Accredited Investor Qualification Form

Information For Accredited Investors Only

Source Industries Incorporated, a Washington Corporation, (the "Company”) is offering 24,000,000 shares of Common Stock for $ .50 per share. In order to view the Private Placement offering online, you must be an accredited investor. If you qualify as an accredited investor, please complete and sign the attached questionnaire and submit to the Company. You agree that your signature written as “/s/ Jane Doe” will serve as your legal signature. The Company will review your submission and if satisfactory the Company will send a password which will allow you to access the documents. If you have any questions please send email to: or contact Jody Langston, President at: office 253-579-5708 cell: 360-297-3099

Accredited Individual Investor Status

You hereby represent and warrant that you are an “Accredited Investor” as that term is defined in Rule 501 of Regulation D as promulgated pursuant to the Securities Act of 1933, as amended (the “Act”), because you represent and warrant that you come within any of the following categories, at the time of the sale of the securities to you (choose one):

A natural person whose individual net worth, or joint net worth with that person’s spouse, at the time of that person’s purchase exceeds $1,000,000.00.

A natural person who had an individual income in excess of $200,000.00 in each of the two most recent years or joint income with that person’s spouse in excess of $300,000.00 in each of those years and has a reasonable expectation of reaching the same income level in the current year.

A director, executive officer, or general partner of the issuer of the securities being offered or sold, or any director, executive officer, or general partner of a general partner of that issuer.

Note: Several other categories of accredited investors are defined in Rule 501. If you are a corporation, pension funds, partnership, LLC or other entity, please contact Jody Langston and a special accredited investor representation will be promptly sent to you.

All information provided on Source Industries investor relations website is for informational purposes only, not intended for investment advice. Neither Source Industries nor any of independent providers is liable for any informational errors, incompleteness, or delays, or for any actions taken in reliance on information contained herein. By accessing this website, you agree not to redistribute the information found therein.


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For more information on specifications, warranty and purchase price please contact: Jody Langston 253.579.5708