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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-0108595
CONFIDENTIAL SONY GM_00254779
EFTA01451786
ℹ️ Document Details
SHA-256
e8b6580e1b304ab21cdc7b4bc01a13b384c7286f38d3a091b76298d27482bd5d
Bates Number
EFTA01451786
Dataset
DataSet-10
Type
document
Pages
1
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