Text extracted via OCR from the original document. May contain errors from the scanning process.
SUBS
UBS Financial Services Inc.
Account Nurnoer
Cicnt
Fund Investment Application Cover Sheet
Fund Name
Ghblaine Maxwell
Account title
Ghklalne Maxwell
Client Name
ACU6
Form
ML2,31837
Control Number
102725
Appkation Id
ECS-0155002191
III
FCS-0155002191
For Internal UseOnly
CI 2007 UBS Financial Services Inc. AN Rights Reserved. Member SPC
CONFIDENTIAL
SDNY_GM_00020458
EFTA_00131078
EFTA01273285
UBS
AlphaKeys Millennium Fund, L.L.C.
Investor Application Form
Investor(s)
Please:
• Complete the Investor Application Form via UBS Online Services ('OLS") Q8
return this entire Subscription Booklet to your Financial Advisor.
• Only fully completed Subscription Booklets (no faxes, no copies) will be accepted.
•
•
Retain a copy for your files.
•
Read the Fund's Memorandum and the Subscription Agreement.
•
Please refer to the enclosed Tax Forms and speak to your UBS Financial Advisor. You may not
be required to complete these forms if your UBS account has already been designated FATCA-
compliant.
Be sure to complete all sections of the Investor Application Form
Financial Advisors/Branch Managers
• Effective July 1, 2014, FATCA compliant tax forms are required for clients to execute new
investments in all Alternative Investments. Please refer to the enclosed Tax Forms and related
submission instructions.
•
Please refer to the Fund Investment Application (' FIA") QuickCard for application submission
instructions, or call UBS Altemative Investments US at 888-962-3842, option 1, sub option 4.
• All Investor Applications must be submitted on FIA to UBS Alternative Investments US
no later than 4 full business days prior to month's end.
ML281817-MAXWELL
CONFIDENTIAL
Private and Confidential
SDNY_GM_00020459
EFTA_00131079
EFTA01273286
Instructions for Completing Investor Application
Prospective investors in the AlphaKeys Millennium Fund, L.LC. (the 'Fund") should read the Memorandum as well
as this Subscription Booklet prior to subscribing.
Please complete all sections of the Investor Application Form. If you invest via O1.5 please follow the instructions on
the OLS system and/or the enclosed informational card. If you invest via this Subscription Booklet please promptly
retum the entire Subscription Booklet to your Financial Advisor. Do not tear out any pages. Retain a copy for your
files.
Please refer to Schedule 2 for the meanings of the capitalized terms used herein.
Please consult your Financial Advisor or call UBS Alternative Investments US for assistance in completing
this Investor Application Form.
A. Capital Contribution Amount
•
Indicate the Capital Contribution applied for (which may be accepted in whole or in part by UBSFA).
•
Provide your Account Number.
•
Funds must be drawn on an account that corresponds exactly to the name of Undersigned.
UBSFA may in its sole and absolute discretion accept as your Capital Contribution an amount less than
the Capital Contribution applied for herein.
CLEARED FUNDS MUST BE IN YOUR ACCOUNT 5 BUSINESS DAYS PRIOR TO MONTH'S END.
B. Investor Information:
•
Provide the Investor's mailing address exactly as it should appear on the address labels.
•
Include the Investor's state of residence or principal place of business, if applicable, and Social Security/Tax
ID Number.
•
Provide the Investors email address.
C. Accredited Investor Representation:
Please read Schedule 1 and check the appropriate box. Generally, an "accredited investor' has a net worth in
excess of $1 million for individuals (together with spouse) or total assets in excess of $S million for entities. To
calculate net worth, exdude the value of your primary residence, and count as a liability any indebtedness
secured by that property in excecc of the fair market value of that property. If you incurred the debt on your
property within 60 days of subscribing for this investment and did not use those funds to purchase that house,
you must include the full value of the debt as part of your liabilities.
The Investor must certify that he, she or it is both an accredited investor and a qualified purchaser in order to
invest in the Fund, unless otherwise determined by UBSFA.
ML281817-MAXWELL
CONFIDENTIAL
Private and Confidential
2
SDNY_GM_00020460
EFTA_00131080
EFTA01273287
Instructions for Completing Investor Application
(continued)
D. Qualified Purchaser Representation:
Please read Schedule 1 and check the appropriate boxes. Generally, a 'qualified purchaser must be an
individual or beneficiary of an IRA- or participant-directed plan or family trust/entity with at least S5 million in
qualified investments or an entity with at least S25 million in qualified investments. The Undersigned must
certify that he, she or it is both an accredited investor and a qualified purchaser in order to invest in the Fund.
E. Benefit Plan Investor Status:
Please read carefully and check the appropriate box.
F. Controlling Person Status:
Please read carefully and check the appropriate box.
G. Certification Regarding Initial Public Equity Offerings:
Please initial and complete all applicable sections.
H. Government Entity Status:
Please read carefully and check the appropriate box(es).
I.
NFA Bylaw 1101 certification
Please read carefully and initial the applicable acknowledgement(s).
.1. Investor Acknowledgement:
Please read the acknowledgements contained in this section carefully, initial the applicable acknowledgements
and complete the applicable certification(s).
K. Investor Signatures:
Please sign.
ML281817-MAXWELL
Private and Confidential
3
CONFIDENTIAL
SDNY_GM_00020461
EFTA_00I 31081
EFTA01273288
Schedule 1
The Undersigned must certify that he, she or
it is an accredited investor and a qualified
purchaser based on the categories listed
below.
I.
Individuals, Joint Tenants and IRAs
The Undersigned, either individually or
together with the Undersigned's spouse, has
a net worth* in excess of 11 million.
II.
Trusts
(a)
The trust has (i) total assets in excess of
S5 million, (ii) it was not formed for the
specific purpose of investng in the Fund,
and (ii) its investment in the Fund is directed
by a person who has such knowledge and
experience in financial and business matters
that he or she is capable of evaluating the
merits and risks of an investment in the
Fund; or
(b) Each Grantor of the trust has the
power to revoke the trust and regain title to
the trust assets, and each grantor is an
accredited investor; a
(c)
The trustee of the trust is a 'bank' as
defined in Section 3(aX2) of the Securities
Act or a savings and loan association or
other institution referred to in Section
3(aXS)(A) of the Sectxities Act
III. Retirement Flans
(a) The plan has total assets in excess of S5
Milian; or
(b) Each participant n the plan is an
accredited investor; or
(c)
The plan is partiopant directed, with
investment decisions made solely by persons
who are accredited investors; or
(d) Investment decisiorts for the plan are
made by a 'plan fiduciary' as defined in
Section 3(21) of ERISA that s a bank,
insurance company, registered inverment
adviser or savings and loan association
N. Corporations, Partnerships, Limited
Liability Companies and Other Entities
{a)
The Undersigned is a corporation,
partnersheo,
United
liability
company,
Massachusetts or similar business trust, a
an
organization
described in Section
501(cX3) of the Internal Revenue Code of
1986, as amended (the "Code"), not
formed for the specific purpose of investing
in the Fund, with total assets in excess of $5
million; or
N) Each shareholder, partner, or other
equity owner of the Undersigned, as the
case night be, is an accredited investor; or
(0 The Undersigned is a 'bank' as
delned in Section 3(3X2) of the Securities
Act or a 'savings and loan association' a
other institution referred to in Section
3(aX5XA) of the Securities Act, whether
acting in its individual or fiduciary capacity;
or
(d) The Undersigned is a 'broker a
dealer' registered pursuant to Section 15 of
the Securities Exchange Act; or
(e) The Undersigned is an 'insurance
company' as defined in Section 2(aX13) of
the Securities Act; or
(t)
The Undersigned is an "investrrent
company' registered under the Investment
Company Act; or
(g) The Undersigned is a 'small business
investment company' licensed by the U.S.
Small Business Administration under Section
(301X0 or (d) of the Small Business
Investment Act; or
(h) The
Undersigned
is
a
• business
development company' as defined in
Section 2(aX48) of the ►'vestment Company
Act or a 'business development company'
defined
in
Section 202(aX22)
of
the
Investment Advisers Act.
Note for Accredited Investor Status:
•
The term net worth means total assets
at fair market vNue minus total liabilities.
To c.slailate net worth: () exclude the fair
market value of your primary residence; (ii)
count as a liability any indebtedness secured
by that property josxcsss of the fair market
value of that property. except that if you
incurred that debt on your property within
60 days of subscribing for this investment
and did not use those funds to purchase
that house, you must include the full value
of the debt as part of your liabilities.
ML281817-MAXWELL
V.
Individuals, Joint Tenants and IRAs
(as applicable)
The Undersigned is a qualified purchaser
because he/she (alone, or together with
his/her spouse, if investing jointly) owns not
less than SS million in investments.• •
VI. 'Family" Corporations, "Family
Foundations, •Family Endowment,
"Family Partnerships, "Family Trusts or
other "Family" Entities
(a)
The Undersigned was not formed for
the specific purpose of investing in the
Fund;
(b)
The Undersigned owns not less than S5
million in investments;• • and
(c)
The Undersigned is owned directly or
indirectly by or for (i) two or more natural
persons who are (A) related as siblings or
spouses (including former spouses), or (B)
direct lineal
descendants by birth or
adoption. (ii) spouses of such persons,
(ii) the
estates
of
such
persons
or
(iv) foundations, charitable organizations or
trusts established by or for the benefit of
such persons.
VR Trusts (Other than Trusts that
qualify under VI or VIII hereof)
(a) The Undersigned was not formed for
the specific purpose of investing in the
Fund; and
(b) The trustee or other authorized person
making decisions with respect to the trust,
and each Settlor or other person who has
contributed asset to the trust, is a person
described in V, VI, Val or IX.
VIII. Other Entities
(a)
The Undersigned was not formed for
the specific purpose of investing in the
Fund; and
(b)
The Undersigned is an entity, acting for
its own account or for the accounts of other
qualified purchasers, which in the aggregate
owns and invests on a discretionary base,
not less than S25 million in investments.• •
CONFIDENTIAL
Private and Confidential
4
SDNY_GM_00020462
EFTA (X)131082
EFTA01273289
Schedule 1 (continued)
QUALIFIED PURCHASER STATUS (can't!)
IX. Entitles that do not qualify under
VI-VIII
The Undersigned is a qualified purchaser
because each beneficial owner of the
Investor's securities is a qualified purchaser
as descnbed herein.
Note:
Trusts may not rely on this certification even
if all of their beneficiaries are qualified
purchasers.
