Telcoin Pre Series A Investment Form

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Please complete the following form to provide the necessary Know Your Customer documentation and to indicate your level of interest in the Telcoin Fundraising event. We will use this information to contact you with Telcoin investment materials for your review and consideration

I am interested in receiving more information about the Telcoin fundraise. *

Yes

Full Name *

Email Address *

Mailing Address (Physical Address: #Street, City, State, ZIP) *

Potential investment amount ($200k USD minimum for accredited investors) *

For United States based individual investors only. To participate in the Telcoin Pre Series A investment round individuals in the United States must meet SEC 'Accredited Investor' requirements detailed here https://www.sec.gov/smallbusiness/exemptofferings/faq *

Yes, I am an accredited investor per SEC guidelines.

No, I am not an accredited investor

Not Applicable. I am not a United States citizen.

Other:

Required

Disclamer

This communication is not an offer to sell securities nor a solicitation of an offer to buy securities which may only be done through a private placement memorandum.

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