Investor QuestionnaireAccredited Investors Verification | |
Unicorn Macro Fund, LP (the “Fund”, as hereinafter defined) operates under Security and Exchange Commission (“SEC”) Rule 506(c), the Commodity Futures Trading Commission (“CFTC”) and the National Futures Association (“NFA”). Accordingly, all capital must be from accredited investors (as defined by the SEC). Furthermore, the SEC requires the Fund to take “...reasonable steps to verify that its investors are accredited investors, which could include reviewing documentation, such as W-2s, tax returns, bank and brokerage statements, credit reports and the like.” In order to satisfy these requirements, the Fund provides an “investor questionnaire.” The investor must fill out the questionnaire and return it to the Fund or provide a sworn affidavit that the investor has filled out the questionnaire and a third-party has verified the answers. All information provided by the undersigned is furnished for the sole use of the Fund for the purposes described above and will be held in confidence by Unicorn Capital Partner, LLC (the “General Partner”) or a third-party verifier and will be made available when necessary or desirable to establish compliance with federal or state securities laws. Any purchase of these “Restricted Securities” will be solely for the account of the undersigned, and not for the account of any other person or with a view to any resale, division or distribution thereof. | |
SECTION 1: COMPLETED BY ALL INVESTORS | |
Please initial, in the space provided below, the scenario that applies to you. | |
______________ | SCENARIO ONE: The undersigned has such knowledge and experience in financial and business matters so as to be capable of evaluating the relative merits and risks of an investment in the Securities; the undersigned is not using a Purchaser Representative (as defined below) in connection with such evaluation. The undersigned offers as evidence of knowledge and experience in these matters the information requested in this Accredited Investor Questionnaire. |
______________ | SCENARIO TWO*: The undersigned will use a Purchaser Representative who satisfies all of the affiliation, financial experience, acknowledgment and disclosure conditions set forth under Rule 501(h) of Regulation D promulgated under the Securities Act of 1933, as amended ("Purchaser Representative") acceptable to the General Partner in connection with evaluating a potential investment in the Securities. The undersigned acknowledges that the following person will be acting as Purchaser Representative in connection with evaluating the merits and risks of an investment in the Securities.
If applicable, the name, employer, address and telephone number of my purchaser representative are as follows: |
* IF YOU HAVE INITIALED SCENARIO TWO, THIS CONFIDENTIAL INVESTOR QUESTIONNAIRE MUST BE ACCOMPANIED BY A COMPLETED AND SIGNED PURCHASER REPRESENTATIVE QUESTIONNAIRE. | |
The undersigned represents and warrants that the above-named Purchaser Representative has furnished the undersigned with a Purchaser Representative questionnaire and that the undersigned and the above-named Purchaser Representative together have such knowledge and experience in financial and business matters that they are capable of evaluating the merits and risks of an investment in the Securities. | |
SECTION 2: COMPLETED BY INDIVIDUAL INVESTORS | |
1. PERSONAL INFORMATION | |
Name: __________________________________ | |
Residence Address: ________________________________________________________________________________________ Street City State Zip Code Country |
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Telephone:_________________________________________ | E-Mail:__________________________________________ |
Citizenship:_________________________________________ | Marital Status:____________________________________ |
Social Security or Taxpayer Identification Number: __________________________________ | |
UNICORN MACRO FUND WILL ONLY USE SUCH INFORMATION TO VERIFY THE POTENTIAL INVESTOR’S STATUS, AND INFORMATION WILL BE STORED IN A SECURE LOCATION. | |
2. SUITABILITY OF INVESTMENT | |
The following questions help us determine the suitability of your investment in Unicorn Macro Fund, LP. The Fund does not have a holding period nor “lock-up period; however, the Fund acknowledges the regulatory “back-office” burden for such liquidity and chooses not to be used as an alternative to a bank. The Fund will provide liquidity whenever needed but seeks investors that have a long term investment horizon. Macro Trading is a complex, sophisticated investing strategy and not suitable for first-time investors. | |
Purpose of Investment and Time Horizon: _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ |
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Investment Experience: _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ |
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Conflict of Interest: _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ |
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3. NET WORTH AND INCOME | |
In accordance with SEC guidance of Rule 506 (c), please initial, in the space provided below, the scenario that applies to you, can be both. You will be required to provide underlying documentation in support of your accredited investor status to either the fund or a third party verifier. The fund or third party verifier reserves the right to request additional documentation, if necessary. Additionally, the fund must be notified of any changes to your status as an accredited investor within 30 days. That change in status will result in an immediate redemption to ensure on-going compliance with sec regulations. |
