Substantiate Your Gains Are QSBS Eligible

Name(Required)

First Last

Email(Required)

Corporation you hold securities in:(Required)

Corporation Website

What is the nature of your relationship to the company?(Required)

When were your securities acquired?(Required)

Have you sold your securities?(Required)

Yes

When did you sell your securities?

Type of security when acquired(Required)

Total Purchase Price(Required)

Total Sales Value(Required)

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Gain

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Savings

Please provide your securities purchase agreements (i.e. share purchase agreement, SAFE, etc.). (Note: In order to be QSBS eligible, you need to have obtained your shares at original issuance from the company.)

Drop files here or

Max. file size: 50 MB.

If your security converted into equity, please Include the documents for the original security (e.g. SAFE) and the converted security (e.g. share purchase agreement).

Did the company ever buy back (i.e. redeem) any of your shares from you or a party related to you?(Required)

Yes

Not Sure

Please provide further details of the company's repurchase of your shares (i.e. reason for repurchase, date of repurchase, amount of shares sold back to the company, and total consideration you received in the repurchase).

Did you hold the securities personally when you first acquired them or did you hold them through another legal entity?(Required)

I held them personally

I held them through another legal entity

Have you transferred your shares to any other person or entity since you obtained them?(Required)

Yes

Not Sure

Please provide additional details of the share transfer (i.e. nature of transfer, who or what entity were shares transferred to, etc.).

Has the company provided any indication that the company level eligibility criteria have been met?(Required)

Yes

Please provide the support you received from the company regarding QSBS eligibility of your shares (i.e. letter / memo).

Max. file size: 50 MB.

Do you have access or can you obtain the corporation's tax returns, financial statements, 409a valuations and/or other documentation that may be helpful in performing an analysis?(Required)

Yes

Estimated Report Cost: $750

Estimated Individual Report Cost:

Estimate

EstimateOver100k

Additional work is required to validate the corporation’s QSBS eligibility using provided documents. Pricing for Corporate validation varies based on the specifics of the corporate history, and the level of comfort desired.