EFTA00236102.pdf

UBS Financial Services Inc. UBS Account Number Client Eligibility Certification: Initial Public Offerings of Equity Securities Account Title Ghislaine Maxwell As a distributor of initial public offerings (IPOs), UBS Financial Services Inc. (the Firm) is subject to regulatory requirements that prohibit the allocation of IPOs of equity securities to accounts owned by certain people. In order for the Firm to determine whether you and all account holders for joint and other multiple-accounts are eligible to receive allocations of IPOs from the Firm, an authorized signatory for your account must be able to make the representation in both Section I AND Section II. If you are unable to check the boxes in Section I and Section II, you will not be eligible to receive IPO allocations from the Firm. In addition, if this Certification form is retumed unsigned or is considered not completed, you will not be eligible to receive IP0 allocations from the Firm. For your convenience, all underlined terms are defined on the back of this form. 1. Financial Industry Regulatory Authority (FINRA) Rule 5130 - Restrictions on the Purchase and Sale of IPO Equity Securities by Securities Industry Professionals Restricted Persons: FINRA Rule 5130 generally prohibits a broker dealer from selling an IPO to any account in which a restricted person has a beneficial interest, unless the restricted person is eligible for an exemption. A restricted person is defined as: 1. An officer, director, general partner, associated person or c. Has the abaity to control the allocation of the IPO. employee of a broker dealer (other than a limited business broker dealer). S. A finder or any person acting in a fiduciary capacity to the managing underwriter with respect to the security offered, 2. An agent of a broker dealer (other than a limited business broker including but not limited to, attomeys, accountants and financial dealer) engaged in the investment banking or securities business. consultants. 3. Owners and affiliates of broker dealers (other than a limited 6. An individual who has the authority to buy or sell securities for a business broker dealer). bank, savings and loan institution, insurance company, investment company, investment advisor or (Ankle investment 4. An immediate family member of 1, 2 or 3 above if the person account. referenced in 1, 2 or 3: a. Materially supoons or receives material suppen from the 7. An immediate family member of (5) or (6) above if the person immediate family member or referenced in (5) or (6) materially suonorts or receives material b Is employed, associated with, or owns the broker dealer, or an groom from the immediate family member. affiliate of the broker dealer, selling the security to the immediate family member; or g Please check this box if your account is NOT beneficially owned by any restricted person as defined above OR is eligible for an exemption (see reverse side for exemptions and indicate Exemption Number ). II. FINRA Rule 5131 • Equity IPO Allocations and Distributions to Executive Officers and Directors of Certain Public and Non-Public Companies Restricted Coveted Persons: FINRA Rule 5131 generally prohibits a broker dealer from allocating an IPO under certain circumstances to any account in which a Covered Person, or someone materially supported by a Covered Person has a beneficial A Covered Person is defined as an executive officer or director of a all( comfeagy or a covered non g Please check this box if your account is NOT henefirially owned by any GuelesLPeczta OR is eligible for an exemption (see reverse side for exemptions and indicate Exemption Number ). Certification As a person(s) duly authorized to represent the account, I (we) certify that all representations in this document are true and correct as of the date below, and further agree to promptly notify the Firm, in writing, if any of the above information changes or becomes inaccurate or • ificrlirriplete . . Ghislaine Maxwell First Name Last Name Signature Date 0104012997 I AC-ID (Rev. 10/11) Pi MEM I( O2011 UBS Financial Services Inc All rights eserved. Member S Page 1/2 CONFIDENTIAL UBSTERRAMAR000003B9 EFTA00236102  UBS Explanation of Terms • "Beneficial Interest" means any economic interest, such as the • "Collective investment account" means any hedge fund, right to share in gains and losses. This does not include the investment partnership, investment corporation or any other receipt of a management or performance fee for operating a collective investment vehicle that is engaged primarily in the collective investment account, or other fees for acting in a purchase and/or sale of securities. A collective investment fiduciary capacity account does not include a family investment vehicle (i e., a legal entity that is beneficially owned solely by immediate family • "Covered Person" means an executive officer or director of a members) or an investment club (i.e., a group of friends, public company or a covered non public company. neighbors, business associates, or others that pool their money to invest in stock or other securities and are collectively responsible • Immediate family member" means an individual's parents, for making investment decisions). mother in law or father in law, spouse, brother or sister, brother in law or sister in law, son in law or daughter in law and children • "Public company" means any company that is registered under and any other person to whom the person provides material Section 12 of the Securities Exchange Act of 1934 or files period support. reports under Section 15(d) thereof. These companies are commonly know as 'reporting companies.' Public information • "Limited business broker-dealer" means any broker-dealer about reporting companies is available at the SEC's website, whose authorization to engage in the securities business is www.sec.gov. limited solely to the purchase and sale of investment company/ variable contracts securities and direct participation program • "Covered non public company" means any non public securities. company satisfying the following criteria! (i) income of at least Si million in the last fiscal year or in two of the last three fiscal years • "Material support" means directly or indirectly providing more and shareholders' equity of at least $15 million; (ii) shareholders' than 25% of a person's income in the prior calendar year. equity of at least 530 million and a two year operating history; or Members of the immediate family member living in the same (iii) total assets and total revenue of at least 575 million in the household are deemed to be providing each other with material latest fiscal year or in two of the last three fiscal years. support Exemptions from FINRA Rules 5130 and 5131 1. Small Ownership Amount. The heftekithatattSIS of: 6 Non-U.S. Mutual Funds. An investment company organized a. restricted persons, in the aggregate, do not exceed 10% of under the laws of a foreign jurisdiction provided that the the account (for Rule 5130); and investment company is listed on a foreign exchange or b. Covered Persons of a particular company, in the aggregate. authorized for sale to the public by a foreign regulatory authority do not exceed 25% of the account (for Rule 5131). and that no person owning $ percent or more of the investment company is a restricted person. 2. Mutual Funds. An investment company registered under the Investment Company Act of 1940. 7. Retirement Funds. An ERISA benefits plan that is qualified under Section 401(a) of the Internal Revenue Code, provided that such 3 Common Trust Funds. A common trust fund that has plan is not sponsored solely by a broker dealer. investments from 1000 or more accounts and does not lout interests in the fund principally to trust accounts of restricted 8. Government Benefits Plans. A state or municipal government persons benefits plan that is subject to state and/or municipal regulation. 4. Insurance Company Accounts. A insurance company general. 9. Charitable Organizations. A tax exempt charitable organization separate, or investment account provided that (a) the account is under Section $01(c)(3) of the Internal Revenue Code. funded by premiums from 1000 or more policyholders or. if a general account. the insurance company has 1000 or more 10 Church Plans. A church plan under Section 414(e) of the Internal policyholders and (b) the insurance company does not limit the Revenue Code. policyholders whose premiums are used to fund the account principally to restricted persons, or if a general account, the insurance company does not limit its policyholders principally to restricted persons. S. listed Companies. A publicly traded entity (other than a broker dealer or an affiliate of a broker dealer where such broker dealer is authorized to engage in the public offering of new issues either as a selling group member or underwriter) that is listed on a national securities exchange, is traded on the NASDAQ National Market, or is a foreign issuer whose securities meet the quantitative designation criteria for listing on a national securities exchange or the NASDAQ National Market. 0104012997 AC-ID (Rev. 10/11) 1 432011 UBS Financial Services Inc. All rights eserved. Member S PC. Page )/2 CONFIDENTIAL UBSTERRAMAR00000390 EFTA00236103