Cutler Capital Management

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To determine if you meet the qualified client standards set forth by the U.S. Securities and Exchange Commission, please fill out the following investor questionnaire:

:: Choose Username and Password

*Username: (minimum 6 characters)

*Password: (minimum 6 characters)

:: Your Profile

Title:	*First Name:	*Last Name:
*Address:	*City:	*State:
*Zip/Postal Code:	*Country:
*Daytime Phone:	Evening Phone:	Fax:
*Email:	*How did you hear about us?

Please answer all three questions accurately to ensure that your qualification is properly assessed.

:: Accredited Investor Status

The interested party certifies he/she is an accredited investor as that term is defined under Rule 501 promulgated under Regulation D of the Securities Act because the undersigned:
	YES	NO
(a) Has an individual net worth, or joint net worth with his or her spouse, in excess of $1,000,000. As used herein, "net worth" means the excess of total assets at fair market value, including home, home furnishings and automobiles, over total liabilities;
(b) Had individual income (exclusive of any income attributable to his or her spouse) of more than $200,000 in each of the past two years, or joint income with his or her spouse of more than $300,000 in each of those years, and reasonably expects to reach the same income level in the current year;

:: Qualified Client Status

The interested party understands and agrees that, in certain circumstances, the Adviser or one or more principals or affiliates thereof, may be subject to certain limitations on performance-based compensation, unless the undersigned meets certain tests set forth in Rule 205-3 under the Investment Advisers Act of 1940. Accordingly, the interested party represents and warrants that:
	YES	NO
(a) The undersigned is a natural person or a company that, as of the date hereof, has a net worth (in the case of a natural person, together with assets held jointly with a spouse) of more than $1,500,000;

For purposes of this section, "company" means a corporation, a partnership, a limited liability company, an association, a trust or any organized group of persons, whether incorporated or not, excluding any company that is excepted from the definition of investment company under Section 3(c)(1) or 3(c)(7) of the 1940 Act.

By selecting "I Agree" below, you are acknowledging your understanding and agreement with the foregoing and represent and warrant to Cutler Capital Management, LLC, that all of the above information you have provided is true and accurate.