1
Investment Bracket Selection
Individual investors are subject to limitations on the total amount they can invest across all Regulation Crowdfunding offerings within any 12-month period. Please select your income and net worth bracket to determine your investment limits.
| Investor Annual Income | Investor Net Worth | Calculation Basis | Investment Limit | Select |
|---|---|---|---|---|
| $30,000.00 | $105,000.00 | Greater of $2,200 or 5% of $30,000 | $2,200.00 | |
| $150,000.00 | $80,000.00 | Greater of $2,200 or 5% of $80,000 | $4,000.00 | |
| $150,000.00 | $107,000.00 | 10% of $107,000 | $10,700.00 | |
| $200,000.00 | $900,000.00 | 10% of $200,000 | $20,000.00 | |
| $1,200,000.00 | $2,000,000.00 | 10% of $1,200,000 (capped at $107,000) | $107,000.00 |
2
Purchase Details
Purchase Date
Shares Available
5,000 shares
Stock Price
$1.00
Shares Purchased to Date
0 shares
Price Per Share
$1.00
Investment Type
Common Equity
3
Accreditation & Disclosures
Officer or Director Referral
4
Electronic Signature & Certifications
Sprowtt Inc. requires an electronic signature to certify the information you have provided. Please read each statement carefully.
Officer Name
Title
Signature Date
Information Accuracy
I certify that all information provided on this page is accurate and true.
Authorized Execution
I am authorized to execute this agreement on behalf of the investor.
Investment Restrictions
I understand there are restrictions on the investor's ability to cancel an investment and obtain a return.
Risk Acknowledgment
I acknowledge that investing in securities offered under Regulation Crowdfunding involves risk, and I should not invest any funds unless I can afford to lose the entire amount.
Backup Withholding
I certify that I am not subject to backup withholding under IRS regulations.
FATCA Compliance
I certify that I am not subject to FATCA (Foreign Account Tax Compliance Act) reporting requirements.
Rule 506(d) Disqualification
I certify that I am not disqualified under Rule 506(d) of Regulation D.
Broker-Dealer Status
I certify that I am not a broker-dealer or registered representative.
Foreign National Status
I certify that I am not a foreign national investing on behalf of a foreign entity.
Foreign Entity Investment
I certify that I am not investing on behalf of a foreign government or foreign entity.
Electronic Signature
Important: By providing your electronic signature, you legally bind yourself to the terms and certifications listed above. Please ensure all information is accurate before proceeding.