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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
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lient is correct and accurate. IL Investor Qualification for Offshore Fund offerings only: I have reviewed the -Country Qualifications" append& to the Memorandum or Subscription Agreement and in any applicable supplement to the Memorandum or set forth in the instructions on the UBS intranet, and I certify tha
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ent is correct and accurate. II. Investor Qualification for Offshore Fund offerings only: I have reviewed the -Country Qualifications" appendix to the Memorandum or Subscription Agreement and in any applicable supplement to the Memorandum or set forth in the instructions on the UBS intranet, and I certify tha
Entities connected to both Limited Liability Company and the Memorandum

Samantha Power
PERSON
United States
LOCATION
George W. Bush
PERSON
Ghislaine Maxwell
PERSONKeogh
ORGANIZATIONQuickCard
ORGANIZATIONUBS Alternative Investments US
ORGANIZATIONBranch Managers
ORGANIZATIONSubscription Booklet
ORGANIZATIONthe Fund Investment Application
ORGANIZATION
Eric Holder
PERSONUBS Financial Services Inc.
ORGANIZATIONDelegate
ORGANIZATIONUBS Financial Advisor
ORGANIZATIONUBS Online Services
ORGANIZATIONthe Fund or Placement Agent
ORGANIZATIONthe State of New York
LOCATIONUBSFA
ORGANIZATION
the U.S. Treasury Department
ORGANIZATIONUndersigned
ORGANIZATION