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Personal Information:
To participate as an investor qualified as a "Sophisticated
Investor" under the United States securities laws and
to be able to receive private placements and participate
in private placements available from VistaWeb IPO, you must
establish your status as a sophisticated investor by answering
the following specific questions.
Employment Occupation Information
1.
Retired
Unemployed
Employed/Not Owner
Owner of Business
Homemaker
Student
Employer Name
Position/Title
Nature of Business
Years Employed at this Employer
Employer's Address and Country
2. Indicate below any publicly traded firms of which
you or any member of your household or any business affiliate
are or would be considered a:
Director
Ten percent Shareholder
Officer
Name of Company
3. Do you or anyone in your organization hold any licenses
for the trading of securities under NASD?
Yes
No
4. Investing Experience. In order to be deemed a sophisticated
investor, we must determine your prior investing experience.
Please advise as to how many years and types of matters
in which you have experienced with:
Stocks
Limited Partnerships
Stock Options
Commodity Futures
Bonds
Mutual Funds
Certificates of Deposit
Private Placement Investing
Financial Information
$
Annual Income
$
Liquid Net Worth
$
Net Worth Excluding Home
Sign this Questionnaire
If you return this Questionnaire through the Nustar
communications link,
please enter your full name on the signature line.
The foregoing statements are true and accurate to the
best of my information and belief and I will promptly
notify Nustar of any changes in the foregoing answers.
Would you like to receive a hard copy of the PPM?
No
Yes