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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
tor 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
a Participant-Directed Retirement Plan, check here: If Investor is Other Retirement Plan, check here: If Investor is a Corporation, Partnership, Limited Liability Company and Other Entity, check here: K (II)a or K (Ilk O (III)c K (III)a or K (01$ Of K (Red K INla or O (IVIla or O (Pik or O (NM or O (IV)e or O or
or 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
a Participant-Directed Retirement Plan, check here: If Investor is Other Retirement Plan, check here: If Investor is a Corporation. Partnership. Limited Liability Company and Other Entity. check here: CI (Nor CI (Mc O (lipc O (III)a or 0 (III)b or 0 Olfid O (IV)a or 0 (II:)ber 0 (Mc or 0 IlV4 or 0 OW or 0 °VII or
vestor Application Form. A. Capital Commitment Amount: • Indicate the Capital Commitment applied for (which may be accepted in whole or in part by UBSFA). (Note: Initially, your account will be debited for 5% of the Capital Commitment plus the Placement Fee, if charged, and any additional amounts ca
Entities connected to both Limited Liability Company and UBSFA

Samantha Power
PERSON
United States
LOCATION
George W. Bush
PERSON
Ghislaine Maxwell
PERSON
Joi Ito
PERSONUBS Fund Advisor
ORGANIZATION
Eric Holder
PERSON
the U.S. Treasury Department
ORGANIZATIONKeogh
ORGANIZATION
Internal Revenue Service
ORGANIZATIONComplex Admin
ORGANIZATIONBranch Managers
ORGANIZATIONthe Memorandum
ORGANIZATIONthe Fund Investment Application
ORGANIZATIONSubscription Booklet
ORGANIZATIONQuickCard
ORGANIZATIONUBS Alternative Investments US
ORGANIZATION
U.S. Treasury
ORGANIZATION
UBS AG
ORGANIZATIONthe State of New York
LOCATION