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Investor Questionnaire
For interested investors not sure if they can legally participate in Goodbuds Wellness Center’s equity crowdfunding campaign can use this questionnaire as a guide tool.
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* Indicates required question
Email
*
Your email
Name
*
Your answer
Phone Number
*
Your answer
Primary Address
*
Your answer
Please list any other state(s) where you own a residence, are registered to vote, pay income taxes or hold a driver’s license, and describe your connection with such state. (Put “None” if not applicable).
Your answer
What is your approximate net worth?
*
Under $75,000
Over $75,000
How many shares are you looking to buy?
*
Under 2,000 shares
2,000 shares (1% equity stake)
4,000 shares (2% equity stake)
6,000 shares (3% equity stake)
8,000 shares (4% equity stake)
10,000 shares (5% equity stake)
Would your prospective investment in the Company exceed ten percent (10%) of your net worth? (Indicate “Not Applicable” if question doesn’t apply).
*
Yes
No
N/A
Do you have adequate means of providing for your current needs and future contingencies?
*
Yes
No
Do you understand and agree that any securities acquired by you will be acquired for investment and you have no need in the foreseeable future for liquidity in any investment in the Company?
*
Yes
No
Are you able to bear the economic loss of the full amount of your investment in the Company?
*
Yes
No
What's your experience in private equity?
Your answer
If interested in a stake 1% or higher, do you have a copy of your credit report? If so, would you be willing to submit a copy to Goodbuds Wellness Center for further consideration?
Yes
No
Clear selection
Do you have any resources that could be beneficial to Goodbuds Wellness Center being successful? If so, please explain. NOTE: Resources range from food industry relationships, media industry relationships, celebrity influence, etc.
*
Your answer
Please indicate that you agree to the following statements:
*
I certify that this questionnaire is complete and correct. I understand that the Company is relying on the above information to determine suitability as a potential investor.
I will notify the Company immediately of any changes in the information contained above that would affect any of my responses in this Questionnaire, that occur prior to the consummation of the potential investment by me in the Company.
I understand and agree that my electronic signature and electronic submission constitutes my signature, acceptance and agreement of the terms of this Questionnaire and that my electronic signature shall be given force and effect as a signature affixed by hand.
Required
Send me a copy of my responses.
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