Investor Qualification Questionnaire


ALL fields are required.

Password
(12 char. max):

Name:

Age:

ZIP:

Country:

US Citizen:

Yes   No

Work Telephone:

E-mail:

Total Net Worth:

 

Liquid Net Worth:

 

Question #1

Are you filling this out on behalf of your employer/company?
Yes    No


Question #2

Do you own securities and/or other liquid investments having an aggregate market value of at least $2,000,000 (Qualified Eligible Participant)?
Yes    No


Question #3

Do you believe that you have sufficent knowledge and experience in financial and business matters to evaluate the merits and risks of hedge funds and managed accounts?
Yes    No


HEDGE FUNDS AND MANAGED ACCOUNT INVESTMENTS INVOLVE A HIGH DEGREE OF RISK AND ARE SUITABLE ONLY FOR PERSONS OF SUBSTANTIAL FINANCIAL MEANS WHO HAVE NO NEED FOR LIQUIDITY OF THEIR INVESTMENTS AND WHO COULD BEAR THE ENTIRE LOSS OF THEIR INVESTMENT.


Statement #1

  The current value of my liquid assets (cash, freely marketable securities, cash surrender value of life insurance, etc.) is sufficient to provide for my current and anticipated needs and possible contingencies, so that I am capable of bearing the economic risk of hedge fund and managed account investments.


Statement #2

  I hereby acknowledge that the information I will be able to access on Bearing Asset Management's website is not an Offer, but is for information purposes only.  I will not share my password.  Any further formal relationship with Bearing Asset Management may require additional steps to insure adherence to local rules and regulations.


Statement #3

  I hereby represent, warrant and covenant that: (i) I am not, nor is any person or entity controlling, controlled by or under common control with me, a person or entity that acts, directly or indirectly, (a) in contravention of any U.S. or international laws and regulations, including anti-money laundering regulations or conventions, (b) on behalf of terrorists or terrorist organizations, including those persons or entities that are included on the List of Specially Designated Nationals and Blocked Persons maintained by the U.S. Treasury Department's Office of Foreign Assets Control (the list may be accessed on the web at http://www.treas.gov/ofac), as such list may be amended from time to time, (c) for a senior foreign political figure, any member of a senior foreign political figure's immediate family or any close associate of a senior foreign political figure, unless Bearing Asset Management , after being specifically notified by you that you are such a person, determines that access shall be permitted, or (d) for a foreign shell bank, and (ii) to the extent that I have any beneficial owners, (a) I have carried out thorough due diligence to establish the identities of such beneficial owners, and (b) based on such due diligence, I reasonably believe that no such beneficial owners are persons described in (i) above.

By electronically signing below, I am affirming that all the information contained herein is true and correct to the best of my knowledge and belief.

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