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SOF III - 1081 Southern Financial LLC
(please attach additional pages if needed)
Name Signatures Tide Role within the Investor
II. Verification of Status as an "Accredited Investor" under Regulation D.
The Investor represents and warrants that it is an "accredited investor" within the meaning of Regulation
D under the Securities Act and it has initialed the applicable statements below pursuant to which the
Investor so qualifies.
PLEASE INITIAL ALL APPLICABLE STATEMENTS BELOW.
1. The Investor has total assets in excess of $5,000,000 AND was not formed for the specific
purpose of acquiring the securities offered, AND is any of the following:
• a corporation;
• a partnership;
• a limited liability company;
• a Massachusetts or similar business trust: OR
• an organization described in Section 501(e)(3) of the Internal Revenue Code.
2. The Investor is any of the following:
• a bank, or any savings and loan association or other institution acting in its individual or
fiduciary capacity;
• a broker or dealer;
• an insurance company;
• an investment company or a business development company under the Investment
Company Act of 1940, as amended;
• a private business development company under the Investment Advisers Act of 1940;
• a Small Business Investment Company licensed by the U.S. Small Business
Administration; OR
• an employee benefit plan whose investment decision is being made by a plan fiduciary,
which is either a bank, savings and loan association, insurance company or registered
investment adviser, or an employee benefit plan whose total assets are in excess of
$5,000,000 or a self-directed employee benefit plan whose investment decisions are made
solely by persons that arc accredited investors.
Investor Questionnaire - 5
Confidential
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SONY-0108588
CONFIDENTIAL SONY GM_00254772
EFTA01451781
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EFTA01451781
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document
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1
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