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efta-01452239DOJ Data Set 10Other

EFTA01452239

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DOJ Data Set 10
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efta-01452239
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
SOF III - 1081 Southern Financial LLC 4. The Investor is a "qualified institutional buyerni acting for its own account or the account of other qualified institutional buyers provided that: a dealer described in paragraph (a)(IXii) of Rule 144A must own and invest on a discretionary basis at least $25 million in securities of issuers that am not affiliated persons of the dealer; AND a plan referred to in paragraph (aX1XD) or (a)(IXE) of Rule 144A, or a trust fund referred to in paragraph (aXI)(F) of Rule 144A that holds the assets of such a plan, will only be deemed to be acting for its own account to the extent that investment decisions are made by the fiduciary, trustee or sponsor of such plan (i.e., there must be at least $100 million of non self-directed assets in the plan) and then only with respect to the assets as to which investment decisions are made by the fiduciary, trustee or sponsor. 5. The Investor is a trust that: is directed by a Qualified Purchaser; was not formed for the specific purpose of investing in the Onshore Feeder Fund; AND with respect to which each senior or other person who contributed assets is a Qualified Person. In order to complete questions I and 3 above, please mad Annex A of this Investor Questionnaire for information regarding what is includable in -investments- and for information regarding the valuation of such "investments." IV. Status as a Politically Exposed Person. Is the Investor (or a beneficial owner owning mom than 25% in interest of the Investor or having the authority to control the Investor) a senior government, political or military official, or an immediate family member or close associate of such person (a "politically exposed person")? Yes No If yes, which government . what position in the government and, if an immediate family member or close associate of a politically exposed person, what relationship to the politically exposed person V. Supplemental Data for Entities. I. Legal form of entity (corporation, partnership, trust, etc.): Jurisdiction of organization: 2. Is the Investor either a tax-exempt foundation or endowment or a pension, profit-sharing, annuity or employee benefit plan which is both involuntary and non-contributory? Yes No As defined in paragraph (a) of Rule 144A under the Securities Act. Investor Questionnaire - 7 Confidential CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0109156 CONFIDENTIAL SDNY_GM_00255340 EFTA01452239

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