Accredited Investor Certification

(Please use the page navigation buttons at the bottom of each page instead of your browser's buttons.
)
Please be assured that this information will be kept strictly CONFIDENTIAL. Halbert Wealth Management will never sell or otherwise share your personal information with anyone. (Privacy policy)
 
Your Name:      Spouse's Name:
Daytime Phone Number:
Email:
 
1. Are you an "Accredited Investor" as defined below?
 

For Individuals: If you qualify as an "Accredited Investor," please check the applicable categories below.

(a) Any natural person whose individual net worth, or joint net worth with that person's spouse, at the time of his purchase exceeds $1,000,000, excluding the value of your primary residence.*
    My approximate net worth is:



(b) Any natural person who had an income in excess of $200,000 in each of the two most recent years or joint income with that person's spouse in excess of $300,000 (both spouses should sign) in each of those years and has a reasonable expectation of reaching the same income level in the current year.
 

2. Do you also meet the Portfolio Requirement of a “Qualified Client” which means any natural person whose individual net worth, or joint net worth with that person's spouse, at the time of his purchase exceeds $2,000,000, excluding the value of your primary residence? *
 

* When calculating net worth, you should (i) exclude your primary residence as an asset, (ii) exclude debt secured by your primary residence, up to the fair market value of your residence, (iii) include the amount of any increase on the debt secured by your primary residence incurred within the last 60 days of making a purchase of the securities (unless related to the acquisition of your primary residence, and (iv) include debt in excess of the fair market value of your primary residence.

Electronic Signature Affirmation

By entering your name and the completion date below, you are providing your electronic affirmation that the information you have provided is accurate as of the date listed, and fairly and completely represents your current financial condition. By signing, you also acknowledge that you understand recommendations made by HWM will be based on this information, plus any subsequent information you may provide orally or in writing.

Enter your name here:      Date of completion:


CAPTCHA Image
Enter security code: [ Different Image ]

ELECTRONIC SIGNATURE AFFIRMATION
By submitting this form, I represent and certify that my foregoing statements and entered information are true and correct.

You can review the HWM privacy policy here: halbertwealth.com/privacy.php