REQUEST ACCESS TO POOLED VEHICLE

PLEASE CHOOSE THE CORRECT FORM BELOW:

(INDIVIDUAL AND IRA INVESTORS)

The undersigned (the "Prospective Investor") is furnishing the information in this Questionnaire in order to enable you to determine (a) whether interests in private investment funds that may be offered by Angeles Investment Advisors (each a "Fund") may be offered to the Prospective Investor without registration of the interests under the Securities Act of 1933, as amended, or any applicable state securities law, (b) whether the Prospective Investor is eligible to invest in a Fund as a “qualified purchaser” as defined in Section 2(a)(51) of the Investment Company Act of 1940, as amended, and (c) whether an investment in a Fund would be "suitable" for the Prospective Investor within the meaning of applicable regulations. This Questionnaire is not an offer to purchase or acceptance of an offer to sell an interest, but is, in fact, a response to a solicitation for information that will permit you to determine the appropriateness of any such sale to the Prospective Investor.

Please be sure to sign and date this Investor Suitability Questionnaire as indicated. Please note that a number of items require that you check or initial the appropriate space in addition to signing the Questionnaire as a whole. If an item is not applicable to you, please write "N/A" or "Not Applicable" in the appropriate spaces, rather than merely leaving them blank. Incomplete Questionnaires cannot be processed. Please attach additional sheets if necessary to answer any questions.

1.   Personal Information

You must provide your full name
  • You must provide your address
  • You must provide your city
  • You must provide your state
  • You must provide your zip code
  • You must provide a business phone number
You must provide a valid e-mail address
You must provide your occupation
You must provide your title / position

2.   Accredited Investors Status (only U.S. person investors need complete)

Check all of the appropriate boxes below indicating the basis on which you qualify as an "accredited investor." Only those who so qualify are eligible to invest in a Fund.

  • I have a net worth (or joint net worth together with my spouse) in excess of $1,000,000 (exclusive of the value of my primary residence), and I have no reason to believe that my net worth will not remain in excess of $1,000,000 for the foreseeable future. For purposes of determining the value of the primary residence to be excluded from net worth, the investor should exclude any net equity in his or her primary residence (i.e., the amount by which the current market value of the residence exceeds the current outstanding balance of any mortgage or other indebtedness secured by the residence). If the current outstanding balance of any such mortgage or other indebtedness exceeds the current market value of the residence, the amount of any such excess shall cause a reduction in the investor’s net worth to the extent that such mortgage or other indebtedness gives the lender recourse to the assets of the investor other than the residence securing the mortgage or other indebtedness.

  • I have had an individual annual adjusted gross income during the last two full calendar years in excess of $200,000 (or joint income together with my spouse in excess of $300,000) and reasonably expect to have an annual income in excess of $200,000 (or joint income together with my spouse of in excess of $300,000) during the current calendar year, I have no reason to believe that my income will not remain in excess of $200,000 (or joint income in excess of $300,000) for the foreseeable future.

  • None of the above

3.   Qualified Purchaser Status

Check all of the appropriate boxes below to certify that you qualify as a “qualified purchaser.” You must review the Schedule hereto before completing this item.

  • I own not less than $5,000,000 in “Net Investments” as described in the Schedule hereto.

  • I am a “Knowledgeable Employee” as described in the Schedule hereto.

  • The sum of "Net Investments" as described in the Schedule hereto that I own plus "Net Investments" as described in the Schedule hereto that I invest on a discretionary basis is not less than $25,000,000.

  • None of the above

4.   Investment History: Background

You must provide details for at least 1 investment
You must include at least one item

5.   Sign and Date Application

The information contained herein is complete and accurate, and the Prospective Investor will notify you promptly of any change in any such information. The Prospective Investor realizes and understands that XXXX may solicit the Prospective Investor in reliance on the truth of the information contained herein. You must check the box to submit your application

(ENTITY INVESTORS)

The undersigned (the "Prospective Investor") is furnishing the information in this Questionnaire in order to enable you to determine (a) whether interests in private investment funds that may be offered by XXXX (each a "Fund") may be offered to the Prospective Investor without registration of the interests under the Securities Act of 1933, as amended (the "Securities Act"), or any applicable state securities law, (b) whether the Prospective Investor is eligible to invest in a Fund as a "qualified purchaser" as defined in Section 2(a)(51) of the Investment Company Act of 1940, as amended (the "Company Act"), and (c) whether an investment in a Fund would be "suitable" for the Prospective Investor within the meaning of applicable regulations. This Questionnaire is not an offer to purchase or acceptance of an offer to sell an interest, but is, in fact, a response to a solicitation for information that will permit you to determine the appropriateness of any such sale to the Prospective Investor.

