EFTA Document EFTA01387896

Investment Experience of Account Owner(s) Year First Traded Options Equities Fixed Income Commodities and Futures Structured Products OTC Derivatives Foreign Currency Alternative Investments (Hedge Funds, Private Equity) Average M Trades Per Year Investment Objectives for the Client Account (Select up to two adjacent objectives): Average Size of Types of Previous Option Trades in $ Experience Covered Call Writing Purchased Options Option Spreads Uncovered Put Writing Uncovered Call Writing None Capital Preservation 1 Income Growth Aggressive Growth Representations Relating to Qualification of the Client Check all that apply. At least one category must be checked. I represent that Client qualifies as an "Accredited Investor" as defined in Regulation D under the Securities Act of 1933 because Client is: a natural person with individual income exceeding $200,000 in each of the two most recent years or joint income with a spouse exceeding 5300,000 in each of those years and a reasonable expectation of the same income level in the current year; a natural person with individual net worth, or joint net worth with a spouse, over $1,000,000, excluding primary residence; a trust with assets in excess of $5,000,000, not formed for the specific purpose of acquiring the securities offered, whose purchases are directed by a sophisticated person; •::", a revocable trust that may be amended or revoked at anytime by the grantors and where all of the grantors are accredited investors; a charitable organization, corporation or partnership with assets exceeding $5,000,000; a business in which all the equity owners are accredited investors; a bank, savings and loan association, registered broker or dealer, insurance company, registered investment company, business development company or licensed small business investment company, • an employee benefit plan, within the meaning of ERISA, if a plan fiduciary that is a bank, insurance company or registered investment adviser makes the investment decisions, or if the plan has over $5,000,000 in total assets or a self-directed plan with investment decisions made solely by accredited investors; a plan established and maintained by a state, its political subdivisions or any agency or instrumentality thereof, for the benefit of its employees with total assets in excess of $5,000,000; or ..; a director, executive officer or general partner of the issuer of the securities being offered. WM179078 SPAA OBSI 013017.093017 Rice 2 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0091108 CONFIDENTIAL SDNY_GM_00237292 EFTA01387896