Status as Benefit Plan Investor (Please Check Each as Applicable. (i) Is the Subscriber or will the Subscriber be, or is the Subscriber or will the Subscriber be acting on behalf of any entity that is or will be, an employee benefit plan that is subject to Part 4 of Subtitle B of Title I of ERISA, or an entity any of the assets of which include assets of any such plan? ☐ Yes ☐ No
Status as Benefit Plan Investor (Please Check Each as Applicable. (i) The Subscriber is either: (1) an “employee benefit plan” within the meaning of Section 3(3) of ERISA and subject to Part 4 of Subtitle B of Title I of ERISA; (2) a “plan” as defined in Section 4975(e)(1) of the Code to which Section 4975 of the Internal Revenue Code applies; (3) any other entity or account whose underlying assets include “plan assets” by reason of a plan’s investment in the entity and such plan investors include those described in clauses (1) or (2); or (4) an insurance company using general account assets, if such general account assets are deemed to include the assets of any of the foregoing types of plans, accounts or arrangements for purposes of Title I of ERISA or Section 4975 of the Internal Revenue Code under Section 401(c)(1)(A) of ERISA or the regulations promulgated thereunder? ☐ Yes ☐ No
