EFTA01452244.pdf

SOF III - 1081 Southern Financial LLC FORM PF This section is to be completed by all investors. Please check the item below that best describes the subscriber. If the subscriber is acting as trustee, agent, representative or nominee for a beneficial owner, please check the item that best describes the beneficial owner. Please check one: ❑ Individual that is a United States person' (or a trust of such a person) ❑ Individual that is not a United States person (or a trust of such a person) ❑ A person that is not a United States person and about which beneficial ownership information is not known and cannot reasonably be obtained because the beneficial interest is held through a chain involving one or more third-party intermediaries ❑ Broker-dealer ❑ Insurance company ❑ Investment company registered with the SEC ❑ Private fund' ❑ Non-profit ❑ Pension plan (other than a governmental pension plan) ❑ Banking or thrift institution (proprietary) ❑ State or municipal government entity'(other than a governmental pension plan) ❑ State or municipal governmental pension plan ❑ Sovereign wealth fund or foreign official institution ❑ Other. Please specify: For purposes of this Form PF, the term "United States person" has the meaning provided in Rule 203(m)-1 under the U.S. Investment Advisers Act of 1940, as amended, which includes any natural person that is resident in the United States. A "private fund" means any issuer that would be an investment company as defined in Section 3 of the 1940 Act but for Section 3(cXI) or 3(c)(7) of the 1940 Act. A "government entity" means any U.S. state (including any U.S. state, the District of Columbia, Puerto Rico, the U.S. Virgin Islands or any other possession of the United States) or political subdivision of a state, including (i) any agency, authority or instrumentality of the state or political subdivision; (ii) a plan or pool of assets controlled by the slate or political subdivision or any agency. authority or instrumentality thcmof; and (iii) any officer. agent. or employee of the state or political subdivision or any agency, authority or instrumentality thereof, acting in their official capacity. Investor Questionnaire - 12 Confidential CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0109161 CONFIDENTIAL SDNY_GM_00255345 EFTA01452244