Investor Qualification Form

Accredited Investor Questionnaire

If you are interested in hearing more about investment opportunities from Crowne Equity Partners, LLC, please complete the accredited investor questionnaire form below.

A member of our team will then contact you to discuss investment opportunities with our company, if the company is able to form a reasonable belief that you are an “accredited investor” (as such term is defined under applicable federal and state securities laws).

We encourage accredited investors to register with our site so that we may keep an accurate record of your information and update you with new investment opportunities. Remember, your information will be kept private and we will not sell or provide your information to anyone!

THIS IS NOT AN OFFER TO SELL SECURITIES. THE PURPOSE OF THIS QUESTIONAIRE IS TO ESTABLISH A PRE-EXISTING RELATIONSHIP AND TO VERIFY THAT YOU ARE QUALIFIED TO INVEST IF WE HAVE ANY AVAILABLE OFFERINGS IN ACCORDANCE WITH THE LAW. THIS QUESTIONNAIRE IS NOT IN CONTEMPLATION OF ANY SPECIFIC OFFERING.

First Name: *

Last Name: *

E-Mail Address: *

Phone: *

Company:

Address (line 1):

Address (line 2):

City:

State:

Zip:

SECTION 2: Investor Qualification

ALL INVESTORS MUST CHECK AND FILL OUT 1 OF THE NEXT 3 AREAS:

Section A: *

NoYes

Income: My annual net income was at least $200K in each of the last two years, or my joint income with my spouse was in excess of $300K in each of those years; and I have reasonable expectation of income in the current year of at least equal to those amounts.

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Section B: *

NoYes

Assets: My current individual net worth or joint net worth with my spouse is at least $1 million (excluding home equity).

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Section C: *

NoYes

Business, Financial & Investment Experience: I am an experienced investor as demonstrated by my following investment, business, and financial background:

Business/Financial Experience:

Occupation:

Prior real estate investments:

Current real estate investments:

Current real estate investment value (ex. 100,000):

Years of real estate experience:

Amount interested in investing:

I hereby certify the above is true and correct *

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