3
Shared Docs
3
Same-Page
3 / 3
Mentions
State. pri (1,40:. Widow./ PTigipat Fixed &sinew) Dr. Other Phone: Fax: Accredited Investor Representation Check only one box. By executing this Investor Application, the Undersigned cerffies that he, she, a it (as applicable) has read and understands the instructions to this Investor Application inducing, but n
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
MIUMIIIMIIIIIIIIIMMIIM IZIMEINO o nonmEmorao rimummannumm IS Winn A A C. Accredited Investor Representation C heck only one box By executing this Investor Application, the Undersigned certifies that he, she. or it (as applicable) (i) has read and understands the instructions to this Investor Application including.
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
te: (Nestor Residence Principal Place of Business) Other Phone: Fax EWE C Accredited Investor Representation Check only one box. By executing this Investor Application, the Undersigned certifies that he, she, or it (as applicable) n has read and understands the instructions to this Investor Application inducing, bu
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 this Investor Application and the Memorandum

Ghislaine Maxwell
PERSONKeogh
ORGANIZATIONSubscription Booklet
ORGANIZATIONthe Fund Investment Application
ORGANIZATIONQuickCard
ORGANIZATIONUBS Alternative Investments US
ORGANIZATIONBranch Managers
ORGANIZATIONUndersigned
ORGANIZATIONUBS Financial Services Inc.
ORGANIZATIONDelegate
ORGANIZATIONVI-VIII
ORGANIZATIONSocial Security/Tax
ORGANIZATIONUBS Online Services
ORGANIZATIONthe Fund or Placement Agent
ORGANIZATIONThis Placement Fee
ORGANIZATION
the U.S. Treasury Department
ORGANIZATIONInvestment Company
ORGANIZATIONUBSFA
ORGANIZATION
Limited Liability Company
ORGANIZATIONUBS Financial Advisor
ORGANIZATION