INVESTOR QUESTIONNAIRE



Access to maglan.com is restricted. In order to obtain access, please complete and submit this form. You will be contacted by a member of our Investor Relations team to verify the information you submit, and your user ID and password will be activated. The investment fund described in this website has not been registered under the federal securities laws of the United States, the securities laws of any state, or the laws of any other jurisdiction. This website shall not constitute an offer to sell or the solicitation of an offer to purchase shares of the fund in any jurisdiction. Such an offer may only be made by the private placement memorandum for the fund, and only to investors who meet certain eligibility requirements. This registration form is not an application form to subscribe for interests in or shares of the fund.



Personal Information
*First Name:
*Last Name:
*Email / Username:
*Password:
Company Name:
*Address 1:
Address 2:
*City:
*State:
*Zip:
Country:
*Phone:


1. You are completing this information on behalf of:
Yourself
Your Organization
Both
2. Are you an accredited Investor Per Section 501(a) of Regulation D
Yes No
If yes, please select one:
Individuals
     The Investor has an individual net worth, or joint net worth with his or her spouse, in excess of $1,000,000. As used herein, "net worth" means the excess of total assets at fair market value, including home furnishings and automobiles (but excluding the value of the primary residence of the Investor), over total liabilities (excluding the indebtedness secured by the primary residence of the Investor up to its fair market value); or
     The Investor had individual income (exclusive of any income attributable to his or her spouse) of more than $200,000 in each of the past two years, or joint income with his or her spouse of more than $300,000 in each of those years, and reasonably expects to reach the same income level in the current year.*
 
Corporations, Partnerships or Limited Liability Companies
     The Investor has total assets in excess of $5,000,000 and was not formed for the specific purpose of acquiring the Interests offered; or
     Each of the Investor's equity owners is an accredited investor as described in this Section III. The General Partner, in its sole discretion, may request information regarding the basis on which such equity owners are accredited.
 
Trusts
     The Investor has total assets in excess of $5,000,000, was not formed for the specific purpose of acquiring the Interests offered and its purchase is directed by a sophisticated person. As used in the foregoing sentence, a "sophisticated person" is one who has such knowledge and experience in financial and business matters that it is capable of evaluating the merits and risks of the prospective investment; or
     The Investor is: (a) a bank as defined in Section 3(a)(2) of the Securities Act, a savings and loan association, or other institution as defined in Section 3(a)(5)(A) of the Securities Act; (b) acting in a fiduciary capacity; and (c) subscribing for the purchase of the Interests being offered on behalf of a trust account or accounts; or
     The Investor is a revocable trust that may be amended or revoked at any time by the grantors thereof and all of the grantors are accredited investors as described herein. The General Partner, in its sole discretion, may request information regarding the basis on which such grantors are accredited.
 
Banks, Savings and Loans and Similar Institutions
     The Investor is a bank as defined in Section 3(a)(2) of the Securities Act or a savings and loan association, or other institution as defined in Section 3(a)(5)(A) of the Securities Act acting in its individual capacity.
 
Insurance Companies
     The Investor is an insurance company as defined in Section 2(13) of the Securities Act.
 
3. Are you a qualified Clients Per Rule 205-3 Under the Investment Advisers Act of 1940
Yes No
If yes, please select one:
Individuals
     The Investor is a qualified purchaser because he/she (alone, or together with his/her spouse, if investing jointly) owns not less than $5,000,000 in investments.*
 
"Family" Corporations, Trusts or Other "Family" Entities
     The Investor: (i) was not formed for the specific purpose of investing in the Partnership; (ii) owns not less than $5,000,000 in investments; and (iii) is owned directly or indirectly by or for: (a) two or more natural persons who are related as siblings or spouse (including former spouses), or direct lineal descendants by birth or adoption; (b) spouses of such persons; (c) the estates of such persons; or (d) foundations, Section 501(c)(3) organizations or trusts established by or for the benefit of such persons.
 
Trusts Other Than Trusts That Qualify under Sections (B) or (D) hereof
     The Investor: (i) was not formed for the specific purpose of investing in the Partnership; and (ii) each trustee (or other authorized person) that is authorized and required to make decisions with respect to this investment is a person described in Sections (A), (B) or (D), at the time the decision to purchase Interests is made, and each settlor or other person who has contributed assets to the Investor is a person described in Sections (A), (B) or (D) at any time such person contributed assets to the Investor.
 
Other Entities
     The Investor: (i) was not formed for the specific purpose of investing in the Partnership; and (ii) is an entity, acting for its own account or the accounts of other qualified purchasers, which in the aggregate owns and invests on a discretionary basis, not less than $25,000,000 in investments (as defined above).
 
Entities That Do Not Qualify under (B)-(D)
     The Investor is a qualified purchaser because each beneficial owner of the Investor's securities is a qualified purchaser as described in this Section IV. Note: This certification does not apply to beneficiaries of an irrevocable trust.
 