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______________ | SCENARIO ONE: Have a net worth over $1 million, either alone or together with a spouse (excluding the value of the person’s primary residence). Brief Description of Net worth basis: _____________________________________________________________________________________________ |
______________ | SCENARIO TWO: Earned income that exceeded $200,000 (or $300,000 together with a spouse) in each of the prior two years, and reasonably expects the same for the current year. For purposes of this Accredited Investor Questionnaire, earned income must satisfy the thresholds for the three years consistently, either alone or with a spouse. Earned income, as reported for federal income tax purposes is less any income attributable to a spouse or to property owned by a spouse, increased by the following amounts (but not including any amounts attributable to a spouse or to property owned by a spouse): (i) the amount of any tax exempt interest income received, (ii) the amount of losses claimed as a limited partner in a limited partnership, (iii) any deduction claimed for depletion, (iv) deductions for alimony paid, (v) amounts contributed to an IRA or Keogh retirement plan, and (vi) any amount by which income from long-term capital gains has been reduced in arriving at adjusted gross income pursuant to the provisions of Section 1202 of the Internal Revenue Code. Brief Description of Income: _____________________________________________________________________________________________ |
4. BANKING AND CREDIT REFERENCE* *The contact information is only used to assure the individual’s net income and/or net worth. |
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Name of the Bank: ________________________________________ | |
Address: ________________________________________________ | |
Name of the Bank Officer: __________________________________ | |
Telephone#1:____________________________________________ | Telephone#2:_________________________________________ |
E-Mail:_________________________________________________ | Fax:_________________________________________________ |
5. NAME AND ADDRESS OF THIRD-PARTY VERIFICATION. | |
Name of the firm: _________________________________________ | |
Address: _______________________________________________ | |
Contact Person: _________________________________________ | |
Telephone#1:____________________________________________ | Telephone#2:_________________________________________ |
E-Mail:_________________________________________________ | Fax:_________________________________________________ |
6. SIGNATURE | |
I, _____________ (Print Name), acknowledge that any purchase of the securities will be solely for the account of the undersigned, and not for the account of any other person or with a view to any resale, division or distribution thereof.
I, _____________ (Print Name), have sufficient knowledge and experience in similar programs or investments to evaluate the merits and risks of private investing (or that I have retained an attorney, accountant, financial advisor or consultant as my purchaser representative); I have received and have had access to materials and relevant information enabling me to make informed investment decisions, and that all data I have requested has been furnished to me. The information herein contained is complete and accurate and may be relied upon by you. |
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______________ Date |
_____________________________________________________________________________ Print Name of Accredited Investor |
_____________________________________________________________________________ Signature |
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_____________________________________________________________________________ Joint Purchasers / Additional Signatories |
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SECTION 3: COMPLETED BY OTHER THAN INDIVIDUAL INVESTORS |
1. GENERAL INFORMATION | |
Name of Entity: _______________________________________________ | |
Principle Office Address: ________________________________________ | |
Type of Organization: __________________________________________ | |
Date and Place of Organization: __________________________________ (Please attach a copy of your organizational documents, as amended.) |
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Telephone#1:____________________________________________ | Telephone#2:_________________________________________ |
E-Mail:_________________________________________________ | Fax:_________________________________________________ |
2. BUSINESS DESCRIPTION | |
A brief description of the business conducted by the entity is as follows: _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ |
The principal person(s) making the decision on behalf of the entity, to subscribe to purchase membership interests is listed below: | ||
Name _____________________________________________________ _____________________________________________________ _____________________________________________________ |
Title _____________________________________________________ _____________________________________________________ _____________________________________________________ |
Each person named above must complete Section 2 of this Questionnaire. | |
3. ACCREDITED INVESTOR STATUS FOR ENTITY | |
Please check the appropriate description which applies to you (if any). You will be required to provide underlying documentation in support of your accredited investor status to either the fund or a third party verifier. The fund or third party verifier reserves the right to request additional documentation, if necessary. Additionally, the fund must be notified of any changes to your status as an accredited investor within 30 days. That change in status will result in an immediate redemption to ensure on-going compliance with sec regulations. |
