CONTACT CRYSTAL AIRWAYS Please Fill out our form and submit it and we will respond promptly. Once this preliminary information is received, we will provide you with the Investor Suitability Questionnaire, via e-mail or fax, as requested.
First Name: Last Name: e-Mail Address: Address: City: State : Zip Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming International State Phone Number: Fax Number:
1. A self-directed employee benefit plan, with investment decisions made solely by persons that are accredited investors? Yes No
2. A natural person whose individual net worth, or joint net worth with such person's spouse, excluding your residence, exceeds US$1,000,000.00? Yes No
3. A natural person who had an individual income in excess of US$200,000.00 in each of the two most recent calendar years and has a reasonable expectation of reaching the same income level in the current year? Yes No
4. A natural person who had joint income with your spouse in excess of US$300,000.00 in each of the two most recent calendar years and has a reasonable expectation of reaching the same income level in the current year? Yes No
5. Any trust, with total assets in excess of US$5,000,000.00 whose purchase of securities is directed by a sophisticated person has with such knowledge and experience in financial and business matters that such person is capable of evaluating the merits and risks of any prospective investment? Yes No
6. An organization described in Section 501(c)(3) of the Internal Revenue Code, corporation, Florida or similar business trust, or partnership with total assets in excess of US$5,000,000.00? Yes No
7. A bank as defined in Section 3(a)(2) of the Act, a savings and loan association or other institution as defined in Section 3(a)(5)(A) of the Act whether acting in its individual or fiduciary capacity? Yes No
8. Any broker or dealer registered pursuant to Section 15 of the Securities Exchange Act of 1934? Yes No
9. An insurance company as defined in Section 2(13) of the Act? Yes No
10. An investment company as defined in Section 2(13) of the Act? Yes No
11. A Small Business Investment Company licensed by the U.S. Small Business Administration under Section 301(c) or (d) of the Small Business Investment Act of 1958? Yes No
12. A plan established and maintained by a state, its political subdivisions, or an agency or instrumentality of a state or its political subdivisions for the benefit of its employees, if such plan has total assets in excess of US$5,000,000.00? Yes No
13. An employee benefit plan within the meaning of the Employee Retirement Income Security Act of 1974, if the investment decision is made by a plan fiduciary, as defined in Section 3(21) of such Act, which is either a bank, savings and loan association, insurance company or registered investment adviser, or an employee benefit plan with total assets in excess of US$5,000,000.00, or, self-directed plan, with investment decisions made solely by persons that are accredited investors? Yes No
The foregoing statements are true and accurate to the best of my information and belief and I will promptly notify Crystal Airways, Incorporated of any changes in the foregoing answers.
I agree (By checking this box, you are agreeing to submit this information to Crystal Airways, Incorporated, and are electronically signing, attesting to the accuracy of the foregoing information. Providing false or misleading information, for the purpose of obtaining a Private Placement Memorandum, is a serious crime and violators will be prosecuted to the fullest extent possible).
Copyright © 1998 - 2006 All rights reserved. Any other trademarks and copyrights used are the property of their respective owners.