Endeavour EIS Investor Interest Form
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Information Requests:
SOPHISTICATED INVESTOR CERTIFICATION
I declare that l am a self-certified sophisticated investor for the purposes of the Financial Services and Markets Act (Financial Promotion) Order 2005 because at least one of the following applies:

> I am a member of a network or syndicate of business angels and have been so for at least the last six months prior to the date below;

> I have made more than one investment in an unlisted company in the two years prior to the date below;

> I am working, or have worked in the two years prior to the date below, in a professional capacity in the
private equity sector, or in the provision of finance for small and medium enterprises; and/or

> I am currently, or have been in the two years prior to the date below, a director of a company with an annual turnover of at least £1 million.

I accept that I can lose my property and other assets from making investment decisions based on financial promotions. I am aware that it is open to me to seek advice from someone who specialises in advising on investments.

HNW INVESTOR CERTIFICATION
I declare that I am a certified high net worth individual for the purposes of the Financial Services and Markets Act (Financial Promotion) Order 2005 because at least one of the following applies:

> I had, during the financial year immediately preceding the date below, an annual income to the value of £100,000 or more;

> I held, throughout the financial year immediately preceding the date below, net assets to the value of £250,000 or more. Net assets for these purposes do not include: 1. the property which is my primary residence or any loan secured on that residence; 2. any rights of mine under a qualifying contract of insurance within the meaning of the Financial Services and Markets Act (Regulated Activities) Order 2001; or 3. any benefits (in the form of pensions or otherwise) which are payable on the termination of my service or on my death or retirement and to which I am (or my dependants are), or may be, entitled.

I accept that I can lose my property and other assets from making investment decisions based on financial promotions. I am aware that it is open to me to seek advice from someone who specialises in advising on investments.
Declaration of being a HNW or sophisticated investor: *
Required
First name & Surname: *
Date of self certification: *
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