Common use of Individuals Clause in Contracts

Individuals. Please complete the following information if you are investing as an individual or jointly with another individual: Name: ________________________. Spouse's full name, if jointly held: ________________________. Date of birth: ________________________. Citizenship: ________________________. Permanent home address: ________________________ ________________________________________________ Marital status: ________________________. Address for notices: ________________________ ________________________________________________ Home telephone number: ________________________. Business telephone number: ________________________. Social security or tax identification number: ________________________. Occupation or profession: ________________________. Are you purchasing Shares for your own account? Yes No If you are not purchasing Shares for your own account, please complete the following:

Individuals. Please complete the following information if you are investing as an individual or jointly with another individual: Name: ________________________. Spouse's ’s full name, if jointly held: ________________________. Date of birth: ________________________. Citizenship: ________________________. Permanent home address: ________________________ ________________________________________________ Marital status: ________________________. Address for notices: ________________________ ________________________________________________ Home telephone number: ________________________. Business telephone number: ________________________. Social security or tax identification number: ________________________. Occupation or profession: ________________________. Are you purchasing Shares for your own account? Yes No If you are not purchasing Shares for your own account, please complete the following:

Individuals. Please complete the following information if you are investing as an individual or jointly with another individual: Name: ________________________. Spouse's full name, if jointly held: ________________________. Date of birth: ________________________. Citizenship: ________________________. Permanent home address: ________________________ ________________________________________________ Marital status: ________________________. Address for notices: ________________________ ________________________________________________ Home telephone number: ________________________. Business telephone number: ________________________. Social security or tax identification number: ________________________. Occupation or profession: ________________________. Are you purchasing Shares for your own account? Yes No If you are not purchasing Shares Units for your own account, please complete the following:

Individuals. Please complete the following information if you are investing as an individual or jointly with another individual: Name: ________________________________________________________. Spouse's full name, if jointly held: __________________________________. Date of birth: ___________________________________________________. Citizenship: ____________________________________________________. Permanent home address: __________________________________________ __________________________________________. Marital status: ___________________________________________________. Address for notices: _______________________________________________ ________________________________________________ Marital status. Home telephone number: ________________________. Address for notices: ________________________ ________________________________________________ Home . Business telephone number: ________________________. Business telephone number: ________________________. Social security or tax identification number: ____________________________. Occupation or profession: __________________________________________. Are you purchasing Shares for your own account? Yes No If you are not purchasing Shares for your own account, please complete the following:

Individuals. Please complete the following information if you are investing as an individual or jointly with another individual: Name: ________________________. _________________________ Spouse's full name, if jointly held: _____________________________. Date of birth: ________________________. _____________________________ Citizenship: ________________________. _____________________________ Permanent home address: ________________________ ___________________ __________________________________________ Marital status: ________________________. _____________________________ Address for notices: ________________________ ___________________ __________________________________________ Home telephone number: ________________________. __________________ Business telephone number: ________________________. __________________ Social security or tax identification number: ________________________. _ Occupation or profession: ________________________. __________________ Are you purchasing Shares for your own account? Yes __________ No __________ If you are not purchasing Shares for your own account, please complete the following: