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Home
About
Who We Are
Leadership Team
Investment Strategy
Innovation Process
Invest
Private Companies
Public Companies
Big Idea Projects
AI Lab
Investment Insights
Podcasts
Articles
Get Involved
Explore Opportunities
Internship Program
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Onboarding Data Gathering Form
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Step
1
of 2
Your Legal Name
*
First
Middle
Last
Preferred Email Address
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The email address you would like for all communication about your account.
Preferred Cell Phone
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What type of account would you like to setup?
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--- Select Choice ---
Individual
Indvidual - IRA
Joint
Entity
Family Office
Institutional
For your IRA, who will be your custodian?
*
--- Select Choice ---
I currently have an IRA at Fidelity
I currently have an IRA at Charles Schwab
I would like to setup an account with STRATA Trust Company
Zynergy Digital Innovation Fund (ZDIF) is on the Fidelity and Learn more about
STRATA Trust Company
The Date You Plan to Subscribe:
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Please choose the 1st day of the month for the month you plan to subscribe.
Current month subscription has to completed by the 3rd of the month at the latest; otherwise, the subscription date should be the 1st of the next month.
Legal Organization Name
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Investor Profile - Choose what best describes you
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--- Select Choice ---
Individual that is a United States person (including their trust)
Individual that i s not a United States person (including their trust)
Broker-dealers that are United States persons
Broker-dealers that are not United States persons
Insurance companies that are United States persons
Insurance companies that are not United States persons
Investment companies registered with the U.S. Securities and Exchange Commission ("SEC")
External private funds 7
Internal private funds
Non-profit organizations that are United States persons
Non-profit organizations that are not United States persons
U.S. pension plans (excluding government pension plans)
Non-U.S. pension funds (plans and funds that are not U.S. private o r governmental pension plans)
Banking o r thrift institutions that are United States persons
Banking or thrift institutions that are not United States persons
U.S. state or municipal government entities' (excluding government pension plans)
U.S. state or municipal governmental pension plans;
A sovereign wealth fund or foreign official institution (excluding pension funds)
Investor that is not a United States person and about which the foregoing beneficial ownership information is not known and cannot reasonably be obtained because the beneficial interest is held through a chain involving one or more third-party intermediaries
Other
(if the Subscriber is acting as a custodian, nominee, trustee, agent or in another similar capacity o n behalf of an underlying beneficial owner, please select the category that best describes the underlying beneficial owner)
Please Specify:
*
The Subscriber represents that the Subscriber is:
A government entity
Not a government entity
The Subscriber represents that the Subscriber is: (please select if applicable)
*
Acting as trustee, custodian or nominee for a beneficial owner that is a government entity
An entity substantially owned by a government entity (e.g., a single investor vehicle) and the investment decisions o f such entity are made or directed by such government entity.
Are you married?
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Yes
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Spouse's Legal Name
First
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Last
Physical Address
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Organization's Physical Address
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--- 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
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Montana
Nebraska
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New Hampshire
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New Mexico
New York
North Carolina
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Ohio
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Pennsylvania
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South Carolina
South Dakota
Tennessee
Texas
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Vermont
Virginia
Washington
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Next
Are you a natural person resident of the United States?
*
Yes
No
Accredited Investor Status
Are you an accredited investor?
*
Yes
No
Financial Criteria
1) Net worth over $1 million, excluding primary residence (individually or with spouse or partner)
and/or
2) Income over $200,000 (individually) or $300,000 (with spouse or partner) in each of the prior two years, and reasonably expects the same for the current year.
OR
Professional Criteria
1) Investment professionals in good standing holding the general securities representative license (Series 7), the investment adviser representative license (Series 65), or the private securities offerings representative license (Series 82)
2) Directors, executive officers, or general partners (GP) of the company selling the securities (or of a GP of that company)
3) Any “family client” of a “family office” that qualifies as an accredited investor
4) For investments in a private fund, “knowledgeable employees” of the fund
OR
Investment Advisers
Investment advisers (SEC- or state-registered or exempt reporting advisers) and SEC-registered broker-dealers
What qualifies you as an accredited investor? (choose one or more)
*
A person whose individual net worth, or joint net worth with that person's spouse or spousal equivalent, exceeds $1,000,000 (regardless of whether the Interest is purchased jointly).
