Accredited Investors Form

Access to offering materials for the MAVEN Technology $5 million common stock offering is restricted to persons who are accredited investors. To confirm your status as an accredited investor, kindly complete the information on the form below. All information will be kept strictly confidential. Once your status has been confirmed, we will provide you with a user name and password to allow you to view our offering materials and we will contact you to discuss the offer and any questions you may have.

Accredited Investor Status:

I am an Accredited Investor within the meaning of Rule 501 of Regulation D under the Securities Act of 1933, because I qualify in the following category or categories. (Check each applicable category)

A person with a net worth of at least $1 Million either individually or jointly with such person's spouse.	A business in which all the equity owners are accredited investors.
A person with income exceeding $200,000 individually or $300,000 jointly with such person's spouse, in each of the two most recent years and a reasonable expectation of the same income level in the current year.	A trust with assets of at least $5 Million, not formed to acquire the securities offered, and whose puchases are directed by a sophisticated person.
A bank, insurance company, registered investment company, business development compnay, or small business investment company.	An employee benefit plan, within the meaning of the Employee Retirement Income Security Act, if a bank, insurance company, or registered investment adviser makes the invesment decisions , or if the plan has total assets in excess of $5 million.
A charitable organization, corporation or partnership with assets exceeding $5 million.

Personal Information:

All information will kept confidential and will absolutely not be shared or sold, but is collected due to regulatory requirements. (* fields required)

*First Name:
*Last Name:
Company/Organization:	(if applicable)
*Address:
*City:
*State:
*Postal Code:
*Phone:
*E-mail:
Preferred method of contact:	Phone E-mail
How you heard of the offer:

Once we have received, reviewed and accepted your information we will respond shortly with a user name and password to view the offer material. Thank you.

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