X. MI Investors that are Entities
(a)
The Undersigned is not a 3(c)(1) or
3(cX7) Company; or
(b) The Undersigned is a Section 3(c)(1) or
3(0(7) Company but does not have ANY
Pre-April 30 Holders; or
(c) the Undersigned is a Section 3(cX1) or
3(cX7) Company and has obtained consent
to its treatment as a qualified purchaser
from all of its ere-April 30 Holders.
XL Investors that checked VI or VII may
check XI Instead of X
The Undersigned has obtained consent to its
treatment as a Quaid-led purchaser from all
of its trustees, drectOrs or general partners.
a
Investors that checked X(b) or X(c)
must also respond YES or NO to XII
Is any direct or indrect beneficial owner of
the Undersigned itself a Section 3(cX1) a
3(cX7) Company that controls, is controlled
by, a is under common control with the
Undersigned? If the Undersigned cannot
answer NO to XII because it has a control
relationship with a beneficial owner that is
itself a Section 3(c)(1) or 3(cX7) Company,
the Undersigned may be required to obtain
consent from the security holders of such
owner.
Notes for Qualified Purchaser Status:
•• The term 'investments' means any a
all (I) securities (as defined n the Securities
Act), except for Control Securities unless
otherwise included as described below;
(2) futures contracts or options thereon held
for
investment
purposes;
(3) 005411
commodities held for investment purposes;
(4) Swaps
and
other
similar
financial
contracts entered into for investment
purpose; (5) real estate held for irrvestment
purposes; and (6) cash and cash equivalents
held for investment purposes.
ML281817-MAXWELL
Control Securities may be included in
'investments' if (A) the issuer of the
Control Securities is itself a registered or
private investment company or is exempted
from the definition of investment company
by Rule 3a-6 or Rule 3a-7 under the
Investment Company Act, (8) the Control
Securities represent securities of an issuer
that files reports pursuant to Section 13 or
15(d) of the Securities Exchange Act, (C) the
issuer of the Control Securities has a dass of
securities listed on a designated off-shore
securities market under Regulation S under
the Securities Act or (0) the issuer of the
Control Securities is a private company with
shareholders' eouity not less than S50
millon determined in accordance with
generally accepted accounting principles, as
reflected in the company's most recent
financial statements (provided such financial
statements were issued within 16 months of
the date of Undersigned's purchase of
Interests).
NOTE. in determining whether the S5
million or S2S million thresholds are met,
investment can be valued at cost or fair
market value as of a recent date. If
investments have been acquired with
indebtedness,
the
amount
of
the
indebtedness
must
be
deducted
in
determining whether the threshold has been
met.
CONFIDENTIAL
Private and Confidential
5
SDNY_GM_00020463
EFTA _00131083
EFTA01273290
Investor Application Form
A. Capital Contribution Applied for: S 2c , 0 00
Mote: Your account will be debited for your Capital Contribution plus the Placement Fee of 2% (which may be waived in limited
circumstances). A Placement Fin will be in addition to your Capital Contribution. Please see the investor Acknowledgement
section for additional information regarding the Placement Fee.
Subscriptions will only be accepted in U.S. Dollars.
Account
B. Investor Information:
SSN/I r..x
Mr.
Investor
Address:
Attention
(Name:)
E-mail;
Mrs.
C.
Ms.
MM.
(Cures cur may iresileble )
State.
pri
(1,40:. Widow./ PTigipat Fixed
&sinew)
Dr.
Other
Phone:
Fax:
Accredited Investor Representation
Check only one box.
By executing this Investor Application, the Undersigned cerffies that he, she, a it (as applicable)
has read and understands the instructions to
this Investor Application inducing, but not limited to. the instrations to calculate the net worth for accredited Investors; and (i) if a "accredited
irWeSta* under Regulation D (generally, net worth in excess of St nation for individuals (together with spouse) or total assets in excess of S5
million for entities) and has calafated net worth as moiled by the iratructions in this Investor Application.
Please read Schedule 1 and check one appropriate box below. Note that you must be both an accredited investor and a qualified purchaser in
order to invest in the Fund.
If investor is an IndwidualARABoint Tenant
(with Rights of Survivorship). check here:
If investor is a Revocable Trust, check has.
O (Ilia or O (gb or O (gc
Invests is an irrevocable Trust,
check here:
)
If Investor is a Participant-Directed
Retirement Ran, check here:
it Investor is Other Retirement Plan,
check here:
If Investor is a Corporation, Partnership,
Limited Liability Company and Other Entity,
check here:
O 00a a
O (r<
O OM
CI gibe or O (labor O (lad
K (Mao O (Mb or O (Alcor O Ond cr O (tile or O PO or O 01.09 or CI (N)h
ML281817-MAXWELL
CONFIDENTIAL
Private and Confidential
6
SDNY_GM_00020464
EFTA_00131084
EFTA01273291
Investor Application Form (continued)
D. Qualified Purchaser Representation:
The Undersigned is a 'qualified purchaser' under the trnestrnent Company Act (generally, individuate, beneficiaries of Etaniparticipant-drerted
piers, and familyttnst entities must own at least $5 million or more in qualified investments and entities must own and invest at least $25 mdion in
qualified investments). The Undersigned must certify that he, she or rt is both an accreted investor and a quailed purchaser in order to invest in
the Fund. Please read Schedule 1 and check the appropriate boxes. Trust entitles should read carefully the specific squalled purchaser
requirements on Schedule 1, including the requirement (for trusts other than MIS relying on certifications in VI and Vim that both the trustee (or
other authorized person making decisions with respect to the bust) and each Senor or other person who has contributed assets to the trust must
own at least 55 million in qualfreci investments.
The Undersigned's execution of this Investor Application constitutes certification of the
Undersigned's status as a 'qualified purchaser. •
If Investor is an Individual or
IRA- or Participant-Directed
Retirement Flan, check here:
If Investor is a
▪ amity' Corporation.
• Fantle Foundation,
• randy" Endowment,
' Family- Partnerships.
• Famly- Tests or Other
' Family' Entitles, check here:
If investor is a Trust (other than
a Trust that qualifies under M or
VIII), check here:
If :nests is another type of
Entity, check here.
If Investor is an Entity that does
not qualify under WW1 check
here:
investors that checked X(b)
X(c) must also respond
YES or NO to tern XII
elm
O Ma, band c
AND
0 Macs
0 Mt' or
0 (10c* or
0 DM
O MN and b
MID
CI 00a or
0 NV or
0 OOO1*
0 NO
O 0/114 and b
MID
O Oa or
0 pOb• or
0 (X)c• or
0 DO
O 0>0
MID
CI Oge or
0 Mb* or
0 ()c• or
0 CYO
an you choded Mb or la above.
0 YES or
0 NO
E.
Benefit Plan Investor Status:
Please certify, by checking the appropriate box below, \tether the Investor is or will be described in any of the following categories: (1) an
'employee benefit plan' (as defined in Section 3(3) of ERISA) that is subject to (NSA; (2) a "plan' (as defined in Section 4975(01) of the Code)
that is subaect to Section 4975 of the Code; or (3) an entity which is deemed to be a 'benefit plan investor" or to hold "plan assets' under the Plan
Assets Rules by reason of scatty investments in such entity by one or more persons described in clause (1) or (2) abase. Examples of the foregoing
include, among other things. 'Keogh' plans, other tax-quaified retirement plans, IRAs, certath other types of employee benefit plans (and
accounts) and entities that are deem* to hold "plan assets' thereof.
iii
Check one
0 YES or
NO
F.
Controlling Person Status:
',ease certify, by checking the appropriate box below, *tether the Investor is or will be described in any of the following categories: (0 a person
oe entity that has discretnary authority or control with respect to the assets of the Fund; (N a person or entity that provides investment advice
for a tee trect or incrirett) with respect to the assets of the Fund; or (IN an 'affiliate' of a person or entity described in cause (Dort above.
For purposes of this representation, an 'affiliate of a person or entity includes any person or entity controling, controlled by or under common
control with the person or entity, inducing by reason of having the power to exercise a controing Influence over the management or policies of
the persona entity.
Check one:
0 YES or
/NO
ML28181 7 -MAXWELL
CONFIDENTIAL
Private and Confidential
7
SONY_GM_00020465
EFTA_00131085
EFTA01273292
Investor Application Form (continued)
G. Certification Regarding India/ Public Equety OH« IngS:
i s b
("L
.
Ruh S130 'Restricted ~
tr
o.
'
. .'r<iurge ins, etc ogi e: erkke: in %h. ~
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.
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'rs.fit V arr 44,4:1, sir.:,• eØ t.^. fry X4O:r '..4.ni• tanefeclal leered r. es icideetrea
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14441./ on4 of the eatinkooks Meted knekr 'NW knew* twipoont' at the back DI dl. ~Ion
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NOTE. cesaptione an, na sppikeete fw IMi.wMut r•threkint haunt.. ifidi~ig a toet aktoun4 teal* e• MINA 4440.al6
wMich are treated e inturS person, fa d.å purpos•
CONFIDENTIAL
Private end Confidential
8
SDNY_GM_00020466
EFTA_00131086
EFTA01273293
Investor Application Form (continued)
G. Certification Regarding Initial Public Equity Offerings (contact):
Rule 5131 'Covered Persons'
(1) Please Initial below if applicable a if the timber is a corporation, partnership, trust or other entity, which apply to any person having
a Beneficial hfferest In the Investor
The Investor, a any person having a Beneficial Interest in the Investor, is (0 an executive officer or director of a Putfic Company
et a Covered No-Pubk Company. or (II) a person recemng Material Support by an executive officer or &ecta of a Pubic
Company a a Covered Non•Pubhc Company (any person in 0 or (11a -5131 Covered Person').
(2) If you iritialed statement (1) above. you must name each relevant Pubk Company ander Covered Non-Public Company:
(3) If you labeled statement (1) above, please initial the following only if such appricabk PublX Company or Covered Non-Public Company:.
(a) is currently a client receiving Investment Banking Services crowded by a FINRA member, or has paid compensation to a FINRA
member for Investment Banking Services in the past 12 months;
(b) expects to retain a FORA member for Investment Banking Services within the next 3 months; or
(c) has entered into an express or impbed obligation. drecdy or indirectly through its executive officers or directors. to retain a
I NRA member for the performance of future Investment Banking Services.
If you Initialed any of hams (a) through (4 above, you may still be ellgibk to parddpate in 'new issues" if you satisfy one of the
exemptions listed under 'New issues Exemptions' et the back of the Subscription Agreement.
ff so, please specify the exemption number here (exemption 1(a) is not available):
If the Investor has represented that he, she or it is not a 'Restricted Person" or a 'Covered Person', the Investor further
represents that he, she or it understands that this certificate expires after one year and agrees promptly to notify the Fund
should the account become a 'Restricted Person' or "Covered Perron'.
