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Contact Information
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Step
1
of 6
Full Name
*
First
Last
Email Address
*
Phone Number
*
Preferred Contact Method
Email
Phone
Text
Mailing Address
*
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
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
State
Zip Code
Company / Entity Name (if applicable)
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Investor Type
*
Individual
Joint (spouses)
Entity (LLC/Corp/Trust/etc.)
Title / Role Within Entity
Entity Type
LLC
Corporation
Trust
Family Office
Investment Fund
IRA/Retirement Account
Other
Country of Citizenship / Formation
*
United States
Canada
United Kingdom
European Union (other)
Other
If Other, please specify
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How do you qualify as an Accredited Investor?
*
Individual Income ($200,000+)
Income joint with spouse ($300,000+)
Net worth ($1M+ Excluding Primary Residence)
Professional certification (e.g., Series 7, 65, 82)
Knowledgeable Employee (if applicable)
Entity with $5M+ in Assets or Other Qualifying Entity
Other SEC Accredited Investor Category
Not sure / need assistance
Select the category that best describes how you qualify as an Accredited Investor. If you are unsure, select "Not Sure/Need Assistance."
Would you like assistance verifying your Accredited Investor status?
*
Yes
No
Questions or Additional Information (Optional)
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Indicative Investment Amount (USD)
*
Funding Timeline
*
Immediately
Within 30 days
Within 60 days
90+ days
How did you hear about Walkabout Innovations? (optional)
Referral
Existing investor
Online search
Newsletter / email
Event / webinar
Other
Anything else you'd like us to know? (optional)
Walkabout verification. information
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Supporting Documentation (Optional)
Drag & Drop Files,
Choose Files to Upload
You can upload up to 5 files.
Examples: CPA Verification letter, attorney letter, registered adviser letter, broker-dealer verification or income docs. You may upload supporting documentation now, or submit your verification and provide documentation later if requested. All uploaded documents are transmitted securely and used solely for investor verification purposes.
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I certify that the information I have provided is true, accurate, and complete to the best of my knowledge.
*
I agree
I understand this is a private Rule 506(c) offering.
*
I agree
I understand my accredited investor status may require verification.
*
I agree
I consent to electronic delivery of disclosures, notices, and documents related to this offering.
*
I consent
I authorize Walkabout Innovations (and its service providers) to contact me regarding this offering via email and phone.
*
I authorize
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