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______________ | A bank, as defined in Section 3(a)(2) of the Securities Act of 1933 ("Act") or any savings and loan association or other institution as defined in section 3(a)(5)(A) of the Act, whether you are acting in an individual or a fiduciary capacity. |
______________ | Any broker or dealer registered pursuant to Section 15 of the Securities Exchange Act of 1934. |
______________ | An insurance General Partner, as defined in Section 2(13) of the Act. |
______________ | An investment General Partner registered under the Investment General Partner Act of 1940. |
______________ | A business development General Partner, as defined in Section 2(a)(48) of the Investment General Partner Act of 1940. |
______________ | A small business investment General Partner licensed by the U.S. Small Business Administration under Section 301(c) or (d) of the Small Business Investment Act of 1958. |
______________ | A plan established and maintained by a state, its political subdivisions, or any agency or instrumentality of a state or its political subdivisions for the benefit of its employees, if such plan has total assets in excess of $5,000,000. |
______________ | An employee benefit plan within the meaning of Title I of the Employee Retirement Income Security Act of 1974 if the investment decision is made by a plan fiduciary, as defined in Section 3(21) of such Act, which is either a bank, savings and loan association, insurance General Partner, or registered investment adviser, or if the employee benefit plan has total assets in excess of $5,000,000, or is a self-directed plan, with investment decisions made solely by persons that are accredited investors. |
______________ | A private business development General Partner as defined in Section 202(a)(22) of the Investment Advisors Act of 1940. |
______________ | An organization described in Section 501(c)(3) of the Internal Revenue Code, corporation, business trust, or partnership, not formed for the specific purpose of acquiring the securities offered, with total assets in excess of $5,000,000.
- List all equity owners: |
______________ | Any trust with total assets in excess of $5,000,000, not formed for the specific purpose of acquiring the securities offered, whose purchase is directed by a sophisticated person*. |
______________ | An entity in which all of the equity owners are accredited investors. |
* A sophisticated person means the person must have, or the company or private fund offering the securities reasonably believes that this person has, sufficient knowledge and experience in financial and business matters to evaluate the merits and risks of the prospective investment. Source: http://www.investor.gov/news-alerts/investor-bulletins/investor-bulletin-accredited-investors | |
4. BANKING AND CREDIT REFERENCE The contact information is only used to assure the individual’s net income and/or net worth. |
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Name of the Bank: ________________________________________ | |
Address: ________________________________________________ | |
Name of the Bank Officer: __________________________________ | |
Telephone#1:____________________________________________ | Telephone#2:_________________________________________ |
E-Mail:_________________________________________________ | Fax:_________________________________________________ |
5. NAME AND ADDRESS OF THIRD-PARTY VERIFICATION. | |
Name of the firm: _________________________________________ | |
Address: _______________________________________________ | |
Contact Person: _________________________________________ | |
Telephone#1:____________________________________________ | Telephone#2:_________________________________________ |
E-Mail:_________________________________________________ | Fax:_________________________________________________ |
6. SIGNATURE | |
The entity, _____________ (Print Name), acknowledges that any purchase of the securities will be solely for the account of the undersigned, and not for the account of any other person or with a view to any resale, division or distribution thereof. The entity, _____________ (Print Name), has, and its officers, employees, directors or equity owners have sufficient knowledge and experience in similar programs or investments to evaluate the merits and risks of private investment (or the entity has retained an attorney, accountant, financial advisor or consultant as a purchaser representative); that because of the background and employment experience of the entity’s equity owners, its officers, directors or employees, it has received and has had access to material and relevant information enabling it to make an informed investment decision, and that all data it has requested has been furnished to it. The information herein contained is complete and accurate and may be relied upon by you.The foregoing answers are true and complete. Attached is the requested information (e.g. Articles of Incorporation, Bylaws, and Resolutions) for your review. |
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______________ Date |
_____________________________________________________________________________ Name of Entity |
By __________________________________________________________________________ _____________________________________________________________________________ Duly Authorized To Signed On Behalf of The Entity |
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_____________________________________________________________________________ Joint Purchasers / Additional Signatories |