For Individuals. Are you:
For Individuals. The undersigned individual is an “Accredited Investor” for one or more of the following reasons (check all that apply): l The undersigned is an individual (not a partnership, corporation, etc.) whose individual net worth, or joint net worth with his or her spouse, presently exceeds $1,000,000. For purposes of the foregoing, “net worth” shall be deemed to include all of your assets, liquid or illiquid (including such items as furnishings, automobile and restricted securities, but excluding the value of your primary residence) minus any liabilities (including such items as loans and other debts and liabilities, but excluding any mortgage on your primary residence to the extent that it does not exceed the fair market value of such residence). l The undersigned is an individual (not a partnership, corporation, etc.) who had (i) an individual income in excess of $200,000 or (ii) joint income together with their spouse in excess of $300,000, in each of the two most recent years and reasonably expect to reach the same income level in the current year. For purposes of the foregoing, “income” is not limited to “adjusted gross income” as that term is defined for federal income tax purposes, but rather includes certain items of income which are deducted in computing “adjusted gross income”. For investors who are salaried employees, the gross salary of such investor, minus any significant expenses personally incurred by such investor in connection with earning the salary, plus any income from any other source including unearned income, is a fair measure of “income” for purposes of this question. For investors who are self-employed, “income” is generally construed to mean total revenues received during the calendar year minus significant expenses incurred in connection with earning such revenues. l The undersigned is a director, executive officer, or general partner of the issuer of the securities being offered or sold, or any director, executive officer, or general partner of a general partner of that issuer. l The undersigned individual is not an “Accredited Investor” because none of the above apply.
For Individuals. For individual members of these associations, their personal or institutional membership in their provincial, regional, or national association provides them with opportunities to participate in national dialogue without having to pay a full membership fee, as is currently required by CLA’s direct membership model.
For Individuals. [Please (3)] Politically Exposed Person (PEP) Status (Also applicable for authorised signatories/Promoters/Karta/Trustee/Whole time Directors) I am PEP I am related to PEP Not Applicable For Non-Individuals providing any of the below mentioned services [Please (3)] Foreign Exchange/Money Changer Services Gaming/Gambling/Lottery/Casino Services Money Lending/Pawning None of the above Second Applicant (To be filled only if the applicant is an individual) I am PEP I am related to PEP Not Applicable Third Applicant (To be filled only if the applicant is an individual) I am PEP I am related to PEP Not Applicable
For Individuals. For individuals to be eligible for long term care Medicaid in 2022, they are allowed to have the following resources: $16,800.00 in assets, certain retirement assets in pay status, a prepaid funeral and a home with $955,000 in equity or less if they are living in the home (so they must be applying for home care). With respect to income, an individual is permitted to have $50 a month if they are in a nursing home. If they are applying for home care they are allowed $934.00 a month in income plus a $20 unearned income credit if applicant or recipient is over 65 years old or disabled. Whether the individual is in the nursing home or at home they are also allowed to keep enough income to cover the cost of medical expenses such as health insurance. If the individual is applying for home care and has more income than allowed it must either be spent down or contributed to a special trust, commonly referred to as a “Pooled Trust.”
For Individuals. ● The undersigned is a natural person whose individual net worth, or joint net worth with spouse, exceeds $1,000,000 (without including the value of the undersigned’s primary residence) at the time of purchase of the Investment Securities. ● The undersigned is a natural person who had an individual income in excess of $200,000 in each of the last two years or joint income with spouse in excess of $300,000 in each of those years and reasonably expects to reach the same income level in the current year. ● The undersigned is not a director, executive officer, or general partner of the Company, or a director, executive officer or general partner of a general partner of the Company. If an Accredited Investor, the undersigned further certifies that: (i) the undersigned (or the undersigned’s professional advisor(s)) has the capacity to protect the undersigned’s interests in this investment; (ii) the undersigned is able to bear the economic risks of this investment; and (iii) the amount of the investment does not exceed 10% of the undersigned’s net worth or joint net worth with spouse. For entities: ● The undersigned is any institutional investor as provided in Regulation Section 230.501(a)(1) under the Securities Act of 1933. ● The undersigned is a private business development company within the meaning of Section 202(a)(22) of the Investment Advisers Act of 1940. ● The undersigned is any organization described in Section 501(c)(3) of the Internal Revenue Code, not formed for the specific purpose of acquiring the Investment Securities, with total assets in excess of $5,000,000. ● The undersigned is a trust with total assets in excess of $5,000,000, not formed for the special purpose of acquiring the Investment Securities, whose investment is directed by a person described in Regulation Section 230.506(b)(2)(ii) under the Securities Act of 1933. ● The undersigned is an entity owned entirely by any of the persons described above.