Epstein Secrets

ment was signed by the Investor, in the country listed below. If in the United States, please indicate the applicable state or territory (including the District of Columbia): C. The Investor hereby represents and warrants that the Investor is at least 21 years of age and is: (1) a citizen of (country): (2) a resident

ethod of communication: ❑E-mail ❑Fax ❑Regular Mail (Please use additional sheet, if necessary) • CATEGORY OF INVESTOR (Please select only one) K Individual U.S. Person (including his/her trusts) K Individual Non-U.S. Person (including his/her trusts) K Broker-Dealer K Insurance Company K Investment

Section 3(c)(1) or 3(c)(7) of the Company Act. For purposes of Form PF, the term "government entity" means any U.S. state (including any U.S. state, the District of Columbia. Puerto Rico, the U.S. Virgin Islands or any other possession of the United States) or political subdivision of a state, including: (i) any agency.

Investor is acting as agent or nominee for a Beneficial Owner, please check the item that best describes the Beneficial Owner.) Please check one: K Individual that is a United States person— (or a trust of such a person) K Broker-dealer K Insurance company K Investment company registered with the SEC

Section 3(c)(1) or 3(c)(7) of the Company Act. For purposes of Form PF, the term "government entity" means any U.S. state (including any U.S. state, the District of Columbia. Puerto Rico, the U.S. Virgin Islands or any other possession of the United States) or political subdivision of a state, including: (i) any agency.

Investor is acting as agent or nominee for a Beneficial Owner, please check the item that best describes the Beneficial Owner.) Please check one: K Individual that is a United States person— (or a trust of such a person) K Broker-dealer K Insurance company K Investment company registered with the SEC

ction 3(c)( I ) or 3(cX7) of the Company Act. • For purposes of Form PF, the tarn "government entity" means any U.S. gate (including any U.S. gate, the District of Columbia, Puerto Rico. the U.S. Virgin Islands or any other posession of the United States) or political subdivision of a state, including: (i) any agency,

Investor is acting as agent or nominee for a Beneficial Owner, please check the item that best describes the Beneficial Owner.) Please check one: K Individual that is a United States person— (or a trust of such a person) K Broker-dealer Insurance company Investment company registered with the Securities