H. Government Entity Status
0)
Is the Investor a Government Entity?
13 Yes
(i)
the Investor is acting as agent representative or nominee for one or more investors, is any of such investors a Government Entity?
K Yes
tf<do
(ID If the answer to question (IC Is 'Yes', please indicate the names of any such investor:
ML281817-MAXWELL
Private and Confidential
9
CONFIDENTIAL
SDNY_GM_00020467
EFTA_00 I 31087
EFTA01273294
Investor Application Form (continued)
1.
NFA 8 slaw 1101 CortifiCation (Moan •110614••1940041441.
nada
IRA as Rsuadaion Mantas.
-
yvtate aseasnm are Arbil%
WI AMA.
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bee:" WI • is
CONFIDENTIAL
Arran one Coolies.
Iv
SONY_GM_00020468
EFTA_0013 1088
EFTA01273295
Investor Application Form (continued)
1.
Investor
Adintewledshesent
'n• ,.•vsenornej .!CA. win, j • 5, ann.
ea, we • :11. a
Man am
ertaraa 24 a
2 4
h/ fifth aiSen
Ip 02•COSes
:JS Naha
tdIgrien
*
PM
.
J
The Undelnigned terattentl
diet S. the or it m e hatted
States person' (as such in
is definer' in
the Cede) kr purposes a
U.S. federal income taxation and has provided to UK ..pfd
and duly
cerepieled
Conn V4.9. Or wawa
form thereto. signed
wider pethiltas
a
fithlthY by such
• p -P r
!'; ;On
fo
Undersigned.
th e Unledelgerad Cilrillsos under penethes of WM"
that (AI its U.S. taxpayer
a•
"WC...CC . 0
idereilketion
isamber, as it egpesra In the investor Appiation
Forth ie this Subscription booklet. is
Ube and correct and ill0 it es NOT pawl to backup VatItt#80161, twat.*
either Mile
CRAMP( th en
beau'
, lintlt athleg.
ha not berm sobbed by the U.S. Internal Revenue. See**
l'IRS1 that it is
militia to baby
tuthholdng
as a mutt of • lath
to report ea theorist a
dividend ... or (3) the Its
has notified it thanes
no kompn subject to backup withholdena.
The UndeSegned YOU natty
the
Fund within IS days rf any of the above anifeatioin
are no long*. raid. Upon aquae
by the Fund
Uthla.
the Undersigned Well proreptly funtob to the Fund said and duly tompithed
Foam W.f.
Cot tur<ewo
lean Memo
signed under penalthe el paigury by suds undenignod.
Ire nets
Ted :as Wt..,
confanso a
dt fM ciamthon
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it
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CONFIDENTIAL
Private and Cott ficiential
SONY_GM_00020469
EFTA_00131089
EFTA01273296
Investor Application Form (continued)
Investor Acknowledgement kordedk
a.
r_tR (AAVC.1
0'.
‘mOrSicrieC
g<ARCO'
1,naomplira mAnowicica .het YY at a• amma ea :V ',AC Mt.
pin
I
.
tliOn NC•4 tat 13...C.Cali Mint
ot. gIrto• 1:iat
$ organ4 $$$$MIDIS n.$ flat ifivell .11 eM11. fund
K. IrmestOi Si9ratureS:
lux at , tn.
Owe:eft* .r.:actfig CoMer
*1f* 46.4110 Ati0aliOn ;
:re 5.oraptca, Mann: ard
gise "Mr
n atTgrOJIM. *OP ;Ivo wrri
A
(etieS Joint
MAxWPII
1.
MOO a rest vrt • •
••• • 3
a •
!....n.ire 0
MAKE SURE YOU HAVE COMPLETED ALL APPUCABLE SECTIONS Of THIS INVESTOR APPLICATION FORM.
CONFIDENTIAL
Private and cm6dendel
t1
SDNY_OM_00020470
EFTA_00131090
EFTA01273297
For Financial Advisors
All Investor Applications must be submitted on M. to UBS Alternate* Investments US no later than 4 full business days prior to month's
end.
I.
Investor Suitability and NFA Bylaw 1101:
With regard to the proposed investment of the aforementioned client In the Fund, I, as financial Advisor to the dient, by signing below, certify that I
have:
(1) informed the dent of al pertinent facts relating to the ligadity and transferability of the Fund, inckaIng the obligation to maintain sufficient
[Parity to meet ongoing capital calls Of the Fund has a capital cal structure) on potentially stun notice and that the Investment may impact the
diem's lose liquidity;
(2) reasonable grounds to believe (on the basis of 'nfonnation obtained from the dent concerning the client's age, investment objectives.
investment experience, income, net worth. financial §tuallat and needs, other investments and any other information known by me, including
the attached CAI) that:
(a)
the lend berg mbecebed for is suitable and appropriate for the client
(b) the dent meets at applicable minimum income, net worth, liquid assets and other objective suitability standards;
(c)
the dent can reasonably benefit (including realizing any intended tax benefit if applicable) from the Fund based on the client's financial
position, overall investment objectives and portfolio structure,
(d) the dent can bear the economic risks of the investment in the fund;
(e) the dent's goals are consistent with the time frame of the investment; and
(I)
the dent appears to have an understandng of:
(i)
the fundamental risks of the Fund (including that the client may lose his or her entire investment);
00
the restrictions on the avidity and transferability of the Fund;
(6) the background and qualifications of the sponsor(s) and immanent manager(s) of the Fund; and
(iv) the tax consequences with respect to an Investment in the Fund;
(3) obtained a valid and duly completed Form W-9 or W-8, as applicable, or successor form thereto, signed alder penalties of (*wry by the client
and I have properly placed such form on fie pursuant to internal UBS policy; and
(4) confirmed, with reasonable due ingery, the clients representations provided in Section I. NFA Bylaw 1101 Certification (if applicable).
Regarding Item 2(b) above, in the event that the dent is an entity (such as a trust or partnership) that does not itself meet the mirimurn investment
requiements (such as net worth) I have ascertained from the appropriate parties (such as the dent's trustee or general partici that al of the client's
beneficial owners meet such requirement.
Wil this investment r
t in the client holding more than 30% of his net worth as evidenced on till in Alternative Investments?
O YES
H NO
If I assisted the dent In completing any information that is required to be provided by the dent in the Investor Apiece-ion I
have done so pursuant to the client's authorization and direction solely based upon information that has been provided to
me by the client If I did not assist the dam in competing any information in the Investor Application. I certify that I have
reviewed the completed Investor Application Form, and I agree that al the information in connection with the client's
investment in the fund that is provided by the client is correct and accurate.
11.
Investor Qualification for Offshore Fund offerings only
I have reviewed the "Country Cuaifications° appendix to the Memorandum or Subscription Agreement and in any applicable supplement to the
Memorandum or stet forth in the instructions on the UBS Intranet and I certify that I have reasonable grounds to believe that the dent isquailed,
under the law of its country of residence, as described therein to invest in the Fwd.
M. Flnandal Advisor Signature (Please Sign Below):
Print Name of Financial Advisor:
Financial Advisor Signature:.
Note: if inst
, the CA/ Statement that accompanies this form must be
dated before or the same day this application is signed.
caso Lim #
P.acement Fee O
% (2%. waivable in lintited drounstancits)
(Fee will be charged In addition to Capital CorarlbutIon.)
Branch CoderTA ND'vision: Ito I 1155 I PinIVA
FInancial Advisors must reconcile the information listed on this
Financial Advisor Telephone If:
application with the client's account records, including updating
the client's not worth, objectives and any other relevant information.
Financial Advisor E-mail Add*
Pirnitirtnitntielf
r signs the following page.
CONFIDENTIAL
Private and Confidential
13
SIDNY_GM_00020471
EFTA_00131091
EFTA01273298
For Branch Managers
IV. Branch Manager Signature
I certify that I have reviewed the completed Investor Suitability and Investor Qualifications sections above. tho dent Investor Application Form and
CAI, and if applicable, the 'Country Qualifications' appends to the Memorandum a the Subscription Agreement and any applicable supplement
thereto a set forth in the instructors on the UBS intranet and I agree, based upon the information known to me, with the Financial Advisor's
determination that the Investment being subscribed for is suitable and appropriate for the dient. I agree that if the fluent Advisor assisted the
client n completing any information that n rehired to be provided by the client in the Invest« Application. based upon information known to me,
that the financial Advisor has done so pusuant to the client's authorization and direction solely based upon information that has been ended to
the Financial Advisor by the diem.
By signing below, if applicable, I have determined that (1) if the proposed investment is for an Access Peson's (as defined in the Investment Adviser
Code of Ethics) employee or employee-related account, my signature evidence my pre-approval of the trade and that (2) the Access
Penn's proposed investment a) will not unfairly limit the ability of eligible clients of VBS Financial Services Inc. ('the Firm') to participate in the
proposed investment and (b) does
resent a
d
mat
I conflict with the interests of the Firm's clients or the rum.
s"
Print Name of Branch Manager:
/e.lie2-
Af5702,41
Branch Manager Signature-
If the above named
-
bar& 0.1/4"
(MUST BE COMPLETED)
t a BS
Mold Service IRA, then the
Note.
tructed, the CAl Statement that accompanies this form
Branch Manager, as a result also signs as the custodian of the IRA
must be dated before or the same day this application is signed
and accepts and agrees to this subscription.
PLAaMENI FEE APPROVAL SECTION - THIS SECTION IS ONLY REQUIRED IF A REDUCED PLACEMENT FEE IS CHARGED
TO be completed by Complex Director or Complex Admin Manager as Delegate (if necessary)
By signing below you have agreed and accepted the reduced placement fee above in section B.
If you do not agree to the reduced placement too, pease inform the brand, who is responsible for contacting AI Investor Service. Call Al Investor
Services (800) 580-2359 option N1 for questions.
Print Name of Complex Director.
Comdex Director Signature:
Date:
(MUST BE CONIIII FTFD)
ML281817-MAXWELL
Private and Confidential
14
CONFIDENTIAL
SDNY_GM_00020472
EFTA 00131092
EFTA01273299
CONFIDENTIAL
.----
EFTA,13I093
EFTA01273300
Subscription Agreement
The Undersigned ashes to became an investor un the
Fund, and to punthare an Interest n the hind upon
the tans and condign set forth herein and in the
Marc:rend= and the Fund Agreement
Accordingly, the Uncle-signed hereby agrees as
from
(A) The Undemgred agrees to become an investor,
and in connection therewith, subscrtes for and
arts to paean an Mutest In and to make a
Capital Confribudon to the Fund
Payment (as
defied in Schedule 2) must be received pig to the
Closing established by the Fund for the sub:edge:tin.
