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EFTA Document EFTA01451790Case File
efta-efta01451790DOJ Data Set 10CorrespondenceEFTA Document EFTA01451790
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SOF III - 1081 Southern Financial LLC
Annex B to Investor Questionnaire
Investor Questionnaire Annex B Signature Page
The Investor consents to the provision of the verification documents referenced in this Annex B by the
Investor's Placement Agent to Deutsche Bank Trust Company Americas.
ENTITY INVESTOR SIGN HERE:
INDIVIDUAL INVESTOR SIGN HERE:
(Print Name of Entity)
(Print Name)
By:
(Signature)
(Signature)
(Print Name and Title)
(Date)
(Date)
Deutsche Bank Representative or other Witness signature (required):
Country in which this Agreement was signed:
B4
Confidential
CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0108601
CONFIDENTIAL
SDNY GM_00254785
EFTA01451790
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