Document:

exh_102.htm

Exhibit 10.2

  Star Gas Partners, L.P.

  2187 Atlantic St.

  Stamford, CT 06902

 

 

Entered into July 22, 2013.  Effective as of October 1, 2013

Mr. Steve Goldman

Star Gas Partners, L.P.

2187 Atlantic Street

Stamford, CT 06904

Dear Steve:

 

This letter confirms your continuing in the position of Chief Executive Officer of Star Gas Partners, L.P. and its subsidiaries (the "Partnership"), effective as of October 1, 2013. In addition, you will continue to serve as the President of the Partnership. We are pleased to offer you the following compensation package and other terms, the levels and conditions of which will be in effect for three years following the date of this letter, unless otherwise modified by agreement between you and the Partnership.

 

Base Salary: Your base annual salary commencing October 1, 2013 will be $360,000 per year. You will be paid $15,000 semi-monthly subject to withholding of all applicable taxes and benefit deductions.

 

Benefit Coverage: You will be eligible to participate in the Partnership's benefits plans in accordance with their terms and conditions.

 

Terms: It is understood that your employment is at will and that either party can terminate the relationship at any time. If the Partnership terminates your employment for reasons other than for cause, or you terminate your employment for good reason, you will be entitled to one year’s salary as severance. Such amount shall be paid to you in a lump sum within 30 days after the termination of your employment. In consideration of this offer you agree that while you are an employee of the Partnership and for twelve months thereafter, you will not compete with the Partnership nor become involved either as an employee, as a consultant or in any other capacity, in the sale of heating oil or propane on a retail basis. You agree that you will not reveal any confidential information concerning the Partnership and that you will not solicit nor seek to hire, employees of the Partnership during that time.

 

Please indicate your acceptance of this offer by signing and dating this letter below.

 

 

  

  

  

Should you have any questions, please do not hesitate to call me.

 

 

Sincerely,

 

 

 

By: /s/ Richard Ambury

Richard Ambury

Chief Financial Officer

 

Accepted:

/s/ Steve Goldman

Steve Goldmanexh_103.htm

Exhibit 10.3

Star Gas Partners, L.P.

2187 Atlantic Street

Stamford, CT 06904

 

 

Entered into July 22, 2013.  Effective as of October 1, 2013

 

Steven Goldman

Star Gas Partners, L.P.

2187 Atlantic Street

Stamford, CT  06904

 

Dear Steve:

 

This will confirm our mutual Agreement with respect to a severance payment to be made to you after a Change in Control (as defined below) with respect to Star Gas Partners, L.P. ("Star Gas") as follows:

 

1. If your employment with Star Gas is terminated for any reason (either by you or by Star Gas), other than by reason of your death, within a period of 180 days following a Change in Control, you will be entitled to receive from Petro Holdings Inc. a severance payment equal to two times your base annual salary in the year of such termination plus two times the average amount paid to you as a bonus and/or as profit sharing during the three years preceding the year of such termination ("Severance Payment"), to be paid to you in a lump sum within 30 days after the termination of your employment. The term "Change of Control" shall mean the present equity owners of Kestrel and their affiliates collectively shall cease for any reason to beneficially own equity interests having the voting power to elect at least a majority of the members of the board of directors or other governing board of the general partner of Star Gas Partners L.P. or any successor entity to Star Gas Partners L.P.

 

2. Controlling Nature of this Agreement. This Agreement shall be in addition to any other agreements between you and Star Gas (or any affiliate of Star Gas). In the event of any conflict between this Agreement and any such other agreement, the terms of this Agreement shall control.

 

3. Full Settlement. The obligation to pay the Severance Payment is subject to receipt by the Partnership of a waiver and release in form reasonably satisfactory to the Partnership pursuant to which you will acknowledge that the Severance Payment is in lieu of all claims against the Partnership and its affiliates arising out of or relating to your employment and the termination of your employment, excepting only compensation and benefits accrued to the date of termination of employment. In no way will you be obligated to seek other employment or take any other action to mitigate the amounts payable to you pursuant to this Agreement.

 

4. Miscellaneous.

 

(a) Successor. This Agreement shall be binding upon and inure to the benefit of the parties and their respective successors and assigns.

 

(b) Waiver of Breach. The waiver by either party of a breach of any provision of this Agreement by the other party shall not be construed as a waiver of any subsequent or continuing breach of the same provision or of any other provision of this Agreement.

 

  

  

  

(c) Notices. All notices and other communications hereunder shall be in writing and shall be deemed to have been given when delivered by hand, or mailed by first-class certified mail, postage prepaid and return receipt requested, or facsimiled or sent by reputable overnight courier addressed as follows:

 

If to Steve Goldman:

 

Star Gas Partners, L.P.

2187 Atlantic Street

Stamford, CT  06904

If to the Company:

Star Gas Partners, L.P.

2187 Atlantic Street

Stamford, CT 06904

Attn: President

With a copy to:

Phillips Nizer LLP

666 Fifth Avenue

New York, NY 10103

Telephone No.: 212-977-9700

Facsimile No.: 212-262-5152

Attn: Alan Shapiro, Esq.

or, in each case, at such other address as may from time to time be specified to the other party in a notice similarly given.

 

(d) Governing Law. This Agreement shall be governed by and construed in accordance with the internal laws of the State of New York without giving effect to the conflicts of law principles thereof.

 

(e) Entire Agreement. This Agreement contains the entire Agreement of the parties and their affiliates relating to the subject matter hereof and supersedes all prior Agreements, representations, warranties and understandings, written or oral, with respect thereto.

 

(f) Validity. If any term or provision of this Agreement or the application thereof to any person, property or circumstance shall to any extent be invalid or unenforceable, the remainder of this Agreement, or the application of such term or provision to persons, property or circumstances other than those as to which it is invalid or unenforceable, shall not be affected thereby, and each term and provision of this Agreement shall be valid and enforceable to the fullest extent permitted by law.

 

(g) Amendments, Miscellaneous, Etc. Neither this Agreement, nor any term hereof, may be changed, waived, discharged or terminated except by an instrument in writing signed by the party against which such change, waiver, discharge or termination is sought to be enforced. This Agreement may be executed in one or more counterparts, each of which shall be deemed an original, and all of which together shall constitute one and the same instrument. The headings contained in this Agreement are for reference purposes only and shall not affect in any way the meaning or interpretation of this Agreement.

 

  

  

  

Please indicate your agreement with the foregoing by signing in the space provided below.

 

 

STAR GAS PARTNERS, L.P.

 

 

By: /s/ Richard Ambury

Richard Ambury

Chief Financial Officer

 

AGREED:

 

 

/s/ Steve Goldman

Steve GoldmanEX-4.1

 Exhibit 4.1 

 

			
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                    , 2013 

Form of Subscription Documents For 
 NF INVESTMENT CORP. 

			
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 DIRECTIONS FOR THE COMPLETION 

OF THE SUBSCRIPTION DOCUMENTS 
 Prospective investors must complete the Subscription Agreement (the “Subscription Agreement”), the Investor Questionnaire (the “Investor Questionnaire”) and any necessary attachments
(the Subscription Agreement, the Investor Questionnaire and all such attachments collectively, the “Subscription Documents”) contained in this package in the manner described below. Capitalized terms not defined herein are used as defined
in the Confidential Private Placement Memorandum of NF Investment Corp., a Maryland Corporation (as amended from time to time). For purposes of these Subscription Documents, the “Investor” is the person or entity for whose account the
common stock is being purchased and that can satisfy the representations and warranties set forth in the Subscription Documents. Another person or entity with investment authority may execute the Subscription Documents on behalf of the Investor, but
should indicate the capacity in which it is doing so and the name of the Investor. 
 1. Subscription Agreement:

 Each Investor should fill in the amount of the Capital Commitment, date, print the name of the Investor and
sign (and print name, capacity and title of signatory, if applicable) on page 19. 
 2. Investor Questionnaire:

 (a) In Section A, each Investor should fill in its name, type of entity, address, tax identification or social
security number, contact person(s), telephone and facsimile numbers, email address, and the other requested information. 
 (b) Each Investor should check the box or boxes in Section B which are next to the category or categories under which the Investor qualifies as an “accredited investor”. 

(c) Each Investor that is an individual should respond to the question in Section C. 

(d) Each Investor that is an entity should provide the information and respond to the questions in Section D. 

(e) Each Investor should respond to the questions in Section E. 

(f) Each Investor should check the box or boxes in Section F that are next to the category or categories under which the
Investor qualifies as either a “qualified purchaser” or “knowledgeable employee.” 
 (g)
Print the name of the Investor and sign (and print name, capacity and title of signatory, if applicable) on page 15 of the Investor Questionnaire. 
 3. Customer Identification Program – Documentation Requirements (if the documentation may have previously been submitted, please contact the Company to confirm.) 

  
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	 	(a)	Formation: 

 Organized
entities, including corporations, partnerships, limited liability companies, and trusts: provide a certificate of formation and formation agreement. 
  

	 	(b)	Identification: 

Investors who are natural persons: provide a current (i.e. non-expired) copy of a government issued photo identification.
 
