AKANTHOS CAPITAL MANAGEMENT, LLC
Website Questionnaire

 

 

The undersigned user of this website (“Website User”) hereby requests access to the Akanthos Capital Management, LLC (“ACM”) website.
 

First Name

Last Name

Company

Address
Phone
Fax
Email

 

In reliance on the following representations and warranties, ACM may, in its sole discretion, issue an individualized password providing access to its website or certain parts of its website.
 

A.

If the Website User is a potential or existing investor in any fund managed by ACM (a “Fund”), the Website User hereby represents and warrants that it (please check a box with respect to each numbered question):

 
1.

has knowledge and experience in financial, tax and business matters and is capable of evaluating the merits and risks of an investment in a Fund;

   

 
2.

has been advised that an investment in a Fund is highly speculative and is able to bear the economic risk of an investment in a Fund;
   

 
3.

is evaluating this Fund for its own account and not in view of a resale or distribution.
   

 
4.

did not learn of the Fund through publicly-available Internet sites;
   

 
5.

is authorized and otherwise qualified to acquire an interest in a Fund and, except as otherwise disclosed to ACM in writing, was not organized for the specific purpose of acquiring an interest in the Fund;
     
6.

is a professional advisor, investor, consultant or custodian to one or more existing investors in a Fund (if so, please list below);
     
   
Name of Account(s):
Account Number(s):
     
7.

is a professional advisor, consultant or custodian to one or more potential investors in a Fund (if so, please list below);
     
   
Name of Account(s):
   

 
8.

is not a “U.S. Person” as defined in Rule 902(o) of Regulation S under the U.S. Securities Act of 1933, as amended (the “Securities Act”), or within the meaning of the U.S. Investment Company Act of 1940, as amended (the “Investment Company Act”) and is not requesting access to the ACM website for or on behalf of, or for the benefit of, any such “U.S. Person”; or
   

 
 

is a “U.S. Person” as described in foregoing statement and an “accredited investor” as defined in Regulation D under the Securities Act because:
   

 
   

(i) it is either (a) a corporation; (b) an organization described in Section 501(c)(3) of the U.S. Internal Revenue Code of 1976, as amended; (c) a Massachusetts or similar business trust; or (d) a partnership, in each case not formed for the specific purpose of investing in a Fund and, in each case, with total assets in excess of $5 million;
 

 

(ii) it is either (a) a bank or any savings and loan association or other institution acting in its individual or fiduciary capacity; (b) a broker or dealer; (c) an insurance company; (d) any investment company or a business development company under the Investment Company Act or a private business development company under the Investment Company Act, as amended; (e) a Small Business Investment Company licensed by the U.S. Small Business Administration; or (f) 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, a registered investment adviser, an employee benefit plan whose total assets are in excess of $5 million, or a self-directed employee benefit plan whose investment decisions are made solely by persons who are accredited investors;
 

 

(iii) it is a trust not formed for the specific purpose of investment in a Fund, with total assets in excess of $5 million and whose investments are directed by a sophisticated person; or
   

(iv) it is an entity as to which all equity owners are accredited investors (if this statement applies to you and statements (i) to (iii) above do not, each of your equity owners must submit an individual questionnaire as provided by ACM);
 
 

B.

By completing this questionnaire, if you are granted access to the website by ACM, you agree that the information on the website is confidential and that you will use the information only in connection with evaluating or analyzing a potential or actual investment in any of the Funds. You may not use the information on the website for any other purpose and may not in any manner publish, disclose or redistribute such information to any third party.
 
 
 

Please indicate below whether you agree to the foregoing and accept the Terms and Conditions of use of this Website:

 
I accept I do not accept