EFTA01358728.pdf

A. PRIVATE FUND Information About the Private Fund 1. (a) Name of the private fund: GOLDENTREE LOAN OPPORTUNITIES XII LTD (b) Private fund identification number: (include the "805-" prefix also) 805-6529401973 2. Under the laws of what state or country is the private fund organized: State: Country: Cayman Islands 3. Name(s) of General Partner, Manager, Trustee, or Directors (or persons serving in a similar capacity): Name of General Partner, Manager, Trustee, or Director CHRISTOPHER WATLER, EDMOND KING 4. The private fund (check all that apply; you must check at least one): r (1) qualifies for the exclusion from the definition of investment company under section 3(c)(1) of the Investment Company Act of 1940 F' (2) qualifies for the exclusion from the definition of investment company under section 3(c)(7) of the Investment Company Act of 1940 5. List the name and country, in English, of each foreign financial regulatory authority with which the private fund is registered. No Information Filed Yes No 6. (a) Is this a "master fund" in a master-feeder arrangement? ✓ r. (b) If yes, what is the name and private fund identification number (if any) of the feeder funds investing in this private fund? No Information Filed Yes No (c) Is this a "feeder fund" in a master-feeder arrangement? r (d) If yes, what is the name and private fund identification number (if any) of the master fund in which this private fund invests? Name of the Private Fund: Private Fund Identification Number: (include the "805-" prefix also) NOTE: You must complete question 6 for each master-feeder arrangement regardless of whether you are filing a single Schedule D, Section 7.B.(1). for the master-feeder arrangement or reporting on the funds separately. 7. If you are filing a single Schedule D, Section 7.B.(1) for a master-feeder arrangement according to the instructions to this Section 7.B.(1), for each of the feeder funds answer the following questions: No Information Filed NOTE: For purposes of questions 6 and 7, in a master-feeder arrangement, one or more funds ("feeder funds") invest all or substantially all of their assets in a single fund ("master fund"). A fund would also be a "feeder fund" investing in a "master fund" for purposes of this question if it issued multiple classes (or series) of shares or interests, and each class (or series) invests substantially all of its assets in a single master fund. Yes No 8. (a) Is this private fund a "fund of funds"? ✓ fir (b) If yes, does the private fund invest in funds managed by you or by a related person? ✓ r NOTE: For purposes of this question only, answer "yes" if the fund invests 10 percent or more of its total assets in other pooled investment vehicles, whether or not they are also private funds, or registered investment companies. Yes No 9. During your last fiscal year, did the private fund invest in securities issued by investment companies registered under the Investment ✓ r. Company Act of 1940 (other than "money market funds," to the extent provided in Instruction 6.e.)? CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0046670 CONFIDENTIAL SDNY_GM_00192854 EFTA01358728