In order to obtain access to this website, please complete and submit this form.

Personal Information:

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


1. You are completing this information on behalf of:

Yourself
Your Organization
Both


2. Are you an accredited investor in accordance with Rule 501(a) of Regulation D of the Securities Act of 1933?

Yes No

If yes, please select one:

I am a natural person who owns at least $5,000,000 in investments (as defined in Rule 2a51-1 under the Investment Company Act of 1940).

I represent a company that (i) owns at least $5,000,000 in investments and (ii) is owned directly or indirectly by or for two or more natural persons who are related as siblings or spouses (including former spouses), or direct lineal descendants by birth or adoption, spouses of such persons, the estates of such persons, or foundations, charitable organizations, or trusts established by or for the benefit of such persons.

I represent a trust that was not formed for the specific purpose of acquiring the securities offered, as to which the trustee or other person authorized to make decisions with respect to the trust, and each person who has contributed assets to the trust, is a qualified purchaser described in clauses (i), (ii), or (iv) of Section 2(a)(51) of the Investment Company Act of 1940.

I am a natural person or an entity who/which is acting for its own account or the accounts of other qualified purchasers and who/which in the aggregate owns and invests on a discretionary basis at least $25,000,000 in investments.

I am a qualified institutional buyer as defined in Rule 144A under the Securities Act of 1933 that is acting for its own account, the account of another qualified institutional buyer, or the account of a qualified purchaser, provided that I am not (1) a dealer described in Rule 144A(a)(1)(ii), that owns and invests on a discretionary basis less than $25,000,000 in securities of issuers that are not affiliated persons of the dealer, or (2) a plan referred to in Rule 144A(1)(1)(i)(D) or (E), or a trust fund referred to in Rule 144A(a)(1)(i)(F) that holds the assets of such a plan, the investment decisions with respect to which are made by the beneficiaries of the plan, unless the investment decisions are made solely by the fiduciary, trustee, or sponsor of such plan.

I represent an entity the outstanding securities of which are beneficially owned solely by qualified purchasers.


3. Are you a qualified purchaser in accordance with Section 2(a)(51) of the Investment Company Act of 1940?

Yes No

If yes, please select one:

I am a natural person who owns at least $5,000,000 in investments (as defined in Rule 2a51-1 under the Investment Company Act of 1940).I represent a company that (i) owns at least $5,000,000 in investments and (ii) is owned directly or indirectly by or for two or more natural persons who are related as siblings or spouses (including former spouses), or direct lineal descendants by birth or adoption, spouses of such persons, the estates of such persons, or foundations, charitable organizations, or trusts established by or for the benefit of such persons.

I represent a trust that was not formed for the specific purpose of acquiring the securities offered, as to which the trustee or other person authorized to make decisions with respect to the trust, and each person who has contributed assets to the trust, is a qualified purchaser described in clauses (i), (ii), or (iv) of Section 2(a)(51) of the Investment Company Act of 1940.

I am a natural person or an entity who/which is acting for its own account or the accounts of other qualified purchasers and who/which in the aggregate owns and invests on a discretionary basis at least $25,000,000 in investments.

I am a qualified institutional buyer as defined in Rule 144A under the Securities Act of 1933 that is acting for its own account, the account of another qualified institutional buyer, or the account of a qualified purchaser, provided that I am not (1) a dealer described in Rule 144A(a)(1)(ii), that owns and invests on a discretionary basis less than $25,000,000 in securities of issuers that are not affiliated persons of the dealer, or (2) a plan referred to in Rule 144A(1)(1)(i)(D) or (E), or a trust fund referred to in Rule 144A(a)(1)(i)(F) that holds the assets of such a plan, the investment decisions with respect to which are made by the beneficiaries of the plan, unless the investment decisions are made solely by the fiduciary, trustee, or sponsor of such plan.

I represent an entity the outstanding securities of which are beneficially owned solely by qualified purchasers.


4. What investment styles suit your particular interest in hedge funds?



5. What are your return objectives?




6. What is your investment horizon?

Long Term (>5 years)
Med Term (2-5 years)
Short Term (<2 years)



7. What is your risk tolerance?

High (Aggressive)
Moderate
Low (Conservative)



8. Do you invest in hedge funds?

Yes No

If yes,

How many years have you been investing in hedge funds?
Approximately how many hedge funds are you invested in?
What percentage do hedge funds comprise of your portfolio?
Do you leverage your investments in hedge funds? Yes No
How much leverage do you utilize?
Who is your leverage provider?
What are the terms of your leverage with that provider?
What is the approximate total value (in US$) of your hedge fund portfolio?
What is the approximate total value (in US$) of your current credit exposure?
What is your average investment size?
Once you invest, how long does it take to get to your average investment size?
What is your turnover in hedge fund investments?



9. 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

If You selected Funds-of-Funds:

What percentage of your assets are institutional investors versus high-net worth?
Do you have lock-up money?
What is your average investment size?
Once you invest, how long does it take to get to your average investment size?
How soon can a manager come visit us?



10. You heard about Locust Wood Capital through (please describe in detail):

News Article:
Conference:
Database/Index:
Current Investor:
Third Party:
Other (Referral):



Anti-Money Laundering Certification

This section must be completed for you/beneficial investor. For this section, please see Definitions.

By submitting this form, I hereby represent and certify that I am not involved in any anti-money laundering scheme and that my investment funds have not been directly or indirectly derived from activities that may contravene U.S. or international laws, rules and regulations designed to avoid money laundering, including, without limitation, the provisions of the Bank Secrecy Act of 1970, as amended. Neither I nor any person controlling, controlled by, or under common control with me, nor any person having a beneficial interest in my investments is a country, territory, person or entity named on the U.S. Department of Treasury’s Office of Foreign Asset Control list, or is a person or entity that resides or has a place of business in a country or territory named in such lists. I agree to notify you promptly should I become aware of any changes to the information set forth in this statement. I hereby agree to hold ACI Capital, LLC and each of its principals, members, directors, officers, and employees harmless and to indemnify the same against any loss arising as a result of a inaccuracy in the foregoing or any other statement in this questionnaire.

If I am (I) acting as trustee, agent, representative or disclosed nominee for another person or entity, or (II) an entity investing on behalf of underlying investors (including a fund-of-funds), other than a publicly traded company listed on an organized exchange (or a subsidiary or a pension fund of such a company) based in a Financial Action Task Force (FATF) Compliant Jurisdiction (the persons, entities and underlying investors referred to in (I) and (II) being referred to collectively as the (Beneficial Owners), I represent and warrant that:

  • I understand and acknowledge the representations, warranties and agreements made herein are made by me (A) with respect to me, and (B) with respect to the Beneficial Owners
  • I have all requisite power and authority from the Beneficial Owners to execute and perform the obligations under this Questionnaire and Registered Users Agreement
  • I have adopted and implemented anti-money laundering policies, procedures and controls that comply with, and will continue to comply in all respects with, the requirements of applicable anti-money laundering laws and regulations
  • I have established or have access to the identity of all Beneficial Owners, hold evidence of or have access to such identities and will make such information available to a fund upon request and have procedures in place to ensure that the Beneficial Owners are not Prohibited Investors.


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.

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