Any placement fee es il &Skim to the ntirthern
initial subscription. The fund may very the mirevurn
like) subsoiron frcm the tore.
(B) The Urn:enigma understands alt agrees that the
Fund reserves the right to reject this Atusoipbon for
an interest for any reason or no reams, th whale or in
pan, and at ary dm@ prior to his, her or its
acceptance. t tie stisaiption is rejected. the
Payment and any Placement Fee paid by the
Underagned, with or without barest, a athicahe,
wall be retuned promptly to tie Urehreathed and this
irrantOr Application shat have no force or effect.
urn acceptance of this Mester Appleation by to
Fund, the Undersigned shall become an tweaor in
the Fund.
Adrrissim of the Uncleared as an
wain %a occur ony upon the Closing
(C) The Unknigned acknowledges and agrees that,
except as may be provided under applicable state
securita laws, the Undersired is rot mated to
cancel, terminate or revoke this Investor Appeal:en
or any agreement cr the power of attorney of the
thelenigned hereunder and this Mesta Appleasko
and such agreement and power of attorney shell
survw
any changes in the transaction Documents
and instrument trom the description thereof In the
Memorandum vetch in the aggregate art not
material or which are contemplared by the
Memorandum and (4, the subsequent death,
disability. incapacity, excepetence, termiratern,
bankruptcy, insolvency or desobion (as applicable) of
the Undersigned, provided that if the Fund does not
accept the Investor App kation on or before the
Clang, this Imator Appacadon, at agreements aid
the power of attorney of the Undenigned thereunder
shaft be canceled and this threpor Appecation wit be
retuned to the Undersored.
(DI The Undersigned agues to provide MSS& the
Fund ander the Placement Arm such addlitha
information, documentation enact representations as
UBSfA, the Fund andfor the Placement Art may
request n order to comply with any pronisen of
Sears 1471 through 1474 of the Code and any
cadence
issued thereunder. The U.MMae
understands that such elonnation. Ocarnentabon
arab recresematicre may be &closed to the
internd Revenue service a Med Tad Partin, as
apac:nate, by the Fund.
The
Undmigred
makes
the
foaming
reaventabort deciaratons and warranties with the
ream that the same be rebid tor in determining
the sutability of the Undesired as an iniestor,
compliance by the Furd with federal and slate
securities taws or the tax status of the Fund Sur
reantniations,
declaradons.
warranties
and
agreement that sate the dale of Closing and full
be deemed to be reaffirmed by the Undersigned at
each tine that the Undersigned makes an ackitional
Capita Contrbuton to the Furd. The act of making
any path adrenal Capita Coranbaion shill be
*Mena of such reaffematicn.
pknoses only and not with
toward diaributip
• resting such Inierests in whole or in part. The
Undersigned understands and agree that he. the or 4
must bear the economic risk of his, her or its
investment for an Indefinite period of tine (suer to
bared Iglu of transfer provided in the Furd
Agreement) becase among ether rests, the
Interest has not been reclaimed under the Searles
Act a uncle the watt laws of certain states and,
therefore, cannot be read. pledged, assigred or
otherwise deposed of unless C is so registered a an
therration Iran regal:mon is available
The
Undersigned understands that the Fund is wax re
obligation to feaster the beteg on his, here' it
Whet a to asat hrn, her a it incomplyong with my
exempt:3n from registration under the Securities Act.
He, she or it also urcleestards that sales or triers ol
the interest we further restriaed by the Furd
Agreement and stare securities
(3) The Undimmed has rot reproduced, &pirated
or dshwed in whole or in prt and at not
reproduce &picas or delver kr whole or in part, the
Memoranda the Feed Agreement or this better
Application Form to any other person or entity. amp
to the Undersigned's profnernal 'dews or as
apes* inert/teed or permitted by Unfit
(C) The Urelmegned has moved eget Ldy read and
undersea is
the fund
Agreement
and
the
Mettoracken, indang, without are acre, the
Sealant of the Memorandum entitled 'Risk Factors'
and 'Pocentie Conflicts of tram' and the sections
or oroidons uterine, among other things. the
organization aid irnestment apecthe and maces of,
and the li b and expenses of an investment in the
Fund Tee Undesired acknowledges that in making
a Scam to subecrIte for an Interest, the
Lndersigned ha feted 'Ole& uPon the Memorandum,
the Fad Agreement and independent inre49*from
made by the Undesired. The Undersigned's
inveurnent In the Fund Is consistent with the
Mestmem purposes, objectives, and castenow
recarevrents and need fog diversification and Wady
of the Undersigned. The aggregate amount of al
investments of the Undersigned that are ilkpad
(fading commitment for and such iwestrnents end
taking into account his, her a is investment in the
Fund) is reasorabie in relation to the Underegrects
net worth
(0) the Undersigned has been provided all
oppertunity to oboe any addelonal information
concerting tie offering of the Interest the And and
all other ricernaticn. in each case to the scent the
fund and LESFA, a the Maniere Agent, possesses
each sienna-ten or can acquit it without
unrearable effort or ma
and has been given
the opportunity to ask stations of, and MISR
asters from. UEISFA anceming the terms al
orations of the offering and other nutters
peruirang to this Irwesanent In making It. Mr or i's
decision to purchase the Merest, the Undesired has
teed sole& upon his, her or its sun ndeperdert
nvestesmors. The Underoared is not myth; or the
Fund, MIA a the Riternell Agent, or any other
person or entity with respect to the legal, tax and
other euncinic coreideratore ineted In his, her or
is ireastmero in the Fund.
(E) The Undersigned understands at acknowledges
that the Underegned must bear the !concert risk of
he, her or es inveSttnent n the Fund 10' so long al
he, she or it is iwened n the Fund. The Undersigned
is aware of the limited wovisiors for tartderablity
The Undersigned has ro current reed for liquicity ih
hid, he or as nvesurent in the Fund, can afford a
complete be of his, her or its invearent in the Fund
and can afford to hold his, her a its Interest for an
indefinite period of time.
(Filly Undersigned acknowledges that:
(A) The Unttnigred will rot sell or otherwise ranee
the interest without registrarn under the Securities
(il The gefering and sale of the interest has rot been
At, or an venation therefrom The Undersigned is
and wi not be registered under the
Act.
acquirer; the meats purchased by the Undersigned
and s being made In reface upon U.S. federal and
mt2t
rar,817
imxvvaLstate
esenctions for trareereara net invieg a
publIcof tering aid the undersigned is an 'aCtedrad
(melte" tat defined in Repletion 0);
the Fuca will not be registered a an inwstnnent
company under the Investrnera Company Act, and
the Undersigned is a 'qualified puritheser (as defined
trader Section ia)(SI) of the Investment Company
Act).
The Undersigned represents that, unto
otherwise cared d U3SFA. he, she
was not
formed for the purpose of Mating In the Fund and
vie not Invest more than 40% of S. her
tote
assets rl the Fund. if the Investor was famed for the
purpose of investing in the Fund, or more than 40%
of its assets MI be invested n the Fund, the
Undersigned represent fut each Waled Oster Of
the investor be "qualified pacheser";
tra Neither the U.S. Securities and Eichange
Commission, the CFTC, nor the seosities commission
of other *grey of any state a Other jureakton has
renewed, approved or passed upon the merits of this
offering, the rarest or the Memorandum
the The Member DISgrole, in the case of a nnenter•
managed fund, or Ultra, In the case of a nail-
merntereanaged fund, with respect to the Fund, is
registered as a 'arrerodity pool operate,' with the
CFTC. The Fund is mama from regestratica patent
to the vernpion under either CRC and 4.1Xay,3),
the de minima esswrption, or Rule 4.7, the lite tour
oarnpeon, for prineteryaffered commodity pools
whose partepants are thread b remain high),
sophisdcated investors and non-ti S. persons
The
Minter Designee a UBSFA a a0Prorate, is
required to report amain Information with the CRC
on CPOPOR throaty. The Fund may operate es an
eeempt corrnicry pool pursuant to the CFTC
Campton% set forth above with respect to
commodity pools offered and sad solely to (a) naval
persons vita re "quailed Mb* persons' under
CRC Rde 4. (ax2), incbing, among others.
'quailed purchems,' and (b) nen-taut persons
wan are *taw 'Quilled eight persons" under
CRC Rile 4.7, inch:dreg "tweed purchasers,' or
"accredited bates?
(v) The Undasia al is eater a natural person who is a
"gaikd eligible person' undo OTC Rule 4.7(42),
inducing, arrong others, 'quaffed purchasers; a a
nail-natural penal veto is tither (1) a 'qualified
eligible person' under CFTC Rule 4.7, inducag
"orefled perchaers." or an 'accreted breve,"
or (2) not retired to be a member of the National
hares Assaiaton or be registered with the CRC
underact/inCFTC no-action lean, and
hi (a) Certain of the Fund's drect or indirect
imestmens may be PFICs and/ce CFCs for V.S. Waal
income Ire putproat CO) n correction with such
InwrsbnentS. various 'areidefemar provisions of the
Code could potentially cause the Undersigned to
recounts taxable income prior to the Rat or the
Undenigrech receipt of distributable proceeds, pay
an imam: charge at recasts that an deemed as
haring been deferred, at
recognize ordinary
Income that. but fa the 'ant-dime' provisoes.
would have been treated as capital gait and (c)
special U.S federal erectile tar reputing requirements
and other ruses may app
to drect and Indeed
investments on FeKs and CFCs. The Undersigned
represents and warrants that he, the or it is farrier
with and accept all gobble U.S. tax arrierences to
Itself, and, If the attestor halm-exempt trust, to such
Investas benefciaries, of a deed
a
thdien
investment in a CFC or PFIC under the provisions of
the Code lincutling any vonse taxes the may ape/ d
the Investor s a private foundation and spade rules
that may be aPpicable to beneficiaries of chaitable
remainder trusts), and la the or it Is not relying on
the Fwd. USSFA. the Placement Agent, a any of
their neepecthe alt hates. emptoyers or Dithers, for
U.S. tar advice of any kind whatsoever in this a. any
other regard. The Undersigned acknowledges tint an
invesvret in the Fund may he* the effect of
roguing the Undersigned to file income or other tax
returns
in
jurisdchons
(including
non-U.S.