A person who had an individual income in excess of $200,000 in each of the two most recent years, or joint income with that person's spouse or spousal equivalent in excess of $300,000 in each of those years, and has a reasonable expectation o f reaching the same income level in the current year;
A trust, with total assets in excess of $5,000,000, not formed for the specific purpose of acquiring the Interest, whose purchase is directed b y a sophisticated person a s described in Rule 506(b)(2)(ii) under the Securities Act;
A revocable trust that may be revoked b y the grantor a t any time and whose grantors are all Accredited Investors;
A person holding, in good standing, one or more o f the following professional certifications/ designations/credentials: (i) General Securities Representative license (Series 7); (i) Private Securities Offerings Representative license (Series 82); or (iii) Investment Adviser Representative license (Series 65);
A person who is a "knowledgeable employee," as defined in rule 3c5(a)(4) under the 1940 Act, of the Fund;
"A person" refers to a human being or natural person.
What qualifies your entity as an accredited investor? (choose one or more)
*
A
“family office,”
as defined in rule 202(a)(11)(G)-1 under the Advisers Act: (i) with assets under management in excess of $5,000,000, (ii) that is not formed for the specific purpose of acquiring the Interest, and (iii) whose prospective investment is directed by a person who has such knowledge and experience in financial and business matters that such family office is capable of evaluating the merits and risks of the prospective investment; or
A
“family office,”
as defined in rule 202(a)(11)(G)-1 under the Advisers Act, of a family office meeting the requirements in Paragraph 13 above, and whose prospective investment in the Fund is directed by such family office pursuant to the Paragraph above.
An entity in which all of the equity owners are Accredited Investors
An entity, of a type not listed in Paragraphs 1, 2, 3, 7, 8 and 9 above, not formed for the specific purpose of acquiring the Interest, owning investments, as defined by the SEC, in excess of $5,000,000
A
private business development company
as defined in Section 202(a)(22) of the Advisers Act
A
bank
a s defined in Section 3(a)(2) of the U.S. Securities Act of 1933, a s amended (the "Securities Act"), or a savings and loan association or other institution as defined in Section 3(a)(5)(A) of the Securities Act whether acting in its individual o r fiduciary capacity; a
broker or dealer
registered pursuant to Section 1 5 of the U.S. Securities Exchange Act of 1934, as amended; an
investment adviser
registered pursuant t o Section 203 of the U.S. Investment Advisers Act of 1940, as amended (the "Advisers Act") or registered pursuant to the laws o f a state; an investment adviser relying on the exemption from registering with the U.S. Securities and Exchange Commission (the "SEC") under section 203(l) or (m) of the Advisers Act; an
insurance company
as defined in Section 2(a)(13) of the Securities Act; a n investment company registered under the U.S. Investment Company Act of 1940, as amended (the "1940 Act"), or a business development company a s defined in Section 2(a)(48) of the 1940 Act; a Small Business Investment Company licensed by the U.S. Small Business Administration under Section 301(c) o r (d) of the U.S Small Business Investment Act o f 1958; a Rural Business Investment Company as defined in Section 384A of the Consolidated Farm and Rural Development Act; a plan established and maintained by a state, its political subdivisions or any agency or instrumentality of a state or its political subdivisions, for the benefit of its employees, if such plan has total assets in excess of $5,000,000; an employee benefit plan within the meaning of the U.S. Employee Retirement Income Security Act of 1974, as amended ("ERISA"), if the investment decision is made by a plan fiduciary, as defined in Section 3(21) of ERISA, which is either a bank, savings and loan association, insurance company, or registered investment adviser, or if the employee benefit plan has total assets in excess of $5,000,000 or, if a self-directed plan, with investment decisions made solely by persons that are Accredited Investors;
Does your entity qualify as an accredited investor?
*
Yes
No
Entities
All equity owners are accredited investors. See criteria below:
Financial Criteria
1) Each owners must have a Net worth over $1 million, excluding primary residence (individually or with spouse or partner)
and/or
2) Each owner must have an Income over $200,000 (individually) or $300,000 (with spouse or partner) in each of the prior two years, and reasonably expects the same for the current year.
