRESENTATIVE QUESTIONNAIRE
Modified Benefits Formula Questionnaire

Terms Of Use

Submissions to this site, including any legal or business forms, posts, responses to questions or other communications by contributors are not intended as and should not be construed as legal advice. You are strongly encouraged to consult competent legal council before engaging in any action based upon content contained on this site.

These downloadable forms are only for personal use. Retransmission, redistribution, or any other commercial use is prohibited. This includes reposting forms from this site to another site offering free legal or other document forms for download.

Please note that the donator may have included different usage terms regarding this form, and you agree to abide by these terms. It is highly recommended that you have a licensed attorney review any legal documents for which you are searching in order to make sure that your needs are being properly and completely satisfied.

Your use of this site constitutes your acceptance of our terms of use and your agreement to hold this site, its officers, employees and any contributors to this site harmless for any damage you might incur from your use of any submissions contained on this site. If you do not agree to the above terms, please do not proceed.

These forms are provided to assist business owners and others in understanding important points to consider in different transactions. They are offered with the understanding that no legal advice, accounting, or other professional service is being offered by these documents or on this website. Laws vary in the different states. Agreements acceptable in one state may not be enforced the same way under the laws of another state. Also, agreements should relate specifically to the particular facts of each situation. Therefore, it is important to consult legal counsel whenever utilizing these forms. The Forms are not a substitute for legal advice YourFreeLegalForms.com is not engaged in recommending or referring members on the site or making claims about the competence, character or qualifications of its participating members.
Close

Thank you for using
Yourfreelegalforms.com


Your online source for 100% free legal and business forms.
Have a form to contribute?
Contribute a legal or business form, checklist or article and have your profile displayed on the same page as the form for free, powerfull, targeted marketing to those searching for legal forms and advice.



Was this form helpful? Yes No
Need a different form? Yes No


Need a different form? Need a custom form or service?

post a request to our community.


Comments




Keywords: legal forms, investor, questionnaire, LLP

close