}radicles) In which the Find a an Ineestrant Fund
Private and Confidential
15
CONFIDENTIAL
SDNV_GM_00020474
EFTA_00131094
EFTA01273301
rit
Subscription Agreement (continued)
covers property or Conducts a as downed to conduct
business,
The Fund's R.15 most key we not be
nada* pncr b Apes 15 and. accorongey. Me
Undersigned will grey need to obtain extensions for
the fing of Mt. her a its own tax num. If the
Undersigned is an IRA, a qualified retirement plan or
other tesexempt entity, it acknowledges and
understands that the Fund and an tenement Fund
are permitted to make initharnems that wi generate
UM To the extent that any such iniesonans
generate USA such USTI would now through to the
Undesired and the Undesired may be receined to
make payments. educing estimated payment, and
file an ixome tax Man for any babe year in which
it has at. To he at Income tax return. It may te
necessary for an lin. a gunned mimment plan or
other taxenmpt entity to dean an employer
identifr.ation runnier. Since the Fund ad any
investment Find are not moulted to avoid venire
UB71, taxtharrpt 'nvestors may recognize a sign( ices
award of UEM as a resift of an nvestmeM mthe
Fund to, accordngy, re strongly urged 53 consult
the own tax adman regarding the adrisabity of an
investment n the fund. The Undersigned ha had the
opartunity to seek independerr. tax adrce in
connedicin wilt making des eweiensent. Nether the
Fund. tit Fiercernent Agent nor any of that *Hanes
amides tax adva r
ccnnedicn with this
imminent The Uncleared advantages that the
tax and regulatory sunrneries raided in the
fintsecondum are of an indicate nature *Sy,* not
constitute tax a regatacey aches and may a may
not be relevant to the Undersigned's personal
circumstances
(0) The Undersigned ha such knowledge and
experierce in financial and business matters that the
Undersigned is capable of evaketing the menu aid
riNa of the Undersigned's invesement in the Fund and
is able to bear such it, and has obtained, In the
Undersicarces judgment sufficient nfoneration from
the kr/dabs auderized representatives to evaluate
the merit and it
of such Investment The
Underbred has evaluated the rob of inswing in
the Fund, understands then art substantial risks of
loss incidental to the purthase ce an mutest aid tea
determined that the Maw is a suitable ointment
for the Undersigned.
(t the Undeterred is acquiing the Interest to
heeerits men accan, for Investment pagan only
and not with a yew toward dstritutirg a rat*
the Intefat in whole a in part.
(I) The Uraregned understands that incentre
Albcattns may aeat n lannive for the mummer
of an twestment Fund, and UBSFA only if eatable
a
cadosed
in the
Memorandum, to make
Imes-teem that we dike or more specurthe than
would be the ease n the an*
of an 'octave
Allocation.
CO t ttis kwestment is covered by an agreement
under a UBS advisory program between u8S a-4 the
Undersisned, the Undersigned acknowledges that If
the Undersigned chooses to ma such UBS advisory
program, the Undersigned may be Carped higew
fees that are applicable to Mesas that are not
subject to an athS• ry contract may be required to
redeem out of the advisory share class or may be
required to watch into a nonadesory share clan.
Such actin may result In tax ccrisequaxes and
other penalties, aid the Undersigned SAVA consult
hie tax DOM« en sit
and axe mews before
making an nvestrnent in the hod.
(10 We Undenigned Understands that by rmessing in
the Fund. the hvestcr will bear his. her or its
propcetonate that of expenses aid fees a an
invest., in tie Fund and, Intently, similar lees.
expenses and the incentive Allecation 0
any
rivestrrem fund. ally where appficable.
0.) Except a cetcbsed in the Horror *akar
fan, the Undersigned Is not a 'Benefit Flan
?mentor' (a such tern is defined in the Man Assets
N11:25781(101;irnVEL
Pans" in alined in section 343; of MCA) that are
seed to the ncludary mainstay provisions d
ERISA, C4 'gars" as defined in Section 4975(eX1) of
the Code) that are suttees to Section <975 d the
Code (racketing an M a Keogh Pler), and (Ii)
entities that would be deemed (under Sc Man Asses
Rules) to be hair* the assets of such an "erreloyee
benefit plan" a 'plan' for purposes of ERISA a
Section 4975 of the Code). If the Undersigned has
represented is the tweeter Apace:ion Form that it is
not and val not be a Benefit flan errestor, and
thereafter the Undersigned becomes a Beret It Plan
tweeter, than, without IiSirq the remedies agent
the um:roped la ib bread'. the Undesigned shal
inrredate/y ratify the Fund n *ding as to what
per Mager Of it Insets constitute 'plan nab-
under the Fein Assets Rules
Mensaher, the
Undesired snail irentedaley notify the Fund in
snag upon any change in the perunethe of Its
assets that constitute 'pbn met' under the Plan
Asset Wes.
lid) a the Undesired is a Benefit Piro Manor, then
the Undersigned (and the fidutary (*outing this
Sunedain
Agreement
on
beta
of
the
Undersigned) reetesera and wrens to the Fund
that
has been informed of and inlerstands the
tenement obectires and paten at and the
investment strategies that may be pursued by, the
fund,
0) 5 5 aware d
the risks aSS5Ciated with an
investment in the Fund ad the fact that the
Underbred vAl be unable to redeem its amens
and that the Fad may urnpasonly redeem Mee*
at oaten tines and wider Obtain orator's a set
forth in the Memorandum;
(le e artplabe, k Is aware of the prowiera
Section 404 d ERISA relating to fduciary duties.
antiwar* the
requirement for overefirg the
nveunientS of a Benefit Plan Hester;
Mit ha glen earn:orbit Ordiderad011 to the fact
and drournearces relevant to an Investment In the
Fund and has detente-red that such invesernern b
reascnably designed, WPM Of the Undersireces
portfolio of inestmeas, to further the pleases of
the Undersigned
OS It acquisition of the Interests Is science-exempt
'Prohibited transacting within the meaning of
Section 406 of ERMA a Section 4975 of the Cod,
Prehthed wider any other snide law to which the
undersigned may be subject;
00 es investment In the Rind is perreabe under any
and al doorrents, taus. ruin, medlar* endi or
spices govening the irrestmers of it assets and
soder EFUSA:
(iii) it a independent of the Fwd. UBSFA, the
;Lament Agent. and any of their aft hates;
hal) it b net relying ard has not reed cn the Fund.
ISSEA. the Placement Agent. any affiliate of any
the forego.* fee any evaluate+ a ether knee:nem
Kiva n respect of the advisability of an irnestment
n the Fund in fight of the Undersigned's asset, cash
needs, reestment antes or strategy, Gera
porno* cerneasititri a plan for riven/ adon
'sate and
fix) i UB5 lariat Trust CCIffPanY is the =Pre
trustee of the Undersigned. the fiduciary has directed
U85 Fiduciary Trust Company to ezedee this
Subsaiabn Agrternent and that el of
the
representations and covenants rack hereunder by
to Undesired apply scab to de fiduCary and the
Undesired and not to UBS Fiduday Trim
Company.
the Undersigned is an 2emp:opte benefit plan*
(as defined in Section 3(3) of EaiSA) that is not subject
to the fiduciary resporabilly rations oil ERISA, a a
'plan' las dined n Section 4975(e)(1) of the Code)
tat d rot subject to Section 4975 of the Cale, then
the Undesired (and the fiduciary executing this
Stbscriptian
Agreement
on
behalf
of
the
Urcleagred) reprint, and warrants to the Fund
that:
(I) it has been info red of and understands the
investment rthatlia and pollees of, and die
investment sbetegieS that may be pursed by, the
Fut:
(IJ it Is aware of the risks anociated with an
imestment in tie Fund and the fact that the
Undersigned will be unable to redeem as merest
and that the hind rnay marches* Interest at certain
times and under avian conditions as sat forth in the
Memorandum
fid it ha given appropriate corsideration to the facts
and orturnstnoes relevant to an IlVeSbrent in the
Fund and ha determined that such twee:nem is
reasonably designed, a part of to Undersigned's
ardor* of inveshnents. to rune the purpose of
the Undesired:
(id its aarastion of the in terests will not result in a
prohitited trisection under ay federal, state a local
tree that is wbeantiegy simile/ to Section 406 of
BMA or Section 4975 of the Code for which an
earraion is not notable;
ed its divestment in the Fund is penessibee under any
and at downents, laws, nda, :orations anaor
poldes goreming the investment ol its asset;
(N) it Is Independent of the Fund, LSSFA, the
Placement Agent. and are d their athletes
Wig it a rot eetying and has not retied on the Fund.
UBSFA. the Placement Agent or army affiliate of any of
the foregoing for any evaluation a other divestment
sake in respect of the athisabdity of an investment
in tie Fund in fight of the Undenred's asset, ash
needs, intleraYert pokier or strategy, overall
patio* composition a plan for deenrecation of
abet5 and
(nil) if UBS Fiduciary That Company a the corporate
trustee of the UndeiNgned, the fiduciary ha drecmd
UBS Fetwirry Trust Company to execute this
SUraiptien Agreemere and that at of the
ranseMations and covenants made hereunder by
the Undeagred appy sotey to the Malay and the
Undersigned and not to UBS Fiduciary True
Company.
(0)The Undersigned understand that
(i) If the Find is noway formed, it has a erred
financial and operating history;
(ii) No fare or sera agency has passed upon the
Interests a made any findings a determination as to
the farmers a this investment
(iii) The representatons, warrantes. agreement,
urattakings and acknowledgment ma* by the
Uncleared no this Subscription Agreement will be
relied tail by the Fund, UBSFA and the Placement
Agent in Mouthing the Undenarects suitatifity as
a thrower of an Interest and the Fund's compliance
with federal and state seethes laws, and shati swam
the Undersigned's admission as an InleVO1;
(iv) A Pbcement Fee of 2% of die Capital
Cat daub* wi be charged if the Undesired
Invest through a brcterage moue, subject to
Walser
by
the
flacement
Agent
r
reread
circumstances, and that the Placement Fee a in
addition to, and vat not reduce, the Undersigned's
capita Cant:bud:4
(v) The Placemen Agent's financial ashisces naive
compassion from the Placement Agent, Inducing
compemaan based sun assets wider management
areVor the Fund's investment perkernarce, and a
paten of the Plaretrent fee, it ardable;
te) If the Furd is a master-feeder SUUCtuft then the
information contained is the Memorandum acne
to tie investment Fund and its sponsor was obtained
bytheFund hem oenain materials finished by the
Private and Confidential
16
CONFIDENTIAL
SDNY_GM_00020475
EFTA_00131095
EFTA01273302
Subscription Agreement (continued)
investment rand and its sponsor. None of Pie
Placement Agent. UBSFA or the Fund participated in
the preparation tnereof, and none of them mar any
representations regaraw, and each of them exprealy
&satins ery ,lablity a marabila to any neF101
in the Fed for, such infomeon or any other
information relating to the anestment Fund sec forth
in the Memorandum. The Undersigned is not Deng
offered an inter, in an irmstrnent Fund, will not be
an investor in an Invesvrent Fund, ell haw no direct
interest in an lineament fund. el have no voting
rites in an Investment Fund and will have no
standing or wane warst an investment Fund. Pats
alines or general partner, investment wises,
officers, dream employee. partners a members.