 Corporations, partnerships, limited liability companies, and trusts: provide a current (i.e. non-expired) copy
of a government issued photo identification of natural persons who ultimately, directly or indirectly, benefit from 10% or more of the proceeds of the entity or hold 10% or more of the control rights. 

Upon review of the above documents, the Company may require additional documentation in order to satisfy its requirements for Know Your
Customer and Anti-Money Laundering. 
 4. Tax Forms: 

Each U.S. Investor is required to fill in and sign and date a Form W-9 and each non-U.S. investor is required to fill in and date the
relevant Form(s) W-8 (W-8BEN, W-8IMY, W-8ECI or W-8EXP), as applicable, in accordance with the instructions to such Form, and in the event that any applicable reduction or exemption from U.S. federal withholding tax is claimed, is required to
provide all applicable attachments or addendums as required to claim such exemption or reduction. Applicable tax forms are included in Appendix F. 
 5. Evidence of Authorization: 
 Each Investor must provide valid evidence of
authorization, such as a list of authorized agents, and a current copy of a government issued photo identification for the individual(s) authorized to sign the Subscription Documents. 

For Corporations: 

Generally, Investors which are corporations must submit certified corporate resolutions authorizing the subscription and identifying the
corporate officer empowered to sign the Subscription Documents. 
 For Partnerships: 

Partnerships must submit a certified copy of the partnership certificate (in the case of limited partnerships) or partnership agreement
identifying the general partners. 

  
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 For Limited Liability Companies: 

Limited liability companies must submit a certified copy of the limited liability operating agreement or certificate of formation
identifying the manager or managing member, as applicable, empowered to sign the Subscription Documents. 
 For Trusts:

 Trusts must submit a copy of the trust agreement. 
 For Employee Benefit Plans: 
 Employee benefit plans must submit a certificate of
an appropriate officer certifying that the subscription has been authorized and identifying the individual empowered to sign the Subscription Documents. 
 6. Delivery of Subscription Documents: 
 Two (2) original completed and
executed copies of the Subscription Agreement and the Investor Questionnaire, together with the original Form W-9 or W-8, (W-8BEN, W-8IMY, W-8ECI or W-8EXP), as applicable, the acknowledgment form and any required evidence of authorization, should
be delivered to the Company at the following address: 
 State Street Bank & Trust Co. 

Attn: Transfer Agency JHT1651 
 200 Clarendon Street 
 Boston, MA 02116 

In addition, please send (i) the completed and executed Subscription Agreement, (ii) the completed and executed Investor
Questionnaire, (iii) the completed and executed acknowledgment form, (iv) the completed Form W-9 or W-8 (W-8BEN, W-8IMY, W-8ECI or W-8EXP), as applicable, and (v) any required evidence of authorization to State Street by facsimile to
the attention of “Multi Client Operations”, at [•] as soon as possible. 
 Inquiries regarding subscription
procedures (including if the Investor Questionnaire indicates that any Investor’s response to a question requires further information) should be directed to the Company at [•]. 

7. Wire Instructions: 
 In connection with an Investor’s investment, the Investor shall be required to contribute capital pursuant to Funding Notices (as defined below). Upon receipt of a Funding Notice, payment shall be
sent by wire transfer pursuant to the wire instructions set forth below. Notwithstanding the foregoing, wire instructions may change in the sole discretion of the Company. Therefore, Investors should wire funds in accordance with the wire
instructions set forth in any Funding Notice issued by the Company. To the extent there is any discrepancy in the wire instructions set forth below and the wire instructions set forth in a Funding Notice, the wire instructions in such Funding Notice
shall prevail. 

  
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 Please wire funds to: 

 

					
		 	Bank:	 	[—]
		 	ABA #:	 	[—]
		 	Account A/C:	 	[—]
		 	Bank A/C Name:	 	NF Investment Corp.
		 	Notation:	 	«InvestorName»

 [remainder of page intentionally left blank] 

  
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 SUBSCRIPTION AGREEMENT 
 NF Investment Corp. 
 c/o State Street Bank & Trust Co. 

One Lincoln Street 
 Boston, MA 02111 

Ladies and Gentlemen: 
 1.
Subscription. 
 (a) The undersigned (the “Investor”) subscribes for and agrees to purchase shares of common
stock, par value $0.01 per share, (“Shares”) in NF Investment Corp. (“NF Investment Corp.” or the “Company”) with a capital commitment (“Capital Commitment”) in the amount set forth on the signature page
below. The Investor acknowledges and agrees that this subscription (i) is irrevocable on the part of the Investor, (ii) is conditioned upon acceptance by or on behalf of the Company, and (iii) may be accepted or rejected in whole or
in part by the Company in its sole discretion. The Investor agrees to be bound by all the terms and provisions of the Company’s Confidential Private Placement Memorandum, as amended, restated and/or supplemented from time to time (the
“Memorandum”), the Company’s Bylaws, attached hereto as Appendix A, as amended from time to time (the “Bylaws”), the Company’s Charter, attached hereto as Appendix B, as amended from time to time (the
“Charter”), the Investment Advisory Agreement with Carlyle GMS Investment Management L.L.C., our investment adviser (the “Adviser”), attached hereto as Appendix C, as amended from time to time (the “Advisory
Agreement”), the Administration Agreement between the Company and Carlyle GMS Finance Administration L.L.C., our administrator (the “Administrator”), attached hereto as Appendix D, as amended from time to time (the
“Administration Agreement,” and together with the Memorandum, the Bylaws, the Charter and the Advisory Agreement, the “Operative Documents”), together with this Subscription Agreement (the “Subscription Agreement”).
Capitalized terms not defined herein are used as defined in the Memorandum. The Company expects to enter into separate Subscription Agreements (the “Other Subscription Agreements,” and, together with this Subscription Agreement, the
“Subscription Agreements”) with other investors (the “Other Investors,” and together with the Investor, the “Investors”), providing for the sale of Shares to the Other Investors. This Subscription Agreement and the
Other Subscription Agreements are separate agreements, and the sales of Shares to the undersigned and the Other Investors are separate sales. 
 (b) The Investor agrees to purchase Shares for an aggregate purchase price equal to its Capital Commitment, payable at such times and in such amounts as required by the Company, under the terms and
subject to the conditions set forth herein. On each Capital Drawdown Date (as defined below), the Investor agrees to purchase from the Company, and the Company agrees to issue to the Investor, a number of Shares equal to the Drawdown Share Amount
(as defined below) at an aggregate price equal to the Drawdown Purchase Price (as defined below); provided, however, that in no circumstance will an Investor be required to purchase Shares for an amount in excess of its Unused Capital
Commitment (as defined below). 

  
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 “Drawdown Purchase Price” shall mean, for each Capital Drawdown Date, an amount in U.S.
dollars determined by multiplying (i) the aggregate amount of Capital Commitments being drawn down by the Company from all Investors on that Capital Drawdown Date, by (ii) a fraction, the numerator of which is the Unused Capital Commitment
of the Investor and the denominator of which is the aggregate Unused Capital Commitments of all Investors that are not Defaulting Investors or Excluded Investors (as defined below). 
 “Drawdown Share Amount” shall mean, for each Capital Drawdown Date, a number of Shares determined by dividing (i) the Drawdown Purchase Price for that Capital Drawdown Date by (ii) the
applicable Per Share Price (as defined below), with the resulting quotient adjusted to the nearest whole number to avoid the issuance of fractional shares. 
 “Per Share NAV” shall mean, for any Capital Drawdown Date or Catch-Up Date (as defined below), the net asset value per Share, as determined by the Company’s Board of Directors (including
any committee of the Board, the “Board”), as of the end of the most recent calendar quarter prior to the date of the Funding Notice (as defined below). 
 “Per Share Price” shall mean, for any Capital Drawdown Date or Catch-Up Date (as defined below), the Per Share NAV; provided, that the Per Share Price shall be subject to the limitations
of Section 23 under the Investment Company Act of 1940, as amended (the “1940 Act”); provided further, however, in the event that the Per Share NAV is less than zero as of the first Capital Drawdown Date that occurs immediately
following the Initial Closing Date (as defined below), then solely for the purpose of such Capital Drawdown Date, the Per Share Price shall be deemed to equal $20.00. 
 “Unused Capital Commitment” shall mean, with respect to an Investor, the amount of such Investor’s Capital Commitment as of any date reduced by the aggregate amount of contributions made by
that Investor at all previous Capital Drawdown Dates and any Catch-Up Date pursuant to Section 1(b) and Section 2(c), respectively. 
 2. Closings. 
 (a) The initial closing of this
Subscription Agreement will take place on such date as determined by the Company at the offices of the Adviser, 520 Madison Avenue, 38th Floor, New York, New York (such date being the “Initial Closing Date,” and the date on which each subsequent
closing occurs, a “Subsequent Closing Date”, and each Subsequent Closing Date with the Initial Closing Date shall be referred to herein as the “Closing Date”). 

(b) The Investor agrees to provide any information reasonably requested by the Company to verify the accuracy of the representations
contained herein, including without limitation the investor questionnaire (the “Investor Questionnaire”). Promptly after the Closing Date, the Company will deliver to the Investor or its representative, if the Investor’s subscription
has been accepted, a letter confirming the Company’s acceptance of the Investor’s subscription. 
 (c) The Company may
enter into Other Subscription Agreements with Other Investors on a Subsequent Closing Date and any Other Investor whose subscription has been accepted at such Subsequent Closing Date referred to as a “Subsequent Investor.” 

