I am a person with income exceeding $200,000 in each of the two most recent years or joint income with my spouse exceeding $300,000 for those years and a resonable expectation of the same income level in the current year.
I have an individual net worth, or joint net worth with my spouse, that exceeds $a million, excluding the value of primary residence
I am operating for a bank, insurance comapny. registered investment company, business development company, or small business investment comapny.
I am operating for an employee benefit plan, within the meaning of the Employee Retirement Income Security Act, if a bank, insurance company, or registered investment adviser makes the investment decisions, or if the plan has total assets in excess of $5 million.
I am operating for a charitable organization, corporation, or partnership with assets exceeding $5 million.
I am operating for a bussiness in which all the equity owners are accredited investors. I am operating for a trust with assets in excess of $5 million, not formed to acquire the securities offered, whose purchases a sophisticated person makes.
None of the above.
Annual Income
2011 income
(All Sources)
2011 income
(All Sources)
2011 income
(All Sources)
Investors Representations
I am likely to lose my entire investment and I can bear the loss.
I will only invest an amount that i can afford to lose completly and have savings to cover any short to medium term needs.
I cannot sell my shares for at least one year and possibly much longer.
I may not get access to my investment cash when I need it. Most investments, if successful, require 5 years or more to provide a return.
Startups are incredibly risky.
Startups typically don't have the revenues and profits that are needed to keep the company going for an extended period of time. They can fail for a variety of reasons, both from within and from outside of the company.
I have sufficient knowledge in business & finance to avaluate the risk.
I have sufficient knowledge to properly assess the risk and can rely on my knowledge and my own research on the investment.
Legal Name and Address
This information is required for a company to issue seccurities to you.It will be provided tp startups you invest in.
Electronic Signature
I understand that Jumpstartfund will be relying on the accuracy and completeness of my responses, and I will represent, warrant, and covenant as follows:
The answers I provided are complete and correct and may be relied upon by Jumpstartfund in determining whether I am qualified to view and purchase securities in transactions that are exempt from registration under the U.S. Securities Act of 1933 and whether I comply with other applicable regulatory requirements; and.
I will notify JumpStartfund immediately of any material change in any statement made herein or any event resulting in the omission of any statement required to be made herein that occurs prior to following the acceptance of my application for access to Jumpstartfund's or its affiliates listings.
Dated: March 4, 2014
I am 18 years or older. I agree the Terms of Service and Invester Agreement.