Qualified Purchase & Accredited Investor Form

In order to see Bristlecone Investments Ltd. investment opportunities please indicate whether you qualify as an Accredited Investor according to the criteria set forth in this Investor Questionnaire:

Method of Qualification: An individual will qualify as an Accredited Investor if he or she meets any one of the following requirements:

A. You are a natural person and had an individual income in excess of $200,000 in each of the two most recent years and reasonably expect an income in excess of $200,000 in the current year. For these purposes “income” means your individual adjusted gross income for federal income tax purposes, plus (i) any deduction for long term capital gain; (ii) any deduction for depletion; (iii) any exclusion for interest; and (iv) any losses of a partnership allocated to an individual limited partner.

B. You are a natural person and had a joint income with your spouse in excess of $300,000 in each of the two most recent years and reasonably expect a joint income with your spouse in excess of $300,000 in the current year. For these purposes “income” shall be determined as set forth in Section (A) above.

C. You are a natural person and have an individual net worth on the date hereof (or joint net worth with your spouse) in excess of $1 million (including your home furnishings and automobiles; provided, however, that the value of your primary residence must be excluded from the calculation of your net worth; provided, further, that to the extent any indebtedness secured by your primary residence exceeds the fair market value of your primary residence such amount must be considered a liability and deducted from your net worth).