  
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 Notwithstanding the provisions of Sections 1(b) and 3, on one or more dates to be determined by the
Company that occur on or following the Subsequent Closing Date but no later than the next succeeding Capital Drawdown Date (each, a “Catch-Up Date”), each Subsequent Investor shall be required to purchase from the Company a number of
Shares with an aggregate purchase price necessary to ensure that, upon payment of the aggregate purchase price for such Shares by the Subsequent Investor in the aggregate for all Catch-Up Dates, such Subsequent Investor’s Invested Percentage
(as defined below) shall be equal to the Invested Percentage of all prior Investors (other than any Defaulting Investors or Excluded Investors) (the “Catch-Up Purchase Price”). Upon payment of the Catch-Up Purchase Price by the Investor on
a Catch-Up Date and payment by Other Investors of the requisite amount, the Company shall issue to each such Subsequent Investor a number of Shares determined by dividing (x) the Catch-Up Purchase Price for such Subsequent Investor minus
the Organizational Expense Allocation (as defined below) by (y) the Per Share Price for such Subsequent Investor as of a Catch-Up Date. For the avoidance of doubt, in the event that the Catch-Up Date and a Capital Drawdown Date occur on the
same calendar day, such Catch-Up Date (and the application of the provisions of this Section 2(c)) shall be deemed to have occurred immediately prior to the relevant Capital Drawdown Date. 

“Invested Percentage” means, with respect to an Investor, the quotient determined by dividing (i) the aggregate amount of contributions
made by such Investor pursuant to Section 1(b) and this Section 2(c) by (ii) such Investor’s Capital Commitment. 

“Organizational Expense Allocation” means, with respect to an Investor, the product obtained by multiplying (i) a fraction, the numerator
of which is such Investor’s Capital Commitment and the denominator of which is the total Capital Commitments received by the Company to date by (ii) the lesser of (a) a dollar amount equal to seven hundred fifty thousand dollars
($750,000) or (b) the total amount of organizational expenses spent by the Company in connection with the Company’s formation. 
 (d) At each Capital Drawdown Date following any Subsequent Closing Date, all Investors, including Subsequent Investors, shall purchase Shares in accordance with the provisions of Section 1(b);
provided, however, that notwithstanding the foregoing, the definitions of Drawdown Share Amount and Per Share Price and the provisions of Section 3(b), nothing in this Subscription Agreement shall prohibit the Company from issuing Shares
to Subsequent Investors whose subscriptions are accepted after the Closing Date at a Per Share Price greater than the Per Share NAV at the time of issuance. 
 (e) In the event that any Investor is permitted by the Company to make an additional capital commitment to purchase Shares on a date after its initial subscription has been accepted, such Investor will be
required to enter into a separate Subscription Agreement with the Company, it being understood and agreed that such separate Subscription Agreement will be considered to be an Other Subscription Agreement for the purposes of this Subscription
Agreement. 

  
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 3. Capital Drawdowns. 

(a) Subject to Section 3(f), purchases of Shares will take place on dates selected by the Company in its sole discretion (each, a
“Capital Drawdown Date”) and shall be made in accordance with the provisions of Section 1(b). 
 (b) The Company
shall deliver to the Investor, at least ten (10) Business Days prior to each Capital Drawdown Date, a notice (a “Funding Notice”) setting forth (i) the Capital Drawdown Date, (ii) the nature of the proposed investment(s) for
which capital is being drawn down, (iii) the aggregate number of Shares to be sold to all Investors on the Capital Drawdown Date and the aggregate purchase price for such Shares, (iv) the applicable Drawdown Share Amount, Drawdown Purchase
Price and Per Share Price and (v) the account to which the Drawdown Purchase Price should be wired. For the purposes of this Subscription Agreement, the term “Business Day” shall have the meaning ascribed to it in Rule 14d-1(g)(3)
under the Securities Exchange Act of 1934, as amended (the “1934 Act”). 
 (c) The delivery of a Funding Notice to the
Investor shall be the sole and exclusive condition to the Investor’s obligation to pay the Drawdown Share Purchase Price identified in each Funding Notice, and shall represent the Company’s acceptance of the Investor’s irrevocable and
ongoing offer to purchase Shares. 
 (d) On each Capital Drawdown Date, the Investor shall pay the Drawdown Purchase Price to
the Company by bank wire transfer in immediately available funds in U.S. dollars to the account specified in the Funding Notice. 
 (e) State Street Bank and Trust Company will act as transfer agent and registrar for the Shares (the “Transfer Agent”), unless and until, either the Company or the Transfer Agent decides to
terminate the agreement between the parties. 
 (f) Upon the earlier of the fifth anniversary of the Initial Closing Date or the
completion of an initial public offering by Carlyle GMS Finance, Inc. that results in an unaffiliated public float of at least 15% of its aggregate capital commitments (the period ending on such date being the “Commitment Period”), any
Unused Capital Commitment (other than any Defaulted Commitment (as defined below)) shall automatically be reduced to zero, except to the extent necessary to pay amounts due under Funding Notices that the Company may thereafter issue to: (a) pay
Company expenses, including management fees, any amounts that may become due under any borrowings or other financings or similar obligations and any other liabilities, contingent or otherwise, in each case to the extent they relate to the Commitment
Period, (b) complete investments in any transactions for which there are binding written agreements as of the end of the Commitment Period (including investments that are funded in phases), (c) fund obligations under any Company guarantee
or indemnity made during the Commitment Period and (d) fulfill obligations with respect to any Defaulted Commitment. 
 (g)
Notwithstanding anything to the contrary contained in this Subscription Agreement, the Company shall have the right (a “Limited Exclusion Right”) to exclude any Investor (such Investor, an “Excluded Investor”) from purchasing
Shares from the Company on any Capital Drawdown date if, in the reasonable discretion of the Company, there is a substantial 

  
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likelihood that such Investor’s purchase of Shares at such time would (i) result in a violation of, or noncompliance with, any law or regulation to which such Investor, the Company, the
Adviser, any Other Investor or a portfolio company would be subject or (ii) cause the investments of “Benefit Plan Investors” (within the meaning of Section 3(42) of the U.S. Employee Retirement Income Security Act of 1974, as
amended (“ERISA”) and certain Department of Labor regulations) to be significant and the assets of the Company to be considered “plan assets” under ERISA or Section 4975 of the U.S. Internal Revenue Code of 1986, as amended
(the “Code”). 
 4. Pledging. Without limiting the generality of the foregoing, the Investor specifically
agrees and consents that the Company may, at any time, and without further notice to or consent from the Investor (except to the extent otherwise provided in this Subscription Agreement), grant security over and, in connection therewith, Transfer
(as defined in Section 8(d)) its right to draw down capital from the Investor pursuant to Section 3, and the Company’s right to receive the Drawdown Share Purchase Price (and any related rights of the Company), to lenders or other
creditors of the Company, in connection with any indebtedness, guarantee or surety of the Company; provided, that, for the avoidance of doubt, any such grantee’s right to draw down capital shall be subject to the limitations on the
Company’s right to draw down capital pursuant to Section 3. 
 5. Dividends. As described more fully in the
Memorandum, the Company generally intends to distribute, out of assets legally available for distribution, substantially all of its available earnings, on a quarterly basis, subject to the discretion of the Board. The Company intends to make
distributions in cash. 
 6. Remedies Upon Investor Capital Drawdown Default. In the event that an Investor fails to pay
all or any portion of the purchase price due from such Investor on any Capital Drawdown Date (such amount, together with the full amount of such Investor’s remaining Capital Commitment, a “Defaulted Commitment”) and such default
remains uncured for a period of ten (10) Business Days, the Company shall be permitted to declare such Investor to be in default of its obligations under this Subscription Agreement (any such Investor, a “Defaulting Investor”) and
shall be permitted to pursue one or any combination of the following remedies: 
 (a) The Company may prohibit the Defaulting
Investor from purchasing additional Shares on any future Capital Drawdown Date or otherwise participating in any future investments in the Company; 
 (b) Fifty percent (50%) of the Shares then held by the Defaulting Investor shall be automatically transferred on the books of the Company, without any further action being required on the part of the
Company or the Defaulting Investor, to the Other Investors (other than any defaulting Other Investor), pro rata in accordance with their respective Capital Commitments; provided, however, that notwithstanding anything to the contrary
contained in this Subscription Agreement, no Shares shall be transferred to any Other Investor pursuant to this Section 6(b) in the event that such Transfer (as defined in Section 8(d)) would (x) violate the Securities Act of 1933, as
amended (the “1933 Act”), 1940 Act or any state (or other jurisdiction) securities or “Blue Sky” laws applicable to the Company or such Transfer (as defined in Section 8(d)), (y) constitute a non-exempt “prohibited
transaction” under Section 406 

  
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of ERISA or Section 4975 of the Code or (z) cause all or any portion of the assets of the Company to constitute “plan assets” under ERISA or Section 4975 of the Code (it
being understood that this proviso shall operate only to extent necessary to avoid the occurrence of the consequences contemplated herein and shall not prevent the Investor from receiving a partial allocation of its pro rata portion of Shares);
provided further, that any Shares that have not been transferred to one or more Other Investors pursuant to the previous proviso shall be allocated among the participating Other Investors pro rata in accordance with their respective
Capital Commitments. The mechanism described in this Section 6(b) is intended to operate as a liquidated damage provision, since the damage to the Company and Other Investors resulting from a default by the Defaulting Investor is both
significant and not easily susceptible to precise quantification. By entry into this Subscription Agreement, the Investor agrees to this Transfer (as defined in Section 8(d)) and acknowledges that it constitutes a reasonable liquidated damage
remedy for any default in the Investor’s obligation of the type described; and 
 (c) The Company may pursue any other
remedies against the Defaulting Investor available to the Company, subject to applicable law. The Investor agrees that this Section 6 is solely for the benefit of the Company and shall be interpreted by the Company against a Defaulting Investor
in the discretion of the Company. The Investor further agrees that the Investor cannot and will not seek to enforce this Section 6 against the Company or any other investor in the Company. 

7. [Reserved.] 

8. Representations and Warranties of the Investor. To induce the Company to accept this subscription, the Investor represents and
warrants as follows: 
 (a) This Subscription Agreement has been duly authorized, executed and delivered by the Investor and,
upon due authorization, execution and delivery by the Company, will constitute the valid and legally binding agreement of the Investor enforceable in accordance with its terms against the Investor, except as such enforceability may be limited by
(i) bankruptcy, insolvency, reorganization, fraudulent conveyance, moratorium or other laws of general application relating to or affecting the enforcement of creditors’ rights and remedies, as from time to time in effect;
(ii) application of equitable principles (regardless of whether such enforceability is considered in a proceeding in equity or at law); and (iii) considerations of public policy or the effect of applicable law relating to fiduciary duties.

 (b) The Shares to be acquired hereunder are being acquired by the Investor for the Investor’s own account for investment
purposes only and not with a view to resale or distribution. 
 (c) The Investor understands that the Company intends to file
elections to be treated as (i) a business development company under the 1940 Act and (ii) a regulated investment company within the meaning of Section 851 of the Code, for U.S. federal income tax purposes; pursuant to those elections,
the Investor will be required to furnish certain information to the Company as required under Treasury Regulations § 1.852-6(a) and other regulations. If the Investor is unable or refuses to provide such information directly to the Company, the
Investor understands that it will be required to include additional information on its income tax return as 

  
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provided in Treasury Regulation § 1.852-7. The Company has filed a registration statement on Form 10 (the “Form 10 Registration Statement”) for its common stock with the U.S.
Securities and Exchange Commission (the “SEC”) under the 1934 Act. The Form 10 Registration Statement is not the offering document pursuant to which the Company is conducting this offering and may not include all information regarding the
Company contained in this Memorandum; accordingly, Investors should rely exclusively on information contained in the Operative Documents in making their investment decisions. 
 (d) (i) The Investor understands that the offering and sale of the Shares are intended to be exempt from registration under the 1933 Act, applicable U.S. state securities laws and the laws of any non-U.S.
jurisdictions by virtue of the private placement exemption from registration provided in Section 4(2) of the 1933 Act, exemptions under applicable U.S. state securities laws and exemptions under the laws of any non-U.S. jurisdictions, and it
agrees that any Shares acquired by the Investor may not be sold, offered for sale, exchanged, transferred, assigned, pledged, hypothecated or otherwise disposed of (each, a “Transfer”) in any manner that would require the Company to
register the Shares under the 1933 Act, under any U.S. state securities laws or under the laws of any non-U.S. jurisdictions. The Investor understands that the Company requires each investor in the Company to be an “accredited investor” as
defined in Rule 501(a) of Regulation D of the 1933 Act (“Accredited Investor”) and the Investor represents and warrants that it is an Accredited Investor. 

(ii) The Investor understands that the offering and sale of the Shares in non-U.S. jurisdictions may be subject to
additional restrictions and limitations, and represents and warrants that it is acquiring its Shares in compliance with all applicable laws, rules, regulations and other legal requirements applicable to the Investor including, without limitation,
the legal requirements of jurisdictions in which the Investor is resident and in which such acquisition is being consummated. Furthermore, the Investor understands that all offerings and sales made outside of the United States will be made pursuant
to Regulation S under the 1933 Act. 
 (e) (i) The Investor may not Transfer its Capital Commitment or any of its Shares unless
(a) the Company provides its prior written consent, (b) the Transfer is made in accordance with applicable securities laws and (c) the Transfer is otherwise in compliance with the transfer restrictions set forth in Appendix E. No
Transfer will be effectuated except by registration of the Transfer on the Company books. Each transferee must agree to be bound by these restrictions and all other obligations as an investor in the Company. 

(ii) The Investor acknowledges that the Investor is aware and understands that there are other substantial restrictions on
the transferability of Shares or Capital Commitment under this Subscription Agreement, the Operative Documents and under applicable law including, but not limited to, the fact that (a) there is no established market for the Shares and it is
possible that no public market for the Shares will develop; (b) the Shares are not currently, and Investors have no rights to require that the Shares be, registered under the 1933 Act or the securities laws of the various states or any non-U.S.
jurisdiction and therefore cannot be Transferred unless subsequently registered or unless an exemption from such registration is available; and (c) the Investor may have to hold the Shares herein subscribed for and bear the economic risk of
this investment indefinitely, and it may not be possible for the Investor to liquidate its investment in the Company. 

  
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 (f) [Reserved.] 

(g) The Investor has been furnished and has carefully read this Subscription Agreement, each Operative Document, in each case as amended,
restated and/or supplemented through the closing date of the Investor’s subscription for Shares, a current copy of the Proxy Voting Policies and Procedures of the Adviser and, to the extent the Investor is a natural person, a current copy of
the NF Investment Corp. Privacy Notice. The Investor has such knowledge and experience in financial and business matters as to be capable of evaluating the merits and risks of an investment in the Shares, is able to bear the risks of an investment
in the Shares and understands the risks of, and other considerations relating to, a purchase of Shares, including the matters set forth under the caption “Risk Factors” in the Memorandum. 

(h) To the full satisfaction of the Investor, the Investor has been furnished any materials the Investor has requested relating to the
Company, the offering of Shares or any statement made in the Memorandum, and the Investor has been afforded the opportunity to ask questions of representatives of the Company concerning the terms and conditions of the offering and to obtain any
additional information necessary to verify the accuracy of any representations or information set forth in the Memorandum. 

(i) Other than as set forth in this Subscription Agreement, the Operative Documents and any separate agreement in writing with the
Company executed in conjunction with the Investor’s subscription for Shares, the Investor is not relying upon any other information (including, without limitation, any advertisement, article, notice or other communication published in any
newspaper, magazine, website or similar media or broadcast over television or radio, and any seminars or meetings whose attendees have been invited by any general solicitation or advertising), representation or warranty by the Company, its Adviser
or any affiliate of the foregoing or any agent of them, written or otherwise, in determining to invest in the Company and the Investor understands that the Memorandum is not intended to convey tax or legal advice. The Investor has consulted to the
extent deemed appropriate by the Investor with the Investor’s own advisers as to the financial, tax, legal, accounting, regulatory and related matters concerning an investment in Shares and on that basis understands the financial, tax, legal,
accounting, regulatory and related consequences of an investment in Shares, and believes that an investment in the Shares is suitable and appropriate for the Investor. 
 (j) If the Investor is not a natural person, (i) the Investor was not formed or recapitalized for the specific purpose of acquiring any Shares in the Company, (ii) the Investor has the power and
authority to enter into this Subscription Agreement and each other document required to be executed and delivered by the Investor in connection with this subscription for Shares, and to perform its obligations hereunder and thereunder and consummate
the transactions contemplated hereby and thereby and (iii) the person signing this Subscription Agreement on behalf of the Investor has been duly authorized to execute and deliver this Subscription Agreement and each other document required to
be executed and delivered by the Investor in connection with this subscription for Shares. If the Investor is a natural person, the Investor has all requisite legal capacity to acquire and hold the Shares and to execute, deliver and comply

  
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with the terms of each of the documents required to be executed and delivered by the Investor in connection with this subscription for Shares. The execution and delivery by the Investor of, and
compliance by the Investor with, this Subscription Agreement and each other document required to be executed and delivered by the Investor in connection with this subscription for Shares does not violate, represent a breach of, or constitute a
default under, any instruments governing the Investor, any law, regulation or order, or any agreement to which the Investor is a party or by which the Investor is bound. 
 (k) The Investor: (i) is not registered or required to be registered as an investment company under the 1940 Act; (ii) has not elected to be regulated as a business development company under the
1940 Act; and (iii) either (A) is not relying on the exception from the definition of “investment company” under the 1940 Act set forth in Section 3(c)(1) or 3(c)(7) thereunder or (B) is otherwise permitted to acquire
and hold more than 3% of the outstanding voting securities of a business development company. 
 (l) The Investor understands
that the Company will not initially be registered as an investment company under the 1940 Act in reliance upon an exemption from registration provided by Section 3(c)(7) thereunder, and it agrees that, until such time that the Company registers
as an investment company under the 1940 Act, any Shares acquired by the Investor may not be Transferred in any manner that would require the Company to register as an investment company under the 1940 Act. The Investor understands that the Company
will initially rely upon an exemption from registration which requires each Investor to be either a “qualified purchaser” as defined in Section 2(a)(51)(A) of the 1940 Act (a “Qualified Purchaser”) or a “knowledgeable
employee” as defined in Rule 3c-5 under the 1940 Act (a “Knowledgeable Employee”), and the Investor represents and warrants that it is a Qualified Purchaser or Knowledgeable Employee. 

