Investor accreditation verification form.
Investors should consult with their own legal and financial advisors before making any investment decisions.
CONFIDENTIAL: For Authorized Persons Only
| Field | Information |
|---|---|
| Full Legal Name | _____________________________________ |
| Current Residence Address | _____________________________________ |
| _____________________________________ | |
| Social Security Number / Tax ID | _____________________________________ |
| Entity Type (if applicable) | ☐ Individual ☐ Partnership ☐ LLC ☐ Corporation ☐ Trust ☐ Other: _____ |
| Contact Phone | _____________________________________ |
| Email Address | _____________________________________ |
I certify that I qualify as an "Accredited Investor" under Securities and Exchange Commission Rule 501(a) under Regulation D, based on ONE or more of the following criteria:
☐ Individual Net Worth: My net worth (excluding primary residence) exceeds $1,000,000
☐ Individual Income: My individual income exceeded $200,000 in each of the past two (2) years and reasonably expects to exceed $200,000 in the current year
☐ Joint Income (Married): My joint income with my spouse exceeded $300,000 in each of the past two (2) years and reasonably expects to exceed $300,000 in the current year
☐ Financial Industry Professional: I hold one or more of the following licenses/certifications:
☐ Knowledgeable Employee: I am a knowledgeable employee of the issuer (EVERYONE LLC), with direct involvement in portfolio management or investment decisions
☐ Entity with Assets: I am an entity with total assets in excess of $5,000,000
☐ Registered Investment Company: I am a registered investment company under the Investment Company Act of 1940
☐ Financial Institution: I am a bank, savings and loan association, or insurance company as defined under Section 3(a)(2) of the Securities Act of 1933
☐ Trust with Assets: I am a trust with total assets exceeding $5,000,000, not formed specifically for the purpose of acquiring the securities offered
☐ Entity with Accredited Owners: I am an entity in which all equity owners are accredited investors as defined herein
By executing this questionnaire, I represent and warrant the following:
Financial Capacity ☐ I can afford to bear the total loss of my investment in EVERYONE LLC
☐ I have adequate means of providing for my current and anticipated financial needs without relying on this investment
Investment Concentration This investment will represent approximately _____ % of my total net worth (Recommendation: No single illiquid investment should exceed 10-15% of net worth)
Experience with Illiquid Investments ☐ Yes ☐ No. I have prior experience investing in private placement offerings under Regulation D
If yes, describe experience: _________________________________________________________________
Investment Objectives My primary investment objective is: ☐ Growth ☐ Income ☐ Capital Preservation ☐ Other: _____
Source of Funds The funds I am investing originate from: ☐ Personal savings ☐ Investment proceeds ☐ Business income ☐ Inheritance ☐ Other: _____
Describe source in detail: _________________________________________________________________
Beneficial Ownership Disclosure Are you investing on behalf of another person or entity? ☐ Yes ☐ No
If yes, provide full details of beneficial owner: ________________________________________________
Sanctions Compliance Certification ☐ I am not, and no beneficial owner of this investment is, a person or entity:
| Item | Amount |
|---|---|
| Principal Investment Amount | $_____________________________________ |
| Proposed Investment Date | _____________________________________ |
| Payment Method | ☐ Wire Transfer ☐ Check ☐ ACH ☐ Other: _________ |
I represent, warrant, and certify that:
I hereby certify under penalty of perjury that all representations, warranties, and certifications herein are true, correct, and complete as of the date of execution.
Investor Signature (Individual)
Printed Name: _____________________________________
Signature: _____________________________________ Date: ______________
Spouse Signature (if applicable)
Printed Name: _____________________________________
Signature: _____________________________________ Date: ______________
For Entities: Authorized Representative
Printed Name & Title: _____________________________________
Signature: _____________________________________ Date: ______________
Entity Name: _____________________________________
If this investor was introduced or advised by a financial professional, that advisor may certify familiarity with the investor's financial situation:
Financial Advisor Name: _____________________________________
Firm: _____________________________________ License #: ______________
Signature: _____________________________________ Date: ______________
Advisor's Certification: I have discussed the risks and suitability of this investment with the above investor.
DOCUMENT CONTROL
| Item | Description |
|---|---|
| Document Status | For execution with legal counsel review |
| Company | EVERYONE LLC |
| Offering | Tranche 1 / Series 1 Participation (Reg D, Rule 506(b)) |
| Date Prepared | March 7, 2026 |
| Legal Review Required | YES. Before Distribution |
This document is confidential and intended solely for the specified investor. Reproduction or distribution without authorization is prohibited.