Apply for Shares

Investment Information

IMPORTANT: Already an Equity Punk? Please make sure you use the same email as your existing shareholding to ensure we do not duplicate your shareholding!

Full Legal Name *

How would you like to pay for your shares? *

Credit or Debit Card

ACH (Electronic Check) - US Bank Account Only

Mail a Check - US Bank Account Only

Wire Transfer

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If you have been given an Intro Code from a friend, enter it here!

Your Details

Investor Questionnaire

This information is needed for us to comply with SEC and state securities regulations. We ask the following questions to determine if the amount you may invest is limited by law.

Are you an "accredited" investor (meaning do you earn over $200,000 per year, have a net worth of $1m or more, or are an institutional investor)?

Yes No

As you are not an "accredited investor" the law limits the total amount you can invest based on your annual income and your net worth. Please provide these so that we may determine if the amount you wish to invest is within these limitations.

Annual Income

Net Worth

Under penalty of perjury, by accepting the agreement below I certify that I have provided my correct taxpayer identification number, and:

I am a US citizen, US resident, or other US person I am not a US citizen, US resident or other US person

And:

I am exempt from backup withholding I am subject to backup withholding (Only check this option if you've been notified by the IRS that you are subject to backup withholding)

Broker-Dealer Customer Agreement

I agree to Cuttone & Co., LLC’s and IQ Capital (USA) LLC’s Customer Agreement

ACH Authorization Form

Name on Account *

Routing Number *

Account Number *

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Account Type *

Business Personal

Account Type *

Checking Savings

Please type your name here to sign ACH authorization

Sign Subscription Agreement

Please type your name here to sign the agreement:

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