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sd-10-EFTA01372394Dept. of JusticeOther

EFTA Document EFTA01372394

5. Related Person is: (check all that apply) (a) r broker-dealer, municipal securities dealer, or government securities broker or dealer (b) I7 other investment adviser (including financial planners) (c) r registered municipal advisor (d) r registered security-based swap dealer (e) r major security-based swap participant (f) r commodity pool operator or commodity trading advisor (whether registered or exempt from registration) (g) r futures commission merchant (h) r banking or

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Dept. of Justice
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sd-10-EFTA01372394
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5. Related Person is: (check all that apply) (a) r broker-dealer, municipal securities dealer, or government securities broker or dealer (b) I7 other investment adviser (including financial planners) (c) r registered municipal advisor (d) r registered security-based swap dealer (e) r major security-based swap participant (f) r commodity pool operator or commodity trading advisor (whether registered or exempt from registration) (g) r futures commission merchant (h) r banking or

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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
5. Related Person is: (check all that apply) (a) r broker-dealer, municipal securities dealer, or government securities broker or dealer (b) I7 other investment adviser (including financial planners) (c) r registered municipal advisor (d) r registered security-based swap dealer (e) r major security-based swap participant (f) r commodity pool operator or commodity trading advisor (whether registered or exempt from registration) (g) r futures commission merchant (h) r banking or thrift institution (i) r trust company accountant or accounting firm (k) r lawyer or law firm (I) r insurance company or agency (m) r pension consultant (n) r real estate broker or dealer (o) r sponsor or syndicator of limited partnerships (or equivalent), excluding pooled investment vehicles (p) r sponsor, general partner, managing member (or equivalent) of pooled investment vehicles I 6. Do you control or are you controlled by the related person? 7. Are you and the related person under common control? Yes No r (7, r 8. (a) Does the related person act as a qualified custodian for your clients in connection with advisory services you provide to clients? r (b) If you are registering or registered with the SEC and you have answered "yes," to question 8.(a) above, have you overcome the r r presumption that you are not operationally independent (pursuant to rule 206(4)-2(d)(5)) from the related person and thus are not required to obtain a surprise examination for your clients' funds or securities that are maintained at the related person? (c) If you have answered "yes" to question 8.(a) above, provide the location of the related person's office responsible for custody of your clients' assets: Number and Street 1: Number and Street 2: City: State: Country: ZIP+4/Postal Code: If this address is a private residence, check this box: r 9. (a) If the related person is an investment adviser, is it exempt from registration? (b) If the answer is yes, under what exemption? RELYING ADVISER Yes No r 10. (a) Is the related person registered with a foreign financial regulatory authority ? C' C. (b) If the answer is yes, list the name and country, in English of each foreign financial regulatory authority with which the related person is registered. No Information Filed 11. Do you and the related person share any supervised persons? 12. Do you and the related person share the same physical location? r r 1. Legal Name of Related Person: CG INVESTMENT MANAGER, LLC 2. Primary Business Name of Related Person: CG INVESTMENT MANAGER, LLC 3. Related Person's SEC File Number (if any) (e.g., 801-, 8-, 866-, 802-) or Other 4. Related Person's (a) GRD Number (if any): (b) CIK Number(s) (if any): No Information Filed 5. Related Person is: (check all that apply) (a) r broker-dealer, municipal securities dealer, or government securities broker or dealer (b) F other investment adviser (including financial planners) CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0066092 CONFIDENTIAL SDNY_GM_00212276 EFTA01372394

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