Please be sure to sign and date this Investor Suitability Questionnaire as indicated. Please note that a number of items require that you check or initial the appropriate space in addition to signing the Questionnaire as a whole. If an item is not applicable to you, please write "N/A" or "Not Applicable" in the appropriate spaces rather than merely leaving them blank. Incomplete Questionnaires cannot be processed. Please attach additional sheets if necessary to answer any questions.

1.   Background Information

  • Trust
  • Limited Liability Company
  • Corporation
  • Employee Benefit Plan
  • General Partnership
  • Other
  • Limited Partnership
You must provide your name
You must provide the jurisidiction in which your entity was formed
You must provide the date formed
  • You must provide the principal address
  • You must provide the city
  • You must provide the state
  • You must provide the zip code
  • You must provide a business phone number
  • You must provide a contact name
You must provide a valid e-mail address

2.   Accredited Investor Status (only U.S. person investors need complete):

Check all of the appropriate boxes below to indicate the basis on which the undersigned qualifies as an "accredited investor." Only those entities who so qualify are eligible to invest in a Fund.

  • Any broker or dealer registered pursuant to Section 15 of the Securities Exchange Act of 1934, as amended.

  • An investment company registered under the Company Act or a business development company as defined in Section 2(a)(48) thereof that was not formed for the specific purpose of investing in a Fund.

  • A bank as defined in Section 3(a)(2) of the Securities Act, or any savings and loan association or other institution as defined in Section 3(a)(5)(A) of the Securities Act, acting for its own account or for the account of an accredited investor.

  • An insurance company as defined in Section 2(13) of the Securities Act, acting for its own account or for the account of an accredited investor.

  • 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, that has total assets in excess of $5,000,000.

  • An employee benefit plan within the meaning of the Employee Retirement Income Security Act of 1974, as amended (“ERISA”), provided that (i) the investment decision is made by a plan fiduciary, as defined in Section 3(21) of ERISA, which is either a bank, savings and loan association, insurance company or registered investment adviser, (ii) the employee benefit plan has total assets in excess of $5,000,000 or (iii) if the plan is self-directed, investment decisions for the plan are made solely by persons that are accredited investors.

  • An organization described in Section 501(c)(3) of the Internal Revenue Code of 1986, as amended, a corporation, Massachusetts or similar business trust, or partnership, not formed for the specific purpose of investing in a Fund, which has total assets in excess of $5,000,000.

  • A private business development company as defined in Section 202(a)(22) of the Investment Advisers Act of 1940, as amended.

  • A trust, insurance company separate account or bank collective trust, not formed for the specific purpose of investing in a Fund, which has total assets in excess of $5,000,000, whose participation in the Fund is directed by a sophisticated person as described in Rule 506(b)(2)(ii) of SEC Regulation D.

  • An entity of which all of the unit owners and participants (e.g., all partners (including limited partners) of a partnership, shareholders of a corporation and the grantor of a grantor trust, but not the beneficiaries of a true trust) are accredited investors.

  • None of the above

3.   Qualified Purchaser Status:

Check all of the appropriate boxes below to certify the basis on which the undersigned qualifies as a "qualified purchaser." You must review the Schedule hereto before completing this item.

  • A company, partnership, trust or other entity (i) that is owned directly or indirectly by or for two or more natural persons who are related as siblings or spouse (including former spouses), or direct lineal descendants by birth or adoption, spouses of such persons, the estates of such persons, or foundations, charitable organizations, or trusts established by or for the benefit of such persons (“Family Company”), (ii) that was not formed for the specific purpose of investing in a Fund, and (iii) that owns not less than $5,000,000 in “Net Investments” as described in the Schedule hereto.

  • A trust (other than a Family Company) that was not formed for the specific purpose of investing in a Fund, as to which each trustee or other person authorized to make decisions with respect to the trust and each settlor or other person who has contributed assets to the trust is a “qualified purchaser.”

  • A company, partnership, trust or other entity that (i) was not formed for the specific purpose of investing in a Fund, (ii) acts for its own account or the accounts of other “qualified purchasers,” and (iii) in the aggregate owns and invests on a discretionary basis not less than $25,000,000 in “Net Investments” as described in the Schedule hereto.

  • A “qualified institutional buyer” (as defined in SEC Rule 144A and described in the Schedule hereto) that meets, if applicable, the dealer and employee benefit plan requirements described in the Schedule hereto.

  • A company, partnership or other entity whose securities are beneficially owned exclusively by “qualified purchasers.”

  • A company, partnership or other entity whose securities are beneficially owned exclusively by “Knowledgeable Employees” as described in the Schedule hereto.

  • None of the above

4.   Sign and Date Application

The information contained herein is complete and accurate and the Prospective Investor will notify you promptly of any change in any such information. The Prospective Investor realizes and understands that XXXX may solicit the Prospective Investor in reliance on the truth of the information contained herein. You must check the box to submit your application

I, the person executing on behalf of the Prospective Investor, represent that I have the authority to execute and deliver this Questionnaire on behalf of such Prospective Investor. You must check the box to submit your application