Investor Access

Form of Investor Qualification Questionnaire & Agreement

The information contained in this Investor Qualification Questionnaire and Agreement is being furnished by you in connection with determining whether you will be granted access to certain password-protected areas of the website of GordonMD® Global Investments LP (“GordonMD®”).

Are you a current GordonMD® Investor? (Yes/No toggle choice for answer):

Yes
No

Representation (Fill out one):



1

Specifications

2

Background
Information

3

Confirmation

Specifications

Definition and Valuation of “Investments” for Purposes of Determining Accredited Investor Status

Unless otherwise indicated below, the following general rules are applicable when determining your “accredited investor” status for purposes of Section 5 of this Agreement.

  1. “Investments” should be valued at either their fair market value as of the most recent practicable date or at cost.
  2. “Investments” include investments held jointly with your spouse.
  3. “Investments” include investments held in any individual retirement account, 401(k) or similar retirement account directed by you and held for your benefit.
  4. The term “Investments” includes the following:
    • (A) securities which are publicly-traded and listed on a U.S. national securities exchange or traded on NASDAQ;
    • (B) shares in registered investment companies such as mutual funds and money market funds;
    • (C) interests in private investment companies such as hedge funds, commodity pools and similar private investment companies;
    • (D) cash and cash equivalents (including foreign currencies) held for investment purposes;
    • (E) real estate held for investment purposes;
    • (F) shares of non-public companies which have total shareholder equity of $50 million or more; and
    • (G) commodity interests, including commodity futures contracts and options thereon, swaps and other financial contracts.
  5. The term “Investments” DOES NOT include the following:
    • (A) jewelry, artwork, antiques and collectibles;
    • (B) investments held in retirement accounts where you do not make the investment decisions (e.g., an employer retirement plan where the investment decisions are not directed by you); and
    • (C) shares in a non-public company in which you have a controlling interest (presumed to exist if you own more than 25% of the voting interests).

Background Information

01General Information

Full Name

Residence Address

Contact Information

02Employment & Business Information

Employer Contact Information

(include all information for the last five years)

+ add employer

03Send Correspondence To



04Educational Background

Educational History

(Beginning with college)

+ add institution

05Financial Information










Does the above income include income received from your spouse or spousal equivalent?



1“Good Standing” means the individual has passed the required examination and currently maintains his or her license or registration, as applicable, in good standing.

2“Please refer to the “Worksheet” for the definition of “Investments” and information regarding the valuation of “Investments”.

06Investor Qualification Representations



07Investment Experience






Acknowledgement & Agreement

The information set forth above is accurate and complete as of the date hereof, and you agree to promptly notify GordonMD® of any material change in such information. You hereby consent to the disclosure of any such information, and any other information furnished to GordonMD®, to any governmental authority, self-regulatory organization or, to the extent required by law, to any other person.

You agree that your rights and interests in gaining access to the information posted in the GordonMD® website are not transferable or assignable.

You acknowledge that in order to make an investment in an investment fund managed by GordonMD®, you will be required to comply with the applicable fund's investment requirements.

You acknowledge and agree that you may not invest in funds posted on the GordonMD® web site for at least 30 days after you have received a password from GordonMD®.

This Agreement shall be governed by, and construed in accordance with, the laws of the State of New York.

Confirmation

Thank you! Your Investor Qualification Questionnaire & Agreement form has been received. GordonMD® Global Investments LP will get back to you shortly.