Investor Form

Please fill out the information below

Physical address of interested party

If UK follow-up with reverse solicitation acknowledgement below:

By checking this box, I certify that I represent myself or am authorized to represent another interested party in requesting document related to [Fund Name] from Velocis Advisors (the "Adviser"). I also certify that communication between the interested party that I represent and the Adviser was initiated by myself on behalf of the interested party that I represent.

If other EU country follow-up with attorneys on that specific country's regulatory requirements for marketing

I represent that I am, or am authorized to represent, an "accredited investor" within the meaning of Rule 501 of Regulation D under the Securities Act of 1933, based on one or more box(es) checked below that qualifies me as an accredited investor:

a bank, insurance company, registered investment company, business development company, or small business investment company;

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;

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

a director, executive officer, or general partner of the company selling the securities;

a business in which all the equity owners are accredited investors;

a natural person with income exceeding $200,000 in each of the two most recent years or joint income with a spouse exceeding $300,000 for those years and a reasonable expectation of the same income level in the current year; or

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