NO IfOO510 * -4 rat
a
sue, Irwestrnent Funds
sponsor, is nasPorsibe for the formation or operation
of the Fund;
(v4 the Fred, UBSFA and the Paternent Agent ham
no no& to palmate n the contra management a
operations of ary investment Fuld and have no
disaelion over the iwesenents made by ary
Imestment Fund; and
(viii Fa SO brag as he. she or it a Messed in the
Fund, and tress otherwise waved by UBSFA, the
Undetected must maintain a brokerage moan veth
an effete of Ulan designeeed by USW.
(p) The Undersigned hes all require poorer. authority
and caterity to acquit and hold the merest end to
execute, claw and compy with the terms of each of
the Instruments required to be executed and dithered
by the Unclean/0 in connection ea the
Undersigned's subsaiption for the :merest inducing
this Sutanipan Aereement. and such execution,
deanery and compliance does not walla with, or
constitute a default adee, arty instruments goveming
the Undersigned, arty law, regulation a order. a arty
agreerrero to which the undersigned is a party or by
Midi the Undersigned may be bound. E the
Jndersiged s an entity, the person executirg and
dehering each of suds femme= on behalf of the
Uneersithied has all requisite power, authority and
capacity to emcee and definer such imamens arid,
opal request by the Red or UBSFA, vii turrish to
the Fund a true aid correct copy d arty formation
documents of the undersigwo, inckding all
alattarten3 thereto.
(Q) All nkrmarien that die Undersigned ha proved
to the Fend UBSFA ce the Statement Agent
conceiving the Undersigned, the Underage:Ps
status. financial position, ktontedge and experience
of fanancia tax rod busies melte, a, h the case
of an Undersigned that a an entity, the Ithardedge
and experience of financial, tax and tudiness matters
of lit person melting the niestment declaim on
behalf of such why, is cotton and template a of
the date set forth heron.
(R) To *awe commence with mthdreerients
imposed by the U.S. Treasury Department in
Cbadar 230, the Undersigned is hereby Informed
that and acknowledges that:
(I) any tax advice contained herein in the
investor
Application
Fonn
or
in
the
Ifieetorandum Is not intended a written to be
used, and cannot be used. fee the purpose of
avoiding penalties raider the Code;
00 the advice Is written to support the
pecenotion or marketing of the transactions a
matters addressed In the memorandum: and
Oil) each investor and potential Investo. in the
Fund should 54140g advice based on his, her or its
particular circumstances from an independent
tax advisor.
(S} The Undersigned undentarab that the to
orequerees of an &vestment in tie Fund depend
ron-U.S tai lass will not be wended a applied in
such a manner as to deprive On undenigned or tare
wafer the tee benefits which he, she a it fright
otherwse expect to receive from ha, her er its
remanent in the Fund.
(T) Notwithstanding any other strewn in this
substrata Agreement. he Fund Parties *Aherne
the Undersigned and the Undersigned's ornpayle.
representable's or oche agents, from and Mw the
carinencerent of arty OSOthiens with any such
any. to ado:. to ary end al persons without
Imitation of any 'rind the tax treatment and tax
structure of the fund and any lunation entered into
by the dud and as metenals c4 any kind (including
tenors or other tax analyser) relating to nett tax
teatmex a tax stnxture that are proaded to the
Undersigned. molar as such treatment nib(
fl
an nines to a US. federal a state income or
franchise to strategy provided to the Undersigned by
tne Fund Fates, except foe any
10-4,114621
klertnying the Fund Parties, any other nests, a
(except to the extent relevant to such tax strata a
tax anneal any norovdic commercial or financial
Morrnation.
M The Underared agrees that, at its discretion. the
Fund a UBSFA may (directly a through a service
provided provide to the an:tanned to the
Undersigned's des: reed agents) staternentS. Mat
and one: conmunkations relate to the Fund
andror Vie Undersigned's investment in the Find in
elecooric am such as anal antra peewee
protected account sieving on the Furors web ate. in
leu of a In edition to sending such otennuncators
as had ape We teatime& Please note that e-tha.
messages re not wan and may contain compner
alas or other defects, may not be Kant*
replicated cn other systems, a may be in cepted.
deleted a Medved with Snout the knowledge of
the sender or the intended reagent the kind aro
UBSFA mate no warranties in relation to these
matters.
Please rote that the Fund and Weak/
resent the right to intercept, Maitre and retain e-
mail messages to and from their systems a aerated
by applicable law. 1 the Undersigned has any debts
tout tie authmteity of an ernal paportedly sera
by the turd or UBSFA (Mealy a though a service
provided the taloa, ed is required to co tact the
Purported weer airrelinely.
(V) the urdersigred s rot now and will not be
(0 clashed es a panne* a an entity dingeded
from its beneficial owner for federal nceme to
purposes, 00 a 'grantor trust; ary portion el each
a treated as owed by the granted') a other
Wang., urdet Sectims 671479 of the Code. a
(1) an 'S coma-Aka' within the meanie of Section
!3611a) of the Co* a, it the Undersgned is such an
•
then
nave of it. Undersigned's (direct a
watt) borefanal owners will here on the date of
the
Undersigned's
ediriseion
a
thereafter
sutstantialy all of the sae of near area a inorrea
interest in the Undersigned abributatie to the
undersigvarts berm in the Fund and (b) siefaction
a the 1001terther irritation described en Treasure
regations g1.7704-101)(1)00 s not a Adrenal
prate of the use of tris treed arungerrem
(W) Except as otherwise permitted by UBSFA In
ventng, the Undertone agrees to keep confidential
and not reproduce, disclose or distant, any
irfarnaton rebtng to the Fund, n WV* Or in part
Ina:ling 'Whoat trnitaticn itiormabon diseased to
leveler by s financia Attar a (0) use ay such
information for .3 own purposes a is am account
except in connection wth tf investment in the Fund
and except/settee/des required by any ngiAat
authority. law a regulation, or by age protest
fabsithstanding the foregoing or anything else in the
Subscription Agreement to the contrary, the Investor
(and each employee, reoresentatra or other agent of
the Investor may dadose to sty end all persons.
without araution of any kind, the federal income tax
Undersigned The Undersigned further uniersords
onomin and lox ware of co cis Nod and 00 eves
that there ow be no asstrarce that the Ccde or the
or its noucti,„„
ro
rutoi a dmy kin d
Nittztpteli
t
mAxwej
e kcluding Opini:C6 or Other tax inane%) that are
provided to the anew relating to such tax treatment
and tee Wucture.
W. WDEMNIRCATION: POWER Of ATTORNEY;
GENERAL
(A) The Undersigned agrees to namely and hold
hanks: the Fund, tEigrA, eath aficer of the Fund
the Paternal Agent, and each of their affiliates.
employees and officers and each other Person, if any.
who controls. is controlled by, a a under corrnson
control with, any of the foregoing, within the
meaning of Section 15 of the Securities Act, against
any and all loss, Sablity. cam. damage and expense
whatsoever (including ar
expanses reasoneby
incurred in investigating, Monne or defending
against ary dam whatsoever) arising an of a based
upon (0 any Wee representation a waramy made by
the Undesired, a
breach or fan by the
Urdersigned to amply with any covenant a
agree:at made by the Undersigned, it this
Stentartal Agreemmt or in any other dthunent
furnished by the Undersigned to any of the foregang
in connection with this transaction or the inataracy
of any informatics) provided by the meta, whether
in this knesta Apples/Ian lam a Gehenna. a (N
any actor fa securities Lew violaters instituted by
the Undersigned wild, finally resolved by lodgment
not to have resulted from the 91055 negigence or
wilful misconduct of any of the foregoing persons
ON The Unciesigned hereby appoints UBSFA as his,
her or in true and lawful represmtadve awl attorney,
in-fact, in his, her a its rat,
place and stead to
make. execute, sign, acknowledge, weer to and he:
(I) Any certificate, business erten% 'ethos name
certificate. a
arrendnent
thereto, a
other
insburrem or document of any kind neccoary at
desirable to accomplish the business. Pence and
niacin of tie fund, cr required by any applicable
federal, state, local o' foreign law
(II) the rued Agreement on behalf of the Undersigned
and any anendment dug approved a traded
therein, and
(ill) Any and all instruments, certificates and other
document which may be deemed necessary a
degrade to effect the winding-up and termilledal of
the Ana This power of aborrey is irrevocable. Is
coupled with an nutrest sufficient in law to appal
an item:able power of attorney and is darned to be
10 secure a proprietary Merest of the donee of
the power or performance of an Obligation owed to
the donee, and sN1 sures and shall not be affected
by the stbsequern death, disability, incanpetexy,
termination, bankruptcy. iraolvency or dessoluan ai
the Undersigned; prodded, however, that this power
Of attorney veil *ranee tpon the subethrecn of
another Mecca for ala of VW brharAtTen
Wobbliest In the Fund or upon the withdrawal of the
Undetsigned.
The Undersigned hereby wavers any and at defenses
eV& may be awiabe to contest, regale **disaffirm
the actions of UBSFA taken 'n good fat under such
Meer of attorney.
(C) If any proem of the Subscription Ageement Is
Maid a unenforceable under any eptuneve
then such Provision that be deemed inoperative to
the extent that it may conflict therewith and shall be
deemed modeed to conform to such applicable law.
Any provision hereof which may be held invalid or
unenforceable under ary appkab'e law shell not
elect the earthy a enforceability of ay other
provisions hereof, and to this extent, the PrabOto
hereof shall be seeable
(D) The Undersigned has reviewed the registration
nicarements of the Commodity Exchange Act. the
CFTC and the Natonal Futures ASSOCiatial appicabk
to conenotty pool operators and ciornmodty tudng
'damn and has determined that the Undersigned a
n compliance with nth requiernents in respect of its
purchase of the Interest hereunder and all other
relevant activias.
