EFTA01384735.pdf

HUBUS133 Alpha Group Capital SECTION C - Individuals Individuals: Full Documentary Evidence For investors in Low or Medium Risk jurisdictions, non-documentary methods of verifying the following five bullet points listed below may be applied by the Administrator using third-party sources where possible. If any of the five bullet points cannot be verified by the administrator, additional documentation will be required'. 1. Full Name 2. Residential Street Address (P.O. Box addresses are not acceptable) 3. Tax Identification Number 4. Date of Birth 5. Tax Form (W-8/W-9) If all five bullet points are not provided. all three of the items listed below should be attached to this form. 1. Valid, legible photo identification (passport, driving license or other form of approved government-issued ID.) 2. 34 party confirmation of current residentiaVstreet address as noted above (utility bill. bank statement or otherwise — only portion of bill providing the address detail is required and should be dated within 6 months of the trade date) 3. Tax Form (W-8AN-9) For joint investors. the same documentation is required for both account holders. For individuals deemed to be in a Flioh Risk jurisdiction' 4. MI of the above information is required. 5. Photo I.D.: Current Copy of a photographic identity document issued by the government or a State-owned entity (e.g.. passport. driver's license). 6. Proof of address: Current copy of utility bill or equivalent (e.g.. bark statement. etc.) Note: Separate copies should be provided for each individual Investor. In completing this section, the investor acknowledges that the investment is being made in their name on their own behalf and is not in any way as a representative(s) of any other party(ies). / / Signature of investor(s) in acknowledgement of the above Date 9 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SONY-0085212 CONFIDENTIAL SDNY_GM_00231396 EFTA01384735