EFTA Document EFTA01374164

AGP LP 519 Alpha Group Capital Paul Barrett ANNEX C AML CERTIFICATION FORM FOR FUND OF FUNDS OR ENTITY THAT INVESTS ON BEHALF OF THIRD PARTIES The undersigned, being the of Insert Title Insert Name of Entity a organized under the laws of Insert Type of Entity Insert Jurisdiction of Organization (the "Company"), does hereby certify on behalf of the Company that it is aware of applicable anti-money laundering laws and regulations, including the requirements of the USA PATRIOT Act of 2001 and the regulations administered by the U.S. Department of the Treasury's Office of Foreign Assets Control (collectively, the "anti-money laundering/OFAC laws"). The Company has anti-money laundering policies and procedures in place reasonably designed to verify the identity of its [beneficial holders] [underlying investors] and their sources of funds. Such policies and procedures are properly enforced and are consistent with the anti-money laundering/OFAC laws such that Alkeon Select Partners LP (the "Partnership") may rely on this Certification. The Company hereby represents to the Partnership that, to the best of its knowledge, the Company's [beneficial holders] [underlying investors] are not individuals, entities or countries that may subject the Partnership to criminal or civil violations of any anti-money laundering/OFAC laws. The Company agrees to promptly notify the Partnership in writing should the Company have any questions relating to any of the investors or become aware of any changes in the representations set forth in this Certification. Date: , 20 By: Name: Title: Appendix G-6 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0068725 CONFIDENTIAL SDNY_GM_00214909 EFTA01374164