INDIVIDUAL INVESTORS. ¨ Any natural person whose net worth, or joint net worth with that person’s spouse, at the time of the purchase exceeds US$1,000,000, excluding the value of the primary residence of such natural person or persons. ¨ Any natural person who had an individual income in excess of US$200,000 in each of the two most recent years or joint income with that person’s spouse in excess of US$300,000 in each of those years and has a reasonable expectation of reaching the same income level in the current year. ¨ Any executive officer or director of the Company.
INDIVIDUAL INVESTORS. Investors that are not individuals (that is, are corporations, partnerships, trusts, etc.) should start at PART II.
1. Name (as it should appear on stock certificate): ______________________________________________________________________
2. Residence address: ________________________________________________ ______________________________________________________________________
3. Home telephone: __________________________________________________
4. Date of birth: _____________________________________________________
5. Social security number: _____________________________________________
6. United States citizen: o Yes o No If no, country of citizenship:_______________________________________________
7. Occupation: ____________________________________________________
8. Number of years: _________________________________________________
9. Present employer: __________________________________________________
10. Position/Title: _____________________________________________________
11. Business address: __________________________________________________ _______________________________________________________________________ 12. Business telephone: _________________________________________________
INDIVIDUAL INVESTORS. (Investors other than individuals should turn to Part II)
1. True False You are a citizen of a country other than the United States.
2. If the answer to the preceding question is true, specify the country of which you are a citizen. Verification of Status as a Non-“U.S. Person” under Regulation S.
3. True False You are a natural person resident in the United States.
INDIVIDUAL INVESTORS. Social Security Number Print Name of Investor No. 1
INDIVIDUAL INVESTORS. 1. Amount of Investment
INDIVIDUAL INVESTORS. 个体投资者 (个体以外的投资者请参阅第二部分) INITIAL EACH BOX TRUE OR FALSE OR COMPLETE, AS APPROPRIATE 每个选项为TRUE或FALSE或COMPLETE，视情况而定 Disclosure of Foreign Citizenship.披露外国国籍。
1. True False You are a citizen of a country other than the United States. 你是美国以外国家的公民。
2. If the answer to the preceding question is true, specify the country of which you are a citizen. 如果上述问题的答案为True，请说明你是哪个国家的公民。 Verification of Status as a Non-“U.S. Person” under Regulation S.根据S条例核实非“美国人”身份
3. True False You are a natural person resident in the United States. 你是一个居住在美国的自然人。
INDIVIDUAL INVESTORS. If the undersigned (i.e. the potential offeree and purchaser of the Securities) is an individual, then the undersigned individual hereby represents and warrants that each statement initialed or checked below is true and correct regarding the undersigned individual (initial or check each statement below that applies to the undersigned individual):
(1) The undersigned's individual net worth, or joint net worth with the undersigned's spouse or spousal equivalent, exceeds $1,000,000. ("Net worth" means the excess of total assets, excluding your primary residence, at fair market value over total liabilities, including your mortgage or any other liability secured by your primary residence only if and to the extent that it exceeds the value of your primary residence. "Net worth" can include the value of any other shares of stock or options and any personal property (e.g. furniture, jewelry, other valuables. "Joint net worth" means the aggregate net worth of you and your spouse or spousal equivalent; assets do not need to be held jointly to be included in the calculation.)
INDIVIDUAL INVESTORS. You must initial here ( ) if you do not meet any of the “New Issue Restricted Person” criteria in Appendix A. If you do not wish to participate in the Fund’s investments in these types of securities, please initial here ( ).
INDIVIDUAL INVESTORS. 第1部分 个人投资方：
INDIVIDUAL INVESTORS. (Investors other than natural persons (for example, corporations, limited liability companies, partnerships and trusts) should turn to Part II on page 4)
