EFTA01358676.pdf

(e) 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 (f) List the name and country, in English, of each foreign financial regulatory authority with which the private fund is registered. 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"? ✓ r. (b) If yes, does the private fund invest in funds managed by you or by a related person? 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.)? 10. What type of fund is the private fund? C hedge fund r liquidity fund r private equity fund r real estate fund r securitized asset fund r venture capital fund r Other private fund NOTE: For funds of funds, refer to the funds in which the private fund invests. For definitions of these fund types, please see Instruction 6 of the Instructions to Part 1A. 11. Current gross asset value of the private fund: $ 61,665,000 Ownership 12. Minimum investment commitment required of an investor in the private fund: $ 1,000,000 NOTE: Report the amount routinely required of investors who are not your related persons (even if different from the amount set forth in the organizational documents of the fund). 13. Approximate number of the private fund's beneficial owners: 2 14. What is the approximate percentage of the private fund beneficially owned by you and your related persons: 1% 15. What is the approximate percentage of the private fund beneficially owned (in the aggregate) by funds of funds: 99% 16. What is the approximate percentage of the private fund beneficially owned by non-United States persons: 99% Your Advisory Services Yes No 17. (a) Are you a subadviser to this private fund? ✓ r. (b) If the answer to question 17(a) is "yes," provide the name and SEC file number, if any, of the adviser of the private fund. If the answer to question 17(a) is "no," leave this question blank. No Information Filed YES No 18. (a) Do any other investment advisers advise the private fund? ✓ r. (b) If the answer to question 18(a) is "yes," provide the name and SEC file number, if any, of the other advisers to the private fund. If the answer CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e) DB-SDNY-0046616 CONFIDENTIAL SDNY_GM_00192800 EFTA01358676