Four City Health Freedom Tour
Home

Investor's Qualifying Questionnaire - For Private Intelligence Briefing and Dinner with
Major General Bert Stubblebine (US Army, Ret.)

Investor Qualification Required by SEC Regulation. Please copy and paste this questionnaire into an email and send to: genbert@fundfornaturalsolutions.org
Picture
No Offer Except through
Private Placement Memorandum
SEC Filing, October 21, 2011
Filing No. 021-167619 / 111150148 - CIK #0001532833
ENROLLMENT FORM (Copy & Paste into email.)

Confidential Questionnaire to Express Interest in Fund Participation

Please include the following in the email:

Full Legal Name
Address
Years in residence
Place of birth
Nationality
Phone:
Cell
Land line
Email

I am looking for:

Investment
__ with income
__ fixed term

Investment Source:

__ IRA/401 funds
___ Other retirement funds
___ Precious Metals
___ Other Assets

Status:

___ Currently Employed
___ Retired
___ Married
___ Single
___ Divorced
___ No. dependents

I am interested in investing

$______________ in a lump sum