For Client Use. A. Subscription Amount: I hereby subscribe for $ (minimum $25,000). B. Accreditation: Please select one of the following. 1. I am an accredited investor under paragraph of Exhibit I on page B-11. 2. I am a non-accredited investor. If you selected #2 above, please fill in the Prospective Purchaser Questionnaire (Exhibit II, page B-12) and, if applicable, the Purchaser Representative Questionnaire (Exhibit II-1, page B-14). C. Benefit Plan Investor Status: The subscriber is ___ or is not ___ a “Benefit Plan Investor” as defined in paragraph 7 above. D. New York Individual Investor or Trustee Status [FOR INDIVIDUAL INVESTORS ONLY]: Please select one of the following. 1. I am an individual investor executing this Subscription Agreement in the State of New York. 2. I am an individual trustee executing this Subscription Agreement in the State of New York on behalf of a trust. 3. I am executing this Subscription Agreement outside of the State of New York. If you selected #1 or #2 above, please read and sign the New York State Power of Attorney (Exhibit III, page B-20) and have your signature notarized.
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For Client Use. A. Subscription Amount: I hereby subscribe for $ $__________ (minimum $25,000).
B. Accreditation: Please select one of the following.
1. I am an accredited investor under paragraph ______ of Exhibit I on page B-11B-9.
2. I am a non-accredited investor. If you selected #2 above, please fill in the Prospective Purchaser Questionnaire (Exhibit II, page B-12) B-9 and, if applicable, the Purchaser Representative Questionnaire (Exhibit II-1, page B-14B-11).
C. Benefit Plan Investor Status: The subscriber is ___ or is not ___ a “Benefit Plan Investor” as defined in paragraph 7 above.
D. New York Individual Investor or Trustee Status [FOR INDIVIDUAL INVESTORS ONLY]: Please select one of the following.
1. I am an individual investor executing this Subscription Agreement in the State of New York.
2. I am an individual trustee executing this Subscription Agreement in the State of New York on behalf of a trust.
3. I am executing this Subscription Agreement outside of the State of New York. If you selected #1 or #2 above, please read and sign the New York State Power of Attorney (Exhibit III, page B-20B-16) and have your signature notarized.
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