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Accredited Investor: I hereby certify that I am an accredited investor in accordance with Rule 501(a) of Regulation D, in that (please select one)
A business in which all the equity owners are accredited investors

A natural person who has individual net worth, or joint net worth with the persons spouse, that exceeds $1 million at the time of the purchase

A natural person with an individual income in excess of $200,000 or in excess of $300,000 with his or her spouse in each of the two most recent years and who has a reasonable expectation of an income in excess of $200,000 individually or in excess of $300,000 with his or her spouse in the current year

A bank, insurance company, registered investment company, business development company, or small business investment company

A trust with assets in excess of $5 million, not formed to acquire the securities offered, whose purchases a sophisticated person makes

A charitable organization, corporation, or partnership with assets exceeding $5 million

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

Qualified Investor: Is the investor a person, individual or entity that would be a "U.S. Person" under Regulation S of the U.S. Securities Act of 1933, as amended?
Yes     No    
For Swiss Investors: Is the Investor a regulated qualified investor within the meaning of Article 10(3)(a) or (b) of the Swiss Collective Investment Schemes Act of June 23, 2006, as amended?*
Yes     No     N/A    

Contact

New York

55 Hudson Yards
550 West 34th Street, Suite 2800
New York, NY 10001

Texas

3949 Maple Avenue
Suite 440
Dallas, TX 75219

map showing the New York location on 34th street between 10th and 11th avenues map showing the Texas location on Maple Avenue between Reagan Street and Shelby Avenue

New York

55 Hudson Yards
550 West 34th Street, Suite 2800
New York, NY 10001

Texas

3949 Maple Avenue
Suite 440
Dallas, TX 75219