(m) Representations for Non-U.S. Persons. (i) If the Investor is not a “United States Person,” as defined below (a
“non-U.S. Person”), the Investor has heretofore notified the Company in writing of such status. For this purpose, “United States Person” means a citizen or resident of the United States, a corporation, partnership or other entity
created or organized in or under the laws of the United States or any political subdivision thereof, an estate the income of which is subject to United States federal income taxation regardless of its source, or any trust (i) the administration
of which may be subject to the primary supervision of a U.S. court and (ii) the authority to control all of the substantial decisions of which is held by one or more U.S. persons. 

(ii) The Investor will notify the Company immediately if the Investor becomes a United States Person. 

(iii) The Investor is acquiring the Shares for its own account for investment purposes only and is not subscribing on
behalf of or funding its commitment with funds obtained from a United States Person. 
 (iv) Except for offers
and sales to discretionary or similar accounts held for the benefit or account of a non-U.S. Person by a U.S. dealer or other professional fiduciary, all offers to sell and offers to buy the Interest were made to or by the Investor while the
Investor was outside the United States and at the time the Investor’s order to buy the Shares originated (and at the time this Subscription Agreement was executed by the Investor) the Investor was outside the United States. 

  
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 (n) If the Investor is, or is acting (directly or indirectly) on behalf of, a
“Plan” (defined below) which is subject to Title I of ERISA or Section 4975 of the Code, or any provisions of any other federal, state, local, non-U.S. or other laws or regulations that are similar to those provisions contained in
such portions of ERISA or the Code (collectively, “Other Plan Laws”): (1) the decision to invest in the Company was made by a fiduciary (within the meaning of Section 3(21) of ERISA and the regulations thereunder, or as defined
under applicable Other Plan Laws) (a “Fiduciary”) of the Plan which is unrelated to the Adviser or any of its employees, representatives or affiliates and which is duly authorized to make such an investment decision on behalf of the Plan
(the “Plan Fiduciary”); (2) the Plan Fiduciary has taken into consideration its fiduciary duties under ERISA or any applicable Other Plan Law, including the diversification requirements of Section 404(a)(1)(C) of ERISA (if
applicable), in authorizing the Plan’s investment in the Company, and has concluded that such investment is prudent; (3) the Plan’s subscription to invest in the Company and the purchase of Shares contemplated hereby is in accordance
with the terms of the Plan’s governing instruments and complies with all applicable requirements of ERISA, the Code and all applicable Other Plan Laws and does not constitute a non-exempt prohibited transaction under ERISA or Section 4975
of the Code or a similar violation under any applicable Other Plan Laws; and (4) the Plan Fiduciary acknowledges and agrees that neither the Adviser nor any of its employees, representatives or affiliates will be a fiduciary with respect to the
Plan as a result of the Plan’s investment in the Company, pursuant to the provisions of ERISA or any applicable Other Plan Laws, or otherwise, and the Plan Fiduciary has not relied on, and is not relying on, the investment advice of any such
person with respect to the Plan’s investment in the Company. “Plan” includes (i) an employee benefit plan (within the meaning of Section 3(3) of ERISA), whether or not such plan is subject to Title I of ERISA, (ii) a
plan, individual retirement account or other arrangement that is described in Section 4975 of the Code, whether or not such plan, individual retirement account or other arrangement is subject to Section 4975 of the Code, (iii) 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 Code under
Section 401(c)(1)(A) of ERISA or the regulations promulgated thereunder and (iv) an entity which is deemed to hold the assets of any of the foregoing types of plans, accounts or arrangements, pursuant to ERISA or otherwise. 

(o) The Investor agrees to notify the Company in writing in the event (i) the Investor either becomes or ceases to be a
“benefit plan investor” within the meaning of Section 3(42) of ERISA, as modified by 29 CFR 2510.3-101(f)(2) or under any Other Plan Law (a “Benefit Plan Investor”), (ii) the Investor reasonably expects that the
Investor will become or cease to be a Benefit Plan Investor, or (iii) if the Investor is an entity that is deemed to hold the assets of any of Plan pursuant to ERISA or any Other Plan Law, the percentage of such Investor’s assets
attributable to Plans either increases or decreases. The Investor also agrees to, within 15 business days of the receipt of a written request from the Company, provide a written update to the Company with regard to any of the foregoing. If the
Company, in its sole discretion, determines that so doing would be useful in ensuring that equity participation in the Company is not significant within the meaning of 29 CFR 2510.3-101(f), the Company may require any Benefit Plan Investor to
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value (as determined by the Company in its sole discretion) to an Investor other than a Benefit Plan Investor (whether an existing Investor or a new Investor). The Investor shall have no claim
against the Company, the Administrator, the Manager or any of their respective affiliates for any form of damages or liability as a result of any such transfer. 
 (q) If the investment in the Shares is being made on behalf of an employee benefit plan maintained outside of the United States primarily for the benefit of persons substantially all of whom are
nonresident aliens (as described in Section 4(b)(4) of ERISA), (i) there is no provision in the instruments governing such plan or any federal, state or local or foreign law, rule, regulation or constitutional provision applicable to the
plan that could in any respect affect the operation of the Company, including operations of the Adviser as contemplated by the Advisory Agreement, or prohibit any action contemplated by the Operative Documents and related disclosure of the Company,
including, without limitation, the investments which may be made pursuant to the Company’s investment strategies, the concentration of investments for the Company and the payment by the plan of incentive or other fees, and (ii) the
plan’s investment in the Company will not conflict with or violate the instruments governing such plan or any federal, state or local or foreign law, rule, regulation or constitutional provision applicable to the plan. 

(r) The Investor was offered the Shares through private negotiations, not through any general solicitation or general advertising, and in
the state listed in the Investor’s permanent address set forth in the Investor Questionnaire. 
 (s) (i) Neither the
Investor, nor any of its affiliates or beneficial owners, (A) appears on the Specially Designated Nationals and Blocked Persons List of the Office of Foreign Assets Control of the U.S. Department of the Treasury (“OFAC”), nor are they
otherwise a party with which any entity is prohibited to deal under the laws of the United States, or (B) is a person identified as a terrorist organization on any other relevant lists maintained by governmental authorities. The Investor
further represents and warrants that the monies used to fund the investment in the Shares are not derived from, invested for the benefit of, or related in any way to, the governments of, or persons within, any country (1) under a U.S. embargo
enforced by OFAC, (2) that has been designated as a “non-cooperative country or territory” by the Financial Action Task Force on Money Laundering or (3) that has been designated by the U.S. Secretary of the Treasury as a
“primary money laundering concern.” The Investor further represents and warrants that the Investor: (I) has conducted thorough due diligence with respect to all of its beneficial owners, (II) has established the identities of all
beneficial owners and the source of each of the beneficial owner’s funds and (III) will retain evidence of any such identities, any such source of funds and any such due diligence. Pursuant to anti-money laundering laws and regulations, the
Company may be required to collect documentation verifying the Investor’s identity and the source of funds used to acquire an Interest before, and from time to time after, acceptance by the Company of this Subscription Agreement. The Investor
further represents and warrants that the Investor does not know or have any reason to suspect that (x) the monies used to fund the Investor’s investment in the Shares have been or will be derived from or related to any illegal activities,
including, but not limited to, money laundering activities, and (y) the proceeds from the Investor’s investment in the Shares will be used to finance any illegal activities. 

  
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 (ii) The Investor will provide to the Company at any time such
information as the Company determines to be necessary or appropriate (A) to comply with the anti-money laundering laws, rules and regulations of any applicable jurisdiction and (B) to respond to requests for information concerning the
identity of Investors from any governmental authority, self-regulatory organization or financial institution in connection with its anti-money laundering compliance procedures, or to update such information. 

