Investor Application Form (continued)

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File: EFTA01273285_p9_i0.png dataset_10
Summary:

The image is a scanned investor application form related to initial public equity offerings. The document is marked as confidential and contains information about eligibility and exemptions for investors.

Content Type:
Image
Document Type:
image
Date:
N/A
Model Used:
gemini-2.0-flash-001
Image Classification
Category:
document_scan
Subcategory:
form
Scene & Environment

Setting: indoor

Location Type: office

Time: unclear

Atmosphere: formal

Background: white background

Document Extraction

Type: form

Key Points:

  • Certification regarding initial public equity offerings
  • Rule 5130 "Restricted Persons"
  • Eligibility for new issues
  • Exemptions for entities

Full Transcription:

Investor Application Form (continued)
G. Certification Regarding Initial Public Equity Offerings:
(NITIAL Rule 5130 "Restricted Persons"
Appropriate
The Fund may elect not to invest in new issues even if your individual account is eligible for such transactions
Please initial the appropriate statement, Ine
statement, ine underugned has itared those statements below with apply to
crporation partnerstyp trust or other entity artist apply to any person nawnge Beneficial Interest in the undersigned
The Investor is any of the following
AINAA memper the late
undersigned
An officer, director gerera parte assatec persona employee NRA membernom or other Lovered Broker Deser
Ar agent at a ovère Broker Dearestime agent is engaged the investment banking or securities Business
An mesate Fame Member of a person speed mio cabove
Aiderate per congin ahal apar Covered Broker Dealer, ouding attorneys, accountants anc
muncial consultants
A perut who has the dully
Tueument comparentadvisi
unhese serige and can institution wrance company.
nvestment AcCOU
Amediadem Mertiser of a person spec ed
Spear
adów w 'eceives from or provides to sati persor Materia
A person ste
Deale
ted to belated checue A or schedule sa for as awning 10% more of averва впиет
secured to be i sond Schedule 9 or schedure of um 80 whose ownership teres isi persa" isted
A jest that cawarty or indirectly 10% or more of pubes reporting company anted required to be istea in
Kesule A or Farm Bl with respect to a Covered Poker Dealer other than a sus company that es listed on a national
andrest 25% or more of a pubic reporting company that sa perto istedi above other
OLENC compary that stea on a mabonal secuntes exchange
As mimed ate fatty Member af a perse sted though
above
receves from or provides to un pesor
An aventurang a corporator patnership muted abrity comparty, trust or other entity in which any of the persons
referred to a thout above has a Benef matinterest any person mia trrowgn ma 530 Restricted Person
For Entities only: If you initialed any any of items (a) through (m) above, you may still be eligible to participate in "new issues" if you
satisfy one of the exemptions listed under "New Issues Exemptions" at the back of the Subscription Agreement.
If so, please specify the exemption number (1 through 10) here (exemption 1(b) is not available):
NOTE: Exemptions are not applicable for individual retirement accounts, individual or joint accounts, UGMA or UTMA accounts.
which are treated as natural persons for this purpose.
Private and Confidential
SDNY_GM_00020466
CONFIDENTIAL
EFTA_00131086
Text in Image
Investor Application Form (continued)
G. Certification Regarding Initial Public Equity Offerings:
Rule 5130 "Restricted Persons"
The Fund may elect not to invest in new issues even if your individual account is eligible for such transactions
Please initial the appropriate statement, Ine
statement, ine underugned has itared those statements below with apply to
crporation partnerstyp trust or other entity artist apply to any person nawnge Beneficial Interest in the undersigned
The Investor is any of the following
AINAA memper the late
undersigned
An officer, director gerera parte assatec persona employee NRA membernom or other Lovered Broker Deser
Ar agent at a ovère Broker Dearestime agent is engaged the investment banking or securities Business
An mesate Fame Member of a person speed mio cabove
Aiderate per congin ahal apar Covered Broker Dealer, ouding attorneys, accountants anc
muncial consultants
A perut who has the dully
Tueument comparentadvisi
unhese serige and can institution wrance company.
nvestment AcCOU
Amediadem Mertiser of a person spec ed
Spear
adów w 'eceives from or provides to sati persor Materia
A person ste
Deale
ted to belated checue A or schedule sa for as awning 10% more of averва впиет
secured to be i sond Schedule 9 or schedure of um 80 whose ownership teres isi persa" isted
A jest that cawarty or indirectly 10% or more of pubes reporting company anted required to be istea in
Kesule A or Farm Bl with respect to a Covered Poker Dealer other than a sus company that es listed on a national
andrest 25% or more of a pubic reporting company that sa perto istedi above other
OLENC compary that stea on a mabonal secuntes exchange
As mimed ate fatty Member af a perse sted though
above
receves from or provides to un pesor
An aventurang a corporator patnership muted abrity comparty, trust or other entity in which any of the persons
referred to a thout above has a Benef matinterest any person mia trrowgn ma 530 Restricted Person
For Entities only: If you initialed any any of items (a) through (m) above, you may still be eligible to participate in "new issues" if you
satisfy one of the exemptions listed under "New Issues Exemptions" at the back of the Subscription Agreement.
If so, please specify the exemption number (1 through 10) here (exemption 1(b) is not available):
NOTE: Exemptions are not applicable for individual retirement accounts, individual or joint accounts, UGMA or UTMA accounts.
which are treated as natural persons for this purpose.
Private and Confidential
SDNY_GM_00020466
CONFIDENTIAL
EFTA_00131086

Significance: The document is an investor application form, and the text relates to eligibility for new issues.

Full Description

The image is a scanned document titled "Investor Application Form (continued)". The document is in English and appears to be a form related to initial public equity offerings. The top of the document contains the title and a section labeled "G. Certification Regarding Initial Public Equity Offerings." Below this, there is a section with the heading "Rule 5130 'Restricted Persons'" and a statement about the fund's ability to elect not to invest in new issues. The document lists several conditions related to the investor's status. The bottom of the document contains a note about exemptions and the phrases "Private and Confidential" and "CONFIDENTIAL". The document also includes the reference numbers "SDNY_GM_00020466" and "EFTA_00131086". The image quality is medium, and the text is readable. The document is a standard form with a formal tone.

Critical Findings
Illegal Activity: suspicious

The document is marked as confidential, which could indicate an attempt to conceal information.

Blackmail Likelihood: possible

The document is marked as confidential, which could be used for leverage.

Raw Analysis