Exhibit D

Confidential Investor Suitability Questionnaire

To: Prospective purchasers of LP Partnership Units offered by CLOVIS AI (the “Partnership”). The Purpose of this Questionnaire is to solicit certain information regarding your financial status to determine whether you are an “Accredited Investor,” as defined under applicable federal and state securities laws, and otherwise meet the suitability criteria established by the Partnership for purchasing Units. This questionnaire is not an offer to sell securities.

Your answers will be kept as confidential as possible. You agree, however, that this Questionnaire may be shown to such persons as the Partnership deems appropriate to determine your eligibility as an Accredited Investor or to ascertain your general suitability for investing in the Units.

Please answer all questions, complete appropriate fields, and execute the signature page.

Personal Information


Address of Principal Residence:_________________________________

___________________________________________ County:__________

Residence Telephone: (______)_____________________

Where are you registered to vote?________________________________

Your driver’s license is issued by the following state:_________________

Other Residences or Contacts: Please identify any other state where you own a residence, are registered to vote, pay income taxes, hold a driver’s license or have any other contacts, and describe your connection with such state:


Please send all correspondence to:

_____ Residence Address (as set forth in item A-2)
_____ Business Address (as set forth in item B-1)

Date of Birth:_________________________________________________
Social Security or Tax I.D. #:__________________________________

Occupations and Income
Business Address:_____________________________________


Business Telephone Number: (______)_________________

Gross income during each of the last two years exceeded:
Last Year Year Before Last
_____Under $50,000 _____Under $50,000
_____ $50,000 to $100,000 _____ $50,000 to $100,000
_____$100,000 to $200,000 _____$100,000 to $200,000
_____Over $200,000 _____ Over $200,000
Joint gross income with spouse during each of the last two years exceeded $300,000?

_____Yes _____No

Estimated gross income during current year exceeds:
_____Under $50,000
_____$50,000 to $100,000
_____$100,000 to $200,000
_____Over $200,000

Estimated joint gross income with spouse during current year exceeds $300,000?
_____Yes _____No

Net Worth
Current net worth or joint net worth with spouse (note that “net worth” includes all of the assets owned by you and your spouse in excess of total liabilities, excluding the value of your primary residence.)

_____$50,000-$100,000 _____$100,000-$250,000 _____$250,000-$500,000
_____$500,000-$750,000 _____$750,000-$1,000,000 _____over $1,000,000

Current value of liquid assets (cash, freely marketable securities, cash surrender value of life insurance policies, and other items easily convertible into cash) is sufficient to provide for current needs and possible personal contingencies:

_____Yes _____No

Affiliation with the Partnership

Are you a director or executive officer of the Partnership?

_____Yes _____No

Investment Percentage of Net Worth

If you expect to invest at least $100,000 in Units, does your total purchase price exceed 10% of your net worth at the time of sale, or joint net worth with your spouse.

_____Yes _____No

Consistent Investment Strategy

Is this investment consistent with your overall investment strategy?
_____Yes _____No

Prospective Investor’s Representations

The information contained in this Questionnaire is true and complete, and the undersigned understands that the Partnership and its counsel will rely on such information for the purpose of complying with all applicable securities laws as discussed above. The undersigned agrees to notify the Partnership promptly of any change in the foregoing information which may occur prior to any purchase by the undersigned of securities from the Partnership.

Prospective Investor named under Personal Information above:

__________________________________ Date:________________

Accepted by CLOVIS AI Managing Director Mack Bryson