CONFIDENTIAL
Private and Confidential
17
SDNY_GM_00020476
EFTA_00131096
EFTA01273303
-.3
Subscription Agreement (continued)
NOMINEE
if the Indented is acting as trustee, agent.
representative a nominee for, a will en* Into a
Swap with a Third Part. the Undersigned wit reify
the Fund mat he. she or Nis acting in such calnotY
and the Indented undestands and acknonedges
that the fermentations, warra reties and agreement
made herein are made by the Undersigned (A) with
respect to the Undersigenf and al) with respect to the
Tied Party. The Uncierkned tether represent and
warren that (i) he, sheet he all requisite power
and authority from said Mid Patty to atom and
perform the oargelion under this Subscripts,
Agreement and fa) with respect to a Third Party
veering into a Swap: (a) the Iled Party is authorized
under its constituent documents and applicable law to
emir into the Swap and motel also be so authorized
to invest drectly In the Fund, (b) the Third Party has
received and renewed a copy of the Memoranda))
and the Fund Agreement; (c) the Third Pity
acknoMmiges that the Fund and its aftliaws are not
responsible kr the legaity. suharlt a
lax
come pences of the Swap ad that the Undersigned
is not an agent of the Fund; and (d) the Third Party is
an .eklba oanuaol CurtiGnant• under the CFTC
tees, an •accrecited investor' under Require:on D
and a 'qualified purchaser' as defined under Steen
Nat5t) of the mwstment Conley Act The
Urdersigred agrees to rulemnify the Fund, UBSSA.
the Placerrent Agent, and each of their alnates, and
their officers and astern for any and all owes,
lataitiet damn damages, cost, fees and am/rem
Inclucfng legal lees and disbursement) arising in
connection with. resting to a Notre from the
Urdenignedn eery Into the Swap frcludew such
losses, estates, dams, damages, costs, fees and
expenses arising an
with,relating to a
resultna from the Undenigners or the Thad Pants
misapasentation or mestaterrat comened here..
a the UnzierSigredn lack of primer atrncreation
from the Third Part to enter alto this SubSCPp1011
Agreenwnt or perform the obligators herthander.
Wain; herein constitutes
an Keener* or
statement by the Fund or Placement Agent to et
irrester's envy ins the Swap, as to the legality of a
Sap ate witablay of a swap for the Undersigned
a the Thad Pry
REPRESENTATIONS
The hind may request from the Urterscried stich
etkitionel information as it may deem necessary to
manse tto efigibity of the Undersi;red to et re
an merest and may mutt from time to are snack
Infemation as It may dean Mastery to determine
;heeled:leyof the Undersigned to bad an Interest of
to enable 1.18SFA to detente the Fund's compliance
with septa* regulatory requirements or is tax
status, and the Ur desist E agrees to provide sixh
inktematien as my reamnably be requested
The Underegred agrees to noNy the Fund prat*
should there be any change in any of the foregone
information.
Vt. GOVERNING LAW AND DISPUTE RESOLUTION
This Investor Application shall be governed by.
and construed In accordance with, the laws of
the State of New York. The Parties hereby agree
that the Parties shell submit all controversies
arising among them in connection with the Fond
or its businesses or concerning any transaction,
dispute a
the constructkm performance or
broach of this or any other agreement. whether
entered into prior to, on or subsequent to the
date hereof to arbitration In accordance with the
provisions set forth below and understand that
arbitration is final and binding on the Parties.
Except with respect to seeldng injunctive relief.
the Parties are waiving their rights to seek
remedies In (own including the right to ley
Vitstsing
limited
than
and
different
from
court
proceedings. The arbitrators award Is not
required to include factual findings or Impel
reasoning. and a Partys right to appellee to
seek modification of rulings by arbitrators is
strictly limited. A panel of arbitrators wit
typically Include a minority of arbitrators who
were or are affiliated with the securities
industry. Coot:pretties shall be determined by
arbitration before,
and
only
before, an
arbitration panel convened by the NYSE and
FINRA. The Parties may also select any other
national senates exchange's arbitration forum
upon which UtSFA Is legally required to
arbitrate the controversy. Such arbitration shall
be governed by the rules of the organization
convening the penal. Judgment on any award of
any such arbitration may be entered in the
Supreme Court of the State of New York or in
any other court having jurisdiction of the Peaty
or Parties against whom such sward is rendered.
Each Party agrees that the deterrninadon of the
arbitrators shall be binding and conclusive upon
them. No Party shall bring a putative or certified
dass action to arbitration. nor seek to enforce
any Pre-dispute arbitration agreement epeinst
any Party who has initiated in court a putative
dass action; or who Is a member of a putative
dass who has not opted out of the class with
respect to any claims eacoapassed by the
putative class action sinless and until: (A) the
dass certification Is detect or (B) the dais is
decertified; or (C) the Party is excluded from the
dais by the court. The forbearance to enforce an
agreement to arbitrate shall not constitute a
waiver of any ngMs under this Subscripdoe
Agreement except to the extant stated herein
Al 'Memnon in re Substripan Agar's'sN be
mated conedentiray by the fond, UBSSA end Ow
Placement Agent. Itwever. the Fund. MGM a the
Henn Agent may present this Sutra/don
Pereerrent and the ireorrnaten prattled herein to
such panes as deemed addable if Cancelled upon to
estabiish that the offer and sale of the Interest is
Derma from registration tinder applicable Ian or (fa
the information is remeed to be disclosed by the
Fund by law a resulaten or is rethare to an au* in
wry anon. WA a proceeding to wadi de Fund,
U3SFA„ the Pitament Agent or thee Willem is a
party a by welch they are a may be bound. In
addition. the Fund may share information detained
atom wth its attires for busmen purposes, such as
et facilitate the sereciw of meccas The fund may
share the reformation described abort for business
purpose will a non-affiliated Rini Para if the entity
b under contact to perform transathon processing,
sinking or manuring IrrieStOr secants on beef
ci the Fund Thls Stbeniption Agreement may be
aecuted three* the use of separate striature pages
a in any ruder of counterparts each correarpan
than fa al purposes. content ow 'tenement
binding on all the Partin notvettrancfng that al
Parties do not esecute tne sane counterpart.
Memoranda was denied by WS% kom the Private
Pacemere Memorandum of an bireSInfent Fund and
provided for inlormatcni purposes oat Neither
U8SFA rot' it affiliates parkinned in the preparation
a
the Private Pacement Mernorandirn of the
rivesenent fund ra haw they Independently verified
the
contents
thereof.
and
they
make
no
represertations a women (eapres or menet
reaming, a
otherwise hive a
accept any
mpenshaity fa. the accuracy or eandeteness of the
contents of the Private necernem Memorandum of
the kwestrrent Fund rix for any other sUtemere
node a purperted to be made by the imamate
Fund or on it bend,.
tante and rts affiliates
accoreirgly Xdaim all or any lathy whether arsine
at tog cr contract that they right otherwise hare in
respect of the Private Pager ternoranta of the
&mam 3 Investment fund a any such reflect. and bear no
1— —
l
irittrAltiVtLiiesperslitity
to update ary curl sqcnnadors
Furthermore, the Investment Fund may amend its
Private Platen Memorandum. however, subject to
tromplence by the Rod with apoicalle law neither
the Fund nor USSFA shall hare any otfigetion to
update the Memorandum.
M Investment Find and its States do rot endorse
and mete no mornmendatios of the Fund and
make no representation regarding, and expand/
dsdarn any Wont or resonant:fit to any redeem
of the Marmeandum or try informal= set forth
herein No twestment Fund it reparable for de
fcrmieen a
operation
the Find. The past
Pen:mar= of an Irrnestrrent Fund or the Fund isnot
Makatea of Saturn results
the eviestment Fund or
of to Fund and there can be no guarantee den !NW
any twesanent Ft rd or the Fund will achieve
comparable result. Thee an be no assurance that
an Imestmert Fund or the Fund wi be able to
implemere it investment strategy o' achew its
awestmers chicanes
*NEW ISSUES'. EXEMPTIONS (Not applicable to
Individual retirement accounts, inarklual or
joint account, UGMA a UTMA accounts that are
treated es natural persons for this purpose)
1.
ta) The Benefical ntesest of rev:iced persons
des rat exited an the aggregate 10% of the
UndenIgned a If the Benencial retest of at
molded pastors n the Undersigned exceeds in the
aggregate 10%
the
sler)igrgcl but the
Wars:gad has instemented anatelueS to reduce
the lionencel Interest of ail resulted petals with
respect to new issues in he magnate below 10%.
CO) The Beneficial Interest of 5131 Covered
Persons does not exceed
the aggregate 25%d the
Undersigned a
Beneficial Interest of ei 5131
Covered Persons
the Undesired eiceeeds
the
25% c/ the Undersgned but the
Undersigned has ineremented procedures to reduce
Ue fiewittal rarest of ail 5131 Covent Permed
with respect to new issues in fm aggregate below
25%.
2. An rent
carporry registered under the
Investram CertanY
3. A common trust turd that has intestment from
ICOO a more amount and does not aril Interest n
the fund printrally to dust accents of restricted
Perin
4.
An Murata company general. separate or
Mestmere accent podded that (a) the WOOS.' Is
funded by preniurns Ina 1000 or more pokyholders
or, Magenta, account the insane company has
1000 or more poky holders and (b) the Methane
conpany does not lint the Foie/totem stag
premiums are used to fund the account print:rain to
reeked persons. or if a general account the
insurance convoy does not knit its perky:elders
principally to estreted press.
S. A Mont waded entity (other then a brokendeder
or an affiliate of a token-dealt, where such broke--
dealer is wthorized to engage n the pubic often.;
of new issue either nesting gain mater a
urderwrker) that is listed on a national securities
adage. as traded on the NASDAQ National Market,
▪ it a foreign Muer vitae sonalies meet de
quaint:atm amennation criteria for lifting on a
national securities exchange or the NASDAQ (alone
Market
6. An investmmt company organized under the twos
• a foreign Madder provided that the iwestmem
company slated on a foreign eaChange a auterieed
for sale to the public by a foreign regulatory authority
and that no person owning S percent or recce of the
Investment a:litany is a restricted person.
Art ERISA benefit plan that
Oaf it., under
Section 401(a)
the Code, prodded that such plan if
not
'eery by a broker dealer.
8. A state a ntnclpal government benefit plan that
a subject to mate art municipal reguaticn.
9. A tarn
dentate organisation under
Section S0l(cX3) of the Code.
IQ A Chtrch plan Leder Section 414(e) of the Code.
CONFIDENTIAL
Ethane and Confidential
18
SONY _GM_000204 77
EF1'A_00B1097
EFTA01273304
Schedule 2
Defined Terms Used Herein
WO) er ac)(7) company
Agreement,
Beneficial Interest
An wiry teat a emceed ban the deflation d
'irriestmeol company' sonde the twestrant Company
Act panuant to Saban
Ter X4(7) Unroof
I h6 tourer Application lam. included the
Sasso-mien Agreement and the fonts Amended and
Restated Limited Whitey Company Apemen
Any economk interest, math as the Ogee to share gains
and Sasses This does nld rathele re receipt o' a
management a pidonnarce lee fa operating a
Coronado Investrnmt Mort a other fan fa acing
in a ficaackey capacity.