All Investors That Are Entities
     The Investor is not an entity that is excepted from the definition of an "investment company" under the Company Act pursuant to Section 3(c)(1) or 3(c)(7) thereof (a "Section 3(c)(1) or 3(c)(7) Company"); or
     The Investor is a Section 3(c)(1) or 3(c)(7) Company but does not have ANY direct "beneficial owners" that have held an interest in the Investor on or before April 30, 1996 (a "Pre-April 30 Holder"); or
     The Investor is a Section 3(c)(1) or 3(c)(7) Company and has obtained consent to its treatment as a qualified purchaser from all of its Pre-April 30 Holders.
 
4. Please choose the category that best describes you:
Fund-of-Funds
Bank
Individual
Fund Manager
Pension Fund
Broker-Dealer
Endowment
Insurance Co.
Family office
Consultant
Foundation
Registered Investment Adviser
Third-Party Marketer
5. You heard about Maglan Capital through (please describe in detail):
News Article:
Conference:
Database/Index:
Current Investor:
Third Party:
Other (Referral):


Anti-Money Laundering Representations:

  1. I hereby acknowledge that the Fund seeks to comply with all applicable laws and regulations concerning money laundering and related activities. I represents that the amounts I contribute to the Fund are not and will not be directly or indirectly derived from activities that may contravene federal, state or international laws and regulations, including anti-money laundering laws and regulations. Federal regulations and Executive Orders administered by the U.S. Treasury Department's Office of Foreign Assets Control ("OFAC") prohibit, among other things, the engagement in transactions with, and the provision of services to, certain foreign countries, territories, entities and individuals (the lists of OFAC prohibited countries, territories, persons and entities can be found at www.treas.gov/ofac). In addition, the programs administered by OFAC (the "OFAC Programs") prohibit dealing with individuals or entities in certain countries regardless of whether such individuals or entities appear on the OFAC lists.
  2. I hereby represent and warrant that none of (i) my, (ii) any person controlling or controlled by me, (iii) if I am representing a privately held entity (including a corporation, limited liability company, trust or partnership), to the best of my knowledge after conducting due diligence, any person having a beneficial interest in me, or (iv) to the best of my knowledge after conducting due diligence, any person for whom I am acting as agent or nominee in connection with this investment, is (x) a country, territory, individual or entity named on an OFAC list, or is a person or entity prohibited under the OFAC Programs or (y) is a senior foreign political figure, any immediate family member or close associate of a senior foreign political figure.
  3. If I represent a non-U.S. banking institution (a "Foreign Bank") or if I receive deposits from, makes payments on behalf of, or handles other financial transactions related to a Foreign Bank, I represent and warrant to the Fund that (i) the Foreign Bank has a fixed address, other than solely an electronic address, in a country in which the Foreign Bank is authorized to conduct banking activities, (ii) the Foreign Bank employs one or more individuals on a fulltime basis, (iii) the Foreign Bank maintains operating records related to its banking activities, (iv) the Foreign Bank is subject to inspection by the banking authority that licensed the Foreign Bank to conduct banking activities; and (v) the Foreign Bank does not provide banking services to any other Foreign Bank that does not have a physical presence in any country and that is not a regulated affiliate.
  4. I acknowledge that if any of the foregoing representations, warranties or covenants ceases to be true or if the General Partner no longer reasonably believes that it has satisfactory evidence as to their truth, notwithstanding any other agreement to the contrary, the General Partner may be required to freeze my investment in the Fund, either by prohibiting additional investments, declining or suspending any withdrawal requests and/or segregating the assets constituting the investment in accordance with applicable regulations, or my investment may immediately be involuntarily distributed by the Fund. In the event that the Fund is required to take any of the foregoing actions, I understand and agree that I shall have no claim against the Fund, the General Partner, the Investment Manager or any of their respective Affiliates, for any form of damages as a result of any of the aforementioned actions.
  5. I understand and agree that any withdrawal proceeds paid to me will be paid to the same account from which my investment in the Fund was originally remitted, unless the General Partner, in its sole discretion, agrees otherwise.
  6. I understand that the Fund, the General Partner or the Investment Manager may release confidential information about me and, if applicable, any underlying beneficial owners, to proper authorities if required by law or if the General Partner or Investment Manager, in its sole discretion, determines that it is in the best interests of the Fund in light of relevant rules and regulations under the laws set forth above.
  7. If I represent a financial institution (as defined under the Anti-Money Laundering Act), I represent that it has an appropriate anti-money laundering program that complies with all applicable laws, rules and regulations and has obtained appropriate background information regarding all of the officers, managers, directors, trustees and beneficial owners of the institution.


Thank you very much for your time. By pressing the "Submit/I Agree" button below, you agree that you have filled in this questionnaire completely, truthfully and to the best of your ability and that you also have read and agree to the Terms of Use Agreement which you should review carefully.