EFTA01395755.pdf

GLDUS143 Henry Nicholas Letter of Authorization for Fund Investment Dear Client: In connection with your subscription for an interest in the alternative investment fund listed below (the "Fund") that is managed by iCapital Advisors, LLC (the "Manager") and offered by Deutsche Bank Securities Inc. ("Deutsche Bank") as placement agent, Deutsche Bank will be required to provide the Manager, the Fund or their affiliates, or the Fund's administrator (collectively referred to herein as "iCapital Parties") with certain information about you, as follows: 1. If you are a natural person: Your name, residential address, and social security or other tax identification number; Evidence regarding date of birth and confirmation of middle initial of name; Copies of identification documents such as your passport or driver's license; Other information related to verification of identity and financial condition as required by applicable law. 2. If you are a corporate structure or trust: Incorporation documentation / formation documentation (for example, certificate of incorporation, memorandum & articles, trust deed (including incorporation documentation for any corporate entities or trusts who are beneficial owners of the undersigned); ID documentation for individuals who are beneficial owners (>25%); Other information related to verification of identity and financial condition as required by applicable law. This information is referred to herein as the "Information". Accordingly, Deutsche Bank requests your consent to share your Information with the iCapital Parties and to receive from the iCapital Parties information pertaining to your Fund investment. Deutsche Bank regards protecting your personal information as one of our fundamental responsibilities. *** PLEASE TURN THE TO NEXT PAGE * * * Confidential 1 EFTA01395755 GLDUS143 Henry Nicholas *** PLEASE CHECK THE FOLLOWING BOXES AND SIGN BELOW *** Name of Fund: Glendower Access Secondary Opportunities IV (U.S.), L.P. ❑ The undersigned authorizes Deutsche Bank to provide the undersigned's Information to the iCapital Parties in order to assist the iCapital Parties to verify the undersigned's identity or obtain other "know your customer" information in connection with the undersigned's investment in the Fund. ❑ The undersigned authorizes Deutsche Bank to transfer funds from the undersigned's Deutsche Bank account referenced below (the "Client Account") in order to fund any required capital contribution by the undersigned to the Fund. ❑ In addition, the undersigned authorizes Deutsche Bank to receive from the iCapital Parties any information relating to the undersigned's Fund investment, including but not limited to all correspondence, statements of account and valuations, at the electronic and/or physical address directed by Deutsche Bank. ❑ The undersigned acknowledges that (1) Fund interests will not be held at Deutsche Bank; (2) estimated values of the Fund provided by the iCapital Parties to Deutsche Bank and reported on Client Account statements provided by Deutsche Bank will be for informational purposes only and may not reflect current Fund values or recent activity; and (3) statements of account for the Fund will be sent directly to the undersigned by the iCapital Parties, and not by Deutsche Bank. The undersigned's authorization shall be valid until revoked in writing. Client Authorization: (If you are signing on behalf of your organization, please ensure you are an authorized signatory) Name: Signature: Title (if applicable): Date: Deutsche Bank Representative Name / Number (if applicable): Subscription Amount: $ Confidential 2 EFTA01395756 GLDUS143 Henry Nicholas Placement Fee: $ Initial Capital Contribution Amount: $ Deutsche Bank Account Number: Confidential 3 EFTA01395757