Cu and CAT Statement
Cant Account Information
Captrel Contribution
cPC
arc
closing
Cod*
Collative leviestmant
Account
Control Securities
Covered Croke, °catty
Covered bonrubfic
Company
FlitSA
A cao tal antribubon in the Find Turas/cc
amain;
A rineolcd foreign cceporai n. as deft ed in Sector
957 of the Cat
The commode, fauns Sarno Canned:on
Each date ups vA•ch LIBSEA accept; Few or fronted
Capital CattribUlialf
The Inertial Reitriut Code of 1996. as mead
My hedge fund. irwestrin partransho, marten
corpontion or any of ere octane fl eas:ant whale
that is engaged Cana* in the puirhice andte sale of
secudbes A coliearre imminent accuse dos rM
include a family Infest:yea velecn(i.t, a legal entity
that is beneficiety awed 100 byname:fete Iambi
members) or an BrieStMent alb fie, a gray of
trends. reapboaa business associates, a others that
pool gob wormy to knelt n stock or other
Ia
and ant coiedively respectable for mating nvistrant
declared.
Sepias% of 104IBIS conlIOOd by the tenancy
A Prober a dealer. other than a Lemke Banes,
BrekeriDealw
My Tamped (aft than a Pubic Comparputhidng
any of the following the ataxia: Of Coro d E'en
SI maim in the la; ftscal armor in bra <lithe Int
throe fecal yens and Parehoklers' may of al least
SIS radon; of CI) thanholiferF 0014 of alma S30
milicth &Ida Two Year Oparating May a(3)tout
Slats and total revenue of at least S75 mien n the
taint decal yard n woof the bat thwe deal wars
The Employee Retirement Waste Security Aid 1974,
as amended, and the nen and reculaniam theeturdes
ML281817-MAXVVELL
Fisendal Mame
PIMA
Paid Agreement
fund Partits
Government Entity
fainter
;mined, ate ramify
Mem bet
Ince/inv. Allocation%
Inns rest
Investment Adviser; Act
Investment Company Mt
Investment Banking
Services
investment Fund
Mania
Wanda' advent to the Urdenigned
Tha Fnarcial tasty Regulatory Authorial. Inc
The Falb Amended and Restated Linked Liabity
Company Advertent as the same may be arrested
from dm* to at
1135FA and its etIOSOIS, fl
ees. alien. clteetal,
MI:ken and Porapsit
Mw state or poliatal abdision of a state. irate:Mg
any opener. authoelty.ce nsuumentalty of re state a
Nadal vabalacts a pool of assets sponsored a
estabished by the stale Ce domed Subdivacon a WY
agent', authatty or Instrumentalcy tread, nclutng,
tot not finked to a 'dented benefit plan* a derma
in sawn 41A) a the Coda t16 US C. 4143. or a
gate general Imo, A pm Or program of a garment
tatty, and ofiren. :swum,
wrofeettes of the gate a
..pkal subarea:in a any agency, authority a
Ste ienere.atitr thereof, ring in he cabal capothy
The pane Who enabishn the bust and wattles10
such hut
An ithaidaall parent motter-iretate or Tather-iblaw,
spade, bother a skew. tirother-n-trre a siodelse,
son-Wow a Claughtte4n4kw and dalten rot any
ore tenon to within the kvfncliial provides material
Pact
morram-basecl aapereatkan pad web reset 40 ifse
Field tones tote anent dsdased in re therramckal
a en lineament Fund, as applicable
M Sven in thefund
freest/ wen Adenas Act of 1910, as arneritd
InseSteent Company Act of 1940, as amended
indoSes. without bwhatkw. aceng as an andensaa.
participating in a wing gat inn afemg for the
ewer or cithevene pang n hallways d a pubic
alining of the twee; acting of a Ararat Maw C a
merger, acrisition a other wrpaate nerprizanon.
providng serene arc* Par Ives °, cede- pirate
imeninere, park nasty uartactons (Pict) a sinew
ii,estheres «otherwise
(P
acting in furtherance of a
wan Wing d the wa r. or saving as pacement
agent for the awn
An urragnteted imvsmen 'Ain In which the kid
may invest. Knee n a fund of fords ed meteefeeder
sPicee
An 'eth. c the Fund
CONFIDENTIAL
Private and Confidendal
19
SDNY_GM_00026478
EFTA_00131098
EFTA01273305
Schedule 2 (continued)
Investor Application and
the application for an merest n the Smcl «luck% in
Investor Application form
thi Booklet
IRA
Limited %Sinus Broket.
Dealer
Material Support
mamba. Designee
Memorandum
NYSE
Parties
Payment
MK
Mourne% Agent
Merement Agents
rinennel A<iker
Pliamtnent Pee
Plan Assets Rut«
PeepApell BO Wady
Inekrickce1retirement accoutt
Arg broker's*: wham eullicontion to nag* n
the secedes tuOneys a lark% tody 1a Ite padese
an4 sele CI investment ccespanyAmnata contracts
vase« ant erect participlOon (4044" ~no
Weedy or Indiana p0Vidn3 n'ON than ?S% Oi a
Detail niece-min the pia C./11rd" NV An
deeMod to ~de nwitti s4aPet to an
kniteciateateriy Member len% In the lame
houeelnkt
%SEA a 'Quelled ~omen' or me members&
the Ford acting by • mangey h interim, in each ute
as set tech 9* Fund Agreement
Confident:el ^Meg Warta at"
c4 tit surd. as NI
sne may be upend supplemereed or madded freer
Settler
tnt Infirm
Pnvate rand
Public Company
ne New York Stook Esthete. Inc
The Unatrignrd, %SST& Be likteMett Agent and tro
Fad
Penn it Sp% knes for an Attest
Passim bein investment COmParty, at de(ned n
Sedida 1297dt eCØ
UK Fared Senecos Inc
Regulation D
Securities Act
Securities /zebrine° Act
Snell Bonn e«
Investment Act
Subscription Agreement
Subsaiption Booklet
Swap
third Party
Finarmil 44vicce anplcood by tne Placement ~I
INGFA
A lee diarged by the ikeernert Agent or 2%d the
Gapho. Ctenniarlips il ccertocto n with an investment
In the Fund. SLtseC. to warier by the Patenient Agent
sen
it Finked tins aunt« me Meternese Rio Worn
charged h is add n »WS CapitaiContrbion
Tro pian resets roods*" in Iced, by me Gopertment
of tatce in !hell S. Coded Federal Regi:n in 29
CJ.R. S 2510.3.101, as anmeld. togetht with
3449013W) deter%
A duct *temsfedial owlet' of a Sectica 3030) or
X0(2)Ccerpary that hea held an interest in the
Urderigned on or before Adma 30.19k6
02012 UBS Arundel Services Inc All Rights IteServed. Merrber 51K
11010G-26984201
ubs corn/financieservicesine
UBS Financial Services Inc. is a subsidiary ot UBS AG.
ke2V1[W7-MAXWELL
Undersigned
A furd earnpt hem reMseation pinoan to Sectian
3(40/Or X.0(7) of the Investment Company AR
AT, =tiny that 4 merino under Seaon 12 d te
Secured« Gering* Ad or Ille gene« mean
pumunt to Sock° 15(d) dwreof
Regulation D snake the Securities Act
SecurCtS Act rd 1933. as amended
Seams Ca:dungy Ad of 1934, as amended
Tee penn who estahrshes the Mgt aid weebutes
assets to oath trina
Snell Norms Inesymnt Act 04 1958
Tie stbscreSion ~re
<entente Neon
Ths ~peon bootalesNch 'dudes Um inmost
Applicant.. Tarn and the Subscridion Agreement and
al exhibits nailed Matto
A AY AP. ~el
nota Or other derkative ~anent
the return from teeth is based In where cc n pan on
the ream ot to Fund
A third Dail
UK Fund Acker. (it.
or an intuit. Mentor, in es
GØ al investment adviser to the Fund or as
=neutrino< ID the Reef. n docketed n tnt
krentorantkin
meremad sminms unable income. n delaaf a 3-4
rein the mewling otSeutons 511 to 514 of kw Coot
The penorn) tiring this ~km App-catcn lam
CONFIDENTIAL
Private and Confidential
20
SD NY_GM_00020479
EFTA_00131099
EFTA01273306
rrm W-9
Min iwrwrao>e
~art«
nr nisa
net~ faer.• Sona
Request for Taxpayer
Identification Number and CertlficatIon
Gnee Fonn to the
~ster.
Do not
~d
to the 1111;„
•41~ i
lieS• M 'Ne KOS 1•• ~ni
New e ess:
rns
not ar.• mr , ne tun,
GlOseoino ~trell
2 Issa
nwerarearato ertet an• .oenere as an
Pa+ ~OSS
be. air ~ml
neletakte inn W•ri nagla bia
sa ens
. • tsolk"
aep
r
unn na
~rana
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0
a parluelin faseliS Or
n ~eiks 3 starecracs
Orr~te
~flas
; ~roene ir ••••
Sna Ola» otta tilanie
ci -røret •ae••• ornés. La Ve ta eleenaa
capan
~mr
, Prereermit
trimpor ber Fela ~~.
mor Fm a oneranwerr
• direined. e ret ne
en 1,4 as9W• S
es ta ene
et.
elesSICS" 01 lot linfleSte
St ant
O OMN
KIRCeena •
en e aua ane
f.
S Mere» tanner. isne ang* ••
116 E 135th Shell
i ča fl ! n20 4 code
New York. NY 10065
7 tnt de(Ouni ••••9014as Ni* 100•4•131.
i Peourrars nemt anis amer KeIrre
taxpayet Identlelcst~ 1411~er 031)
Entre na Ta n ta 11013104a4
001 11•4 Tala/ia« auet aillet er non gimm
kne rare
Danna ~ane
For rennar. the te generally >OS OCCS l•Ck•My eafles
ar •
MOMS tbin. fl > 0e0Oelee0e er a)/~0
raly. Sal a* Pla I n9ntApgteaooape 3. For ceter
~~
et .• you. ernorrw rernmeroon mr*,
Fyou 00 nat ravSa ~Mer. ~
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7/N M Dago 3.
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4.n nr/ti tron tet nam*. ••• mr harar% tr ~trio
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inggeye knelatan ~Se
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beat aneataSI arkromthor Yo9 ir.rtn
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of Form
er. nalf "an Wa Nel~i•In ra a renn to fa an nal
ta ga est Man aur nat
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