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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
lient is correct and accurate. 11. Investor Qualification for Offshore Fund offerings only I have reviewed the "Country Cuaifications° appendix to the Memorandum or Subscription Agreement and in any applicable supplement to the Memorandum or stet forth in the instructions on the UBS Intranet and I certify tha
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
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
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
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 UBSFA and the Memorandum

Ghislaine Maxwell
PERSONQuickCard
ORGANIZATIONSubscription Booklet
ORGANIZATIONUBS Alternative Investments US
ORGANIZATIONBranch Managers
ORGANIZATIONthe Fund Investment Application
ORGANIZATIONKeogh
ORGANIZATION
Samantha Power
PERSON
George W. Bush
PERSON
the U.S. Treasury Department
ORGANIZATIONDelegate
ORGANIZATION
United States
LOCATIONUBS Fund Advisor
ORGANIZATIONUBS Online Services
ORGANIZATIONUBS Financial Services Inc.
ORGANIZATIONUndersigned
ORGANIZATIONthe Fund or Placement Agent
ORGANIZATION
Limited Liability Company
ORGANIZATIONComplex Admin
ORGANIZATIONUBS Financial Advisor
ORGANIZATION