(iii) To comply with applicable U.S. anti-money laundering laws and regulations, all payments and contributions by the
Investor to the Company and all payments and distributions to the Investor from the Company will only be made in the Investor’s name and to and from a bank account of a bank based or incorporated in or formed under the laws of the United States
or that is regulated in and either based or incorporated in or formed under the laws of the United States and that is not a “foreign shell bank” within the meaning of the U.S. Bank Secrecy Act (31 U.S.C. § 5311 et seq.), as amended,
and the regulations promulgated thereunder by the U.S. Department of the Treasury, as such regulations may be amended from time to time. 
 (iv) The representations and warranties set forth in this Section 8(s) shall be deemed repeated and reaffirmed by the Investor to the Company as of each date that the Investor is required to make a
capital contribution to, or receives a distribution from, the Company. If at any time during the term of the Company, the representations and warranties set forth in this Section 8(s) cease to be true, the Investor shall promptly so notify the
Company in writing. 
 (v) The Investor understands and agrees that the Company may not accept any amounts from a
prospective Investor if such prospective Investor cannot make the representations set forth in this Section 8(s). 
 (t) In
the event that the Investor is, receives deposits from, makes payments to or conducts transactions relating to, a non-U.S. banking institution (a “Non-U.S. Bank”) in connection with the Investor’s investment in Shares, such Non-U.S.
Bank: (i) has a fixed address, other than an electronic address or a post office box, in a country in which it is authorized to conduct banking activities, (ii) employs one or more individuals on a full-time basis, (iii) maintains
operating records related to its banking activities, (iv) is subject to inspection by the banking authority that licensed it to conduct banking activities and (v) does not provide banking services to any other Non-U.S. Bank that does not
have a physical presence in any country and that is not a registered affiliate. The Investor agrees and acknowledges that, among other remedial measures, (A) in order to comply with governmental regulations and/or if the Company determines in
its sole discretion that such action is in the best interests of the Company, the Company may “freeze the account” of the Investor, either by prohibiting additional investments by the Investor, segregating assets of the Investor and/or
suspending other rights the Investor may have under the Operative Documents and (B) the Company may be required to report such action or confidential information relating to the Investor (including without limitation, disclosing the
Investor’s identity) to regulatory authorities. 

  
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 (u) The Investor acknowledges that, in order to comply with the provisions of the U.S.
Foreign Account Tax Compliance Act (“FATCA”) and avoid the imposition of U.S. federal withholding tax, the Company may, from time to time, require further information and/or documentation from the Investor and, if and to the extent
required under FATCA, the Investor’s direct and indirect beneficial owners (if any), relating to or establishing any such owner’s identity, residence (or jurisdiction of formation), income tax status, and other required
information and may provide or disclose such information and documentation to the U.S. Internal Revenue Service. The Investor agrees that it shall provide such information and documentation concerning itself and its beneficial owners, if any, as and
when requested by the Company sufficient for the Company to comply with its obligations under FATCA. The Investor acknowledges that, if the Investor does not provide the requested information and documentation, the Company may, at its sole
option and in addition to all other remedies available at law or in equity, prohibit additional investments, decline or delay any redemption requests by the Investor and/or deduct from such Investor’s account and retain amounts sufficient to
indemnify and hold harmless the Company from any and all withholding taxes, interest, penalties and other losses or liabilities suffered by the Company on account of the Investor’s not providing all requested information and documentation in a
timely manner. The Investor shall have no claim against the Company, the Administrator, the Adviser or any of their respective affiliates for any form of damages or liability as a result of any of the aforementioned actions. 

(v) The Investor acknowledges that the Company intends to enter into one or more revolving credit facilities with one or more syndicates
of banks or to incur indebtedness in lieu of or in advance of Capital Contributions. In connection therewith, each Investor hereby agrees to cooperate with the Company and provide financial information and other documentation reasonably and
customarily required to obtain such facilities. 
 (w) None of the information concerning the Investor nor any statement,
certification, representation or warranty made by the Investor in this Subscription Agreement or in any document required to be provided under this Subscription Agreement (including, without limitation, the Investor Questionnaire and any forms W-9
or W-8 (W-8BEN, W-8IMY, W-8ECI or W-8EXP), as applicable, contains any untrue statement of a material fact or omits to state a material fact necessary in order to make the statements contained therein or herein not misleading. 

(x) The Investor agrees that the foregoing certifications, representations, warranties, covenants and agreements shall survive the
acceptance of this Subscription Agreement, each Capital Drawdown Date and the dissolution of the Company, without limitation as to time. Without limiting the foregoing, the Investor agrees to give the Company prompt written notice in the event that
any statement, certification, representation or warranty of the Investor contained in this Section 8 or any information provided by the Investor herein or in any document required to be provided under this Subscription Agreement (including,
without limitation, the Investor Questionnaire and any forms W-9 or W-8 (W-8BEN, W-8IMY, W-8ECI or W-8EXP), as applicable, ceases to be true at any time following the date hereof. 

(y) The Investor agrees to provide such information and execute and deliver such documents as the Company may reasonably request to
verify the accuracy of the Investor’s representations and warranties herein or to comply with any law or regulation to which the Company, the Adviser, the Administrator or a portfolio company may be subject. 

  
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 (z) The execution, delivery and performance of this Subscription Agreement by the
Investor do not and will not result in a breach of any of the terms, conditions or provisions of, or constitute a default under, any indenture, mortgage, deed of trust, credit agreement, note or other evidence of indebtedness, or any lease or other
agreement, or any license, permit, franchise or certificate, to which the Investor is a party or by which it is bound or to which any of its properties are subject, or require any authorization or approval under or pursuant to any of the foregoing,
violate the organizational documents of the Investor, or violate any statute, regulation, law, order, writ, injunction or decree to which the Investor is subject. The Investor has obtained all authorizations, consents, approvals and clearances of
all courts, governmental agencies and authorities and such other persons, if any, required to permit the Investor to enter into this Subscription Agreement and to consummate the transactions contemplated hereby and thereby. 

9. [Reserved] 

10. Public Pension Fund Reform Code of Conduct. If the Investor is a retirement plan established or maintained for its employees
(current or former) by the Government of the United States, the government of any State or political subdivision thereof, or by any agency or instrumentality of any of the foregoing (a “Government Plan”), then: 

(a) the Company certifies to such Government Plan that, as of the date hereof, all provisions of the Public Pension Fund Reform Code of
Conduct adopted by The Carlyle Group, predecessor to The Carlyle Group L.P. (“Carlyle”), on May 14, 2009 (as such Code may be amended, modified or supplemented from time to time, the “Code of Conduct”) are in full force and
effect and that Carlyle, after making such inquiries as are required by the Code of Conduct, is in compliance therewith and will continue to remain in compliance with Paragraph 3 thereof throughout the term of the Company; provided that,
notwithstanding the foregoing, the Government Plan acknowledges that Paragraphs 19 through 23 of the Code of Conduct are inapplicable to the Company and that conflicts of interest matters are addressed in the Memorandum, as contemplated by Paragraph
24 of the Code of Conduct; 
 (b) the Government Plan acknowledges and agrees pursuant to Paragraph 15 of the Code of Conduct
that confidential or sensitive information about the Government Plan may be disclosed in connection with the activities of the Company; 
 (c) the Government Plan acknowledges that (i) the disclosures made by Carlyle pursuant to the Code of Conduct are made available for review on the Company’s website; (ii) such disclosures
will be updated regularly and will remain available for review on such website; and (iii) a copy of the Code of Conduct is available upon request; 
 (d) notwithstanding Section 18 of the Code of Conduct, neither the Company nor Carlyle nor their respective affiliates shall be subject to such Government Plan’s regulations and internal rules
and policies that are not otherwise applicable to such person; and 

  
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 (e) in the event that there has been a finding by any court or governmental body of
competent jurisdiction in a final judgment or an admission by Carlyle in a settlement of any lawsuit (provided, for the avoidance of doubt, that the settlement of a lawsuit shall not in and of itself be deemed an admission) that Carlyle has
materially violated the Code of Conduct with respect to such Government Plan and such material violation has not been cured (to the extent curable) within 60 calendar days after such finding or admission, then such Government Plan shall be excused
from its obligation to purchase additional Shares from the Company in connection with any Funding Notice, provided that, within seven calendar days after such Government Plan has received such Funding Notice, such Government Plan shall have notified
the Company of its intention to exercise such excuse right. 
 11. Further Advice and Assurances. All information which
the Investor has provided to the Company, including the information in the Investor Questionnaire, is true, correct and complete as of the date hereof, and the Investor agrees to notify the Company immediately if any representation, warranty or
information contained in this Subscription Agreement or any of the information in the Investor Questionnaire, becomes untrue at any time. The Investor agrees to provide such information and execute and deliver such documents with respect to itself
and its direct and indirect beneficial owners as the Company may from time to time reasonably request to verify the accuracy of the Investor’s representations and warranties herein, establish the identity of the Investor and the direct and
indirect participants in its investment in Shares, to the extent applicable, to effect any transfer and admission and/or to comply with any law, rule or regulation to which the Company may be subject, including, without limitation, compliance with
anti-money laundering laws and regulations or for any other reasonable purpose. 
 12. Power of Attorney. (a) The
Investor, by its execution hereof, hereby irrevocably makes, constitutes and appoints the Company as its true and lawful agent and attorney-in-fact, with full power of substitution and full power and authority in its name, place and stead, to make,
execute, sign, acknowledge, swear to, record and file: 
 (i) any and all filings required to be made by the
Investor under the 1934 Act with respect to any of the Company’s securities which may be deemed to be beneficially owned by the Investor under the 1934 Act; 

(ii) all certificates and other instruments deemed advisable by the Company in order for the Company to enter into any
borrowing or pledging arrangement; 
 (iii) all certificates and other instruments deemed advisable by the
Company to comply with the provisions of this Subscription Agreement and applicable law or to permit the Company to become or to continue as a business development corporation; and 

(iv) all other instruments or papers not inconsistent with the terms of this Subscription Agreement which may be required
by law to be filed on behalf of the Company. 