OR
Professional Criteria
3) Each owner is an Investment professionals in good standing holding the general securities representative license (Series 7), the investment adviser representative license (Series 65), or the private securities offerings representative license (Series 82)
What qualifies your entity as an accredited investor? (choose one or more)
*
A private business development company a s defined in Section 202(a)(22) of the Advisers Act;
An organization described in Section 501(c)(3) of the U.S. Internal Revenue Code of 1986, as amended, a corporation, a Massachusetts or similar business trust, a partnership, or a limited liability company, not formed for the specific purpose of acquiring the Interest, with total assets i n excess o f $5,000,000;
A director, executive officer, managing member or general partner of the Fund, or a director, executive officer, managing member or general partner of a general partner of the Fund;
Qualified Client Status
The Subscriber represents that the Subscriber is a "Qualified Client" because, a t the time of the sale o f the Interest to the Subscriber, the Subscriber i s (please select one o r more categories if and as applicable):
A natural person who, or a company that, immediately after entering into his or its direct or indirect investment in the Fund has a t least $1,100,000 under the management of the Investment Manager;
A natural person who, or a company that, immediately prior t o entering into his or its nvestment in the fund has a net worth (together, in the case of a natural person, wit ssets held jointly with a spouse) of more than $2,200,000. For this purpose (i) one's primary residence should not b e included as a n asset; (ii) indebtedness secured by one's primary residence, up to the estimated fair market value of the primary residence at the time this Subscription Agreement i s entered into, should not be included a s a liability (except that i f the amount of such indebtedness outstanding at the time of calculation exceeds the amount outstanding 6 0 days before such time, other than a s a result o f the acquisition of the primary residence, the amount of such excess should be included as a liability); and (iii) indebtedness that is secured by the person's primary residence in excess of the estimated fair market value of the primary residence should be included as a liability;
A
"qualified purchaser"
(as defined i n Section 2(a)(51) of the U.S. Investment Company Act of 1940, as amended (the "1940 Act")) immediately prior to entering into his or its investment in the Fund; or
A natural person who immediately prior to entering into his o r her investment in the Fund is (a) an executive officer (president, any vice president in charge of a principal business unit, division or function, or any other officer who performs a policy making function, or any other person who performs similar policy making functions), director, trustee, general partner, or person serving in a similar capacity, of the Investment Manager, or (b) an employee of the Investment Manager (other than an employee Investment Manager) who, in connection with his or her regular functions o r duties, participates in the investment activities of the Investment Manager (provided that such employee has been performing such functions and duties for or on behalf of the Investment Manager, or substantially similar functions or duties for or on behalf of another company, for at least 12 months).
Investment Company Status
The Subscriber (please select one o r more categories as applicable):
Is or holds itself out as being engaged primarily, o r proposes t o engage primarily, i n the business of investing, reinvesting, or trading i n securities;
Is engaged or proposes to engage in the business o f issuing face-amount certificates of the installment type, or has been engaged i n such business and has any such certificate outstanding;
Is engaged or proposes to engage in the business of investing, reinvesting, owning, holding, or trading in securities, and owns or proposes to acquire investment securities having a value exceeding 40% of the value of such issuer's total assets (exclusive of government securities and cash items) on an unconsolidated basis; or
None of the above.
Restricted Person Status
Are you a "Restricted Person?"
*
No
Yes
I don't know
a Investment Your
If the Subscriber is a Restricted Person that is a corporation, partnership, limited liability company, trust, collective investment vehicle or other entity, it must complete the following Item C.2. 2. The Subscriber represents that (please select one (and only one) o f the following):
(a) None of its beneficial owners are Restricted Persons, and it agrees to notify the Fund immediately in writing if any of its beneficial owners are or become Restricted Persons.
(b) The Subscriber is not owned solely by Restricted Persons and will not allocate to estricted Persons more than 10% of the new issues profits or losses allocated to it b he Fund. The Subscriber agrees to notify the Fund immediately in writing if th foregoing statement becomes untrue or inaccurate.
(c) Neither of the above statements i s correct.
Bad Actor Representation
Has the Subscriber or, in the case of a Subscriber that is a n entity, the beneficial owners o f the Subscriber's interest in the Fund:
Have you ever been convicted in any jurisdiction in the United States, within the last ten years of any felony or misdemeanor?
Yes
No
Acknwogement
*
Yes, I agree to receive reports, notices, and other communications electronically. I further certify that all information I have provided is accurate, complete, and true to the best of my knowledge.
Additional Comment or Important Information
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