  
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 (b) With respect to the Investor and the Company, the foregoing power of attorney:

 (i) is coupled with an interest and shall be irrevocable; 

(ii) may be exercised by the Company either by signing separately as attorney-in-fact for the Investor or, after listing
all of the Investors executing an instrument, by a single signature of the Company acting as attorney-in-fact for all of them; 
 (iii) shall survive the assignment by the Investor of the whole or any fraction of its Shares; 
 (iv) shall terminate concurrently with the termination of the Capital Commitment, in accordance with Section 3(f); and 

(v) may not be used by the Company in any manner that is inconsistent with the terms of this Subscription Agreement and
any other written agreement between the Company and the Investor. 
 13. Indemnity. The Investor understands that the
information provided herein (including the Investor Questionnaire) will be relied upon by the Company for the purpose of determining the eligibility of the Investor to purchase Shares in the Company. The Investor agrees to provide, if requested, any
additional information that may reasonably be required to determine the eligibility of the Investor to purchase Shares in the Company. To the fullest extent permitted under applicable law, the Investor agrees to indemnify and hold harmless the
Company, the Adviser, the Administrator, and their affiliates and each partner, member, officer, director, employee, and agent thereof, from and against any loss, damage or liability due to or arising out of a breach of any representation, warranty
or agreement of the Investor contained in this Subscription Agreement (including the Investor Questionnaire) or in any other document provided by the Investor to the Company or in any agreement executed by the Investor in connection with the
Investor’s investment in Shares. 
 14. Miscellaneous. This Subscription Agreement is not transferable or assignable
by the Investor. Any purported assignment of this Subscription Agreement will be null and void. The representations and warranties made by the Investor in this Subscription Agreement (including the Investor Questionnaire) shall survive the closing
of the transactions contemplated hereby and any investigation made by the Company. The Investor Questionnaire, including without limitation the representations and warranties contained therein, is an integral part of this Subscription Agreement and
shall be deemed incorporated by reference herein. This Subscription Agreement may be executed in one or more counterparts, all of which together shall constitute one instrument. Notwithstanding the place where this Subscription Agreement may be
executed by any of the parties hereto, the parties expressly agree that this Subscription Agreement shall be governed by and construed in accordance with the laws of the State of Delaware, without giving effect to the choice of law principles
thereof. To the fullest extent permitted by law, the sole and exclusive forum for any action, suit or proceeding with respect to this Subscription Agreement shall be a federal or state court

  
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located in the state of Delaware, provided that to the extent the appropriate court located in the state of Delaware determines that it does not have jurisdiction over such action, then the sole
and exclusive forum shall be any federal or state court located in the state of Maryland, and each party hereto, to the fullest extent permitted by law, hereby irrevocably waives any objection that it may have, whether now or in the future, to the
laying of venue in, or to the jurisdiction of, any and each of such courts for the purposes of any such action, suit or proceeding and further waives any claim that any such action, suit or proceeding has been brought in an inconvenient forum, and
each party hereto hereby submits to such jurisdiction and consents to process being served in any such action, suit or proceeding, without limitation, by United States mail addressed to the party at the parties address specified herein or in the
Investor Questionnaire. EACH OF THE PARTIES HERETO HEREBY IRREVOCABLY WAIVES ANY AND ALL RIGHT TO TRIAL BY JURY IN ANY LEGAL PROCEEDING ARISING OUT OF OR RELATED TO THIS SUBSCRIPTION AGREEMENT OR THE TRANSACTIONS CONTEMPLATED HEREBY, TO THE FULLEST
EXTENT PERMITTED BY LAW. 
 15. Confidentiality. The Investor acknowledges that the Memorandum and other information
relating to the Company has been submitted to the Investor on a confidential basis for use solely in connection with the Investor’s consideration of the purchase of Shares. The Investor agrees that, without the prior written consent of the
Company (which consent may be withheld at the sole discretion of the Company), the Investor shall not (a) reproduce the Memorandum or any other information relating to the Company (including, without limitation any future information provided
to the Investor as to the Company’s estimated net asset value or net asset value per share, asset levels, financial performance or other financial or operating results prior to the filing of such information with the SEC), in whole or in part,
or (b) disclose the Memorandum or any other such information relating to the Company to any person who is not an officer or employee of the Investor who is involved in its investments, or partner (general or limited) or affiliate of the
Investor (it being understood and agreed that if the Investor is a pooled investment fund, it shall only be permitted to disclose the Memorandum or other information related to the Company if the Investor has required its investors to enter into
confidentiality undertakings no less onerous than the provisions of this Section 15), except to the extent (1) such information is in the public domain (other than as a result of any action or omission of Investor or any person to whom the
Investor has disclosed such information) or (2) such information is required by applicable law or regulation to be disclosed. The Investor further agrees to return the Memorandum and any other information relating to the Company if no purchase
of Shares is made or upon the Company’s request therefore. The Investor acknowledges and agrees that monetary damages would not be sufficient remedy for any breach of this section by it, and that in addition to any other remedies available to
the Company in respect of any such breach, the Company shall be entitled to specific performance and injunctive or other equitable relief as a remedy for any such breach. 
 16. Necessary Acts, Further Assurances. The parties shall at their own cost and expense execute and deliver such further documents and instruments and shall take such other actions as may be
reasonably required or appropriate to evidence or carry out the intent and purposes of this Subscription Agreement or to show the ability to carry out the intent and purposes of this Subscription Agreement. 

  
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 17. No Joint Liability Among the Company, the Adviser, and the Administrator. The
Company shall not be liable for the fulfillment of any obligation or the accuracy of any representation of the Adviser or the Administrator under or in connection with this Subscription Agreement. The Adviser shall not be liable for the fulfillment
of any obligation or the accuracy of any representation of the Company or the Administrator under or in connection with this Subscription Agreement. The Administrator shall not be liable for the fulfillment of any obligation or the accuracy of any
representation of the Company or the Adviser under or in connection with this Subscription Agreement. There shall be no joint and several liability of the Company, the Adviser, and the Administrator for any obligation under or in connection with
this Subscription Agreement. 
 18. Independent Nature of Investors’ Obligations and Rights. Third-Party
Beneficiaries. The obligations of the Investor hereunder are several and not joint with the obligations of any Other Investor. Nothing contained herein or in any other agreement or document delivered at any closing, and no action taken by the
Investor pursuant hereto or thereto, shall be deemed to constitute the Investors as a partnership, an association, a joint venture or any other kind of entity, or create a presumption that the Investors are in any way acting in concert with respect
to such obligations or the transactions contemplated by this Agreement. This Agreement is not intended to confer upon any person, other than the parties hereto, except as provided in Sections 3(h), 4, 7(b) and 13, any rights or remedies hereunder.

  
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 IN WITNESS WHEREOF, the undersigned has executed this Subscription Agreement on the date
set forth below. 
  

			
	 Date:
                                
	 	Amount of Capital Commitment

  

					
		 	$ 	 	 

  

			
		 	 INDIVIDUAL, JOINT IN TENANCY,

INDIVIDUAL IRA INVESTOR:

		
		 	
		 	  

		 	(Print Name)
		
		 	
		 	  

		 	(Signature)
		
		 	PARTNERSHIP, CORPORATION, LIMITED LIABILITY COMPANY, TRUST, CUSTODIAL ACCOUNT, OTHER INVESTOR:
		
		 	
		 	  

		 	(Print Name of Entity)

  

					
		 	By: 	 	 
		 		 	(Signature)

  

			
		 	
		 	  

		 	(Print Name and Title)

 Agreed and accepted as of the
                     day of                 :

 NF INVESTMENT CORP. 
  

			
	By: 	 	 
	Name:
	Title:

  
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 INVESTOR QUESTIONNAIRE 
 Note:   Questions regarding this questionnaire should be directed to [•]. 
  

	A.	General Information 

  

			
	 1.      Print Full Name of Investor
	 	Individual, Individual IRA, Joint in Tenancy:
		
		 	
		 	  

		 	First
                            Middle
                                         
   Last
		
		 	
		 	  

		 	Entity Name
		
		 	Entity: To assist the Company in preparing the its tax filings, please check the category into which you fall:

  

					
	 Partnership
	  	 ̈	  	
	 C-Corporation
	  	 ̈	  	
	 S-Corporation
	  	 ̈	  	
	 Estate
	  	 ̈	  	
	 Grantor Trust
	  	 ̈	  	
	 Trust-EIN (a trust with an
	  		  	
	 EIN in this format: 12-3456789)
	  	 ̈	  	
	 Trust-SSN (a trust with an
	  		  	
	 EIN in this format: 123-45-6789)
	  	 ̈	  	
	 IRA-EIN
	  	 ̈	  	
	 IRA-SSN
	  	 ̈	  	
	 Exempt Organization
	  	 ̈	  	
	 LLP
	  	 ̈	  	
	 LLC
	  	 ̈	  	
	 Nominee-EIN
	  	 ̈	  	
	 Nominee-SSN
	  	 ̈	  	
	 Other
	  	 ̈	  	

  

			
	 2.      U.S. Taxpayer Identification or Social Security Number:
	 	
		 	  

		
	 3.      Date of Birth:
	 	
		 	  

	
	 4.      Primary Contact Person For This Account and for General
Notices:

 Name:
                                         
                                         
     
 Address:
                                         
                                         
   
 _________________________________________________ 

Telephone:
                                         
                                        

Fax:
                                         
                                         
         

  
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	4.	Contact Person(s) For This Account for Financial Information and Reporting (including quarterly and annual financial reports and capital account statements):

  

					
	
Name:                       
                                         
                                     
	 		  	Name:                            
                                         
                            
			
	
Address:                      
                                         
                                  
	 		  	Address:                            
                                         
                       
			
		 		  	
	  
	 		  	  

			
	
Telephone:                      
                                         
                              
	 		  	Telephone:                           
                                         
                    
			
	
Fax:                       
                                         
                                         
 
	 		  	Fax:                            
                                         
                                
			
	
E-mail:                       
                                         
                                    
	 		  	E-mail:                            
                                         
                          
	
	 5.      Contact Person(s) For This Account for Capital Call and Distribution
Notices:

			
	
Name:                       
                                         
                                     
	 		  	Name:                            
                                         
                            
			
	
Address:                      
                                         
                                  
	 		  	Address:                            
                                         
                       
			
		 		  	
	  
	 		  	  

			
	
Telephone:                      
                                         
                              
	 		  	Telephone:                           
                                         
                    
			
	
Fax:                       
                                         
                                         
 
	 		  	Fax:                            
                                         
                                
			
	
E-mail:                       
                                         
                                    
	 		  	E-mail:                            
                                         
                          
	
	 6.      Contact Person For This Account for Legal Documentation (please limit to one
contact):

			
	
Name:                       
                                         
                                     
	 		  	
			
	
Address:                      
                                         
                                  
	 		  	
			
		 		  	
	  
	 		  	
			
	
Telephone:                      
                                         
                              
	 		  	
			
	
Fax:                       
                                         
                                         
 
	 		  	
			
	
E-mail:                       
                                         
                                    
	 		  	

  
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	7.	Contact Person For This Account for Tax Matters (including Form 1099 distribution) (please limit to one contact): 

Name:
                                         
                                         
     
 Address:
                                         
                                         
   
 _________________________________________________ 
 Telephone:
                                         
                                        

Fax:
                                         
                                         
         
 E-mail:
                                         
                                         
         
  

	8.	For distributions of cash, please wire funds to the following bank account: 

 Bank Name:                               
                                         
                                         
                                         
                                         
                             
 Bank Location:                              
                                         
                                         
                                         
                                         
                         
 Account Number:                              
                                         
                                         
                                         
                                         
                    

Account Name:                   
                                         
                                         
                                         
                                         
                                   

Bank’s Routing No.:                 
                                         
                                         
                                         
                                         
                            
 For further credit to:                           
                                         
                                         
                                         
                                         
                  

(if any)                    
                                         
                                         
                                         
                                         
                                         
         

Reference:                     
                                         
                                         
                                         
                                         
                                         
  

SWIFT Code:                    
                                         
                                         
                                         
                                         
                                      

 

	9.	For distributions in-kind, please: 

 Credit securities to my brokerage account at the following firm: 

Firm Name:                    
                                         
                                         
                                         
                                         
                                        

Address:                     
                                         
                                         
                                         
                                         
                                         
     

Account Name:                   
                                         
                                         
                                         
                                         
                                   

Account Number:                   
                                         
                                         
                                         
                                         
                               

DTC Number                    
                                         
                                         
                                         
                                         
                                      

 

	10.	Permanent Address of Investor: 

(if different from address for Notices above)          
                                         
                                         
                                         
                               

 

			
	 	  	  

	 	  	  

  
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	B.	Accredited Investor Status 

 The Investor
represents and warrants that the Investor is an “accredited investor” within the meaning of Rule 501 of Regulation D under the Securities Act of 1933, as amended (the “1933 Act”), and has checked the box or boxes below which are
next to the category or categories under which the Investor qualifies as an accredited investor: 
 FOR INDIVIDUALS, INDIVIDUAL IRAS, JOINT IN
TENANCY: 
  

					
	  ̈    
	 	(A)  	 	A natural person with individual net worth (or joint net worth with spouse) in excess of $1 million. For purposes of this item, “net worth” means the excess of total
assets at fair market value, including automobiles and other personal property and property owned by a spouse, but excluding the value of the primary residence of such natural person, over total liabilities. For this purpose, the amount of any
mortgage or other indebtedness secured by an Investor’s primary residence should not be included as a “liability”, except to the extent the fair market value of the residence is less than the amount of such mortgage or other
indebtedness.
			
	  ̈
	 	(B)	 	A natural person with individual income (without including any income of the Investor’s spouse) in excess of $200,000, or joint income with spouse in excess of $300,000, in
each of the two most recent years and who reasonably expects to reach the same income level in the current year.
	
	 FOR ENTITIES:

			
	  ̈
	 	(A)	 	An entity, including a grantor trust, in which all of the equity owners are accredited investors (for this purpose, a beneficiary of a trust is not an equity owner, but the grantor
of a grantor trust may be an equity owner).
			
	  ̈
	 	(B)	 	A bank as defined in Section 3(a)(2) of the 1933 Act, or any savings and loan association or other institution as defined in Section 3(a)(5)(A) of the 1933 Act whether acting in its
individual or fiduciary capacity.
			
	  ̈
	 	(C)	 	An insurance company as defined in Section 2(a)(13) of the 1933 Act.

  
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	  ̈    
	 	(D)  	 	A broker-dealer registered pursuant to Section 15 of the Securities Exchange Act of 1934, as amended (the “1934 Act”).
			
	  ̈    
	 	(E)  	 	An investment company registered under the Investment Company Act of 1940, as amended (the “1940 Act”).
			
	  ̈    
	 	(F)  	 	A business development company as defined in Section 2(a)(48) of the 1940 Act.
			
	  ̈    
	 	(G)  	 	A Small Business Investment Company licensed by the Small Business Administration under Section 301(c) or (d) of the Small Business Investment Act of 1958, as
amended.
			
	  ̈    
	 	(H)  	 	A private business development company as defined in Section 202(a)(22) of the Investment Advisers Act of 1940, as amended (the “Advisers Act”).
			
	  ̈    
	 	(I)  	 	A corporation, an organization described in Section 501(c)(3) of the United States Internal Revenue Code of 1986, as amended, Massachusetts or similar business trust, or
partnership, in each case not formed for the specific purpose of acquiring Shares, with total assets in excess of $5 million.
			
	  ̈    
	 	(J)  	 	A trust with total assets in excess of $5 million not formed for the specific purpose of acquiring Shares, whose purchase is directed by a person with such knowledge and experience
in financial and business matters as to be capable of evaluating the merits and risks of an investment in the Shares.
			
	  ̈    
	 	(K)  	 	An employee benefit plan within the meaning of the United States Employee Retirement Income Security Act of 1974, as amended (“ERISA”) if the decision to invest in the
Shares is made by a plan fiduciary, as defined in Section 3(21) of ERISA, which is either a bank, savings and loan association, insurance company, or registered investment adviser, or if the employee benefit plan has total assets in excess of $5
million or, if a self-directed plan, with investment decisions made solely by persons that are accredited investors.

  
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	  ̈    
	 	(L)  	 	A plan established and maintained by a state, its political subdivisions, or any agency or instrumentality of a state or its political subdivisions for the benefit of its employees,
if the plan has total assets in excess of $5 million.

  

	C.	Supplemental Data for Individuals, Individual IRAs, Joint in Tenancy 

 Please indicate whether you are investing the assets of any retirement plan, employee benefit plan or other similar agreement (such as an IRA or “Keogh” plan). 

 ̈    
Yes             ̈     No 
 If the above question was answered “Yes,” please indicate the type of retirement plan, employee benefit plan or other similar agreement below: 

 

			
	 	  	  

  

	D.	Supplemental Data for Entities 

 1. If
the Investor is not a natural person, the Investor must furnish the following supplemental data (Natural persons may skip this Section of the Investor Questionnaire): 
 Legal form of entity (trust, corporation, partnership, limited liability company, etc.):
                                         
                            
 Jurisdiction of organization and location of domicile:
                                         
                                         
                                   

Beneficial Ownership: 
  

					
	 Full Name
	  	 Full Legal Address
	  	 Designation*

		  		  	
	  
	  	  
	  	  

		  		  	
	  
	  	  
	  	  

		  		  	
	  
	  	  
	  	  

		  		  	
	  
	  	  
	  	  

  

	*	Please designate officer, director, general partner, managing director, member, trustee, settlor or beneficial owner 

2. Is the Investor (i) an entity treated as an individual (including, without limitation, an organization described in Sections 401(a), 501(c)(17)
or 509(a) of the Code) for purposes of Section 542(a)(2) of the Code or (ii) an entity disregarded from its owner for U.S. federal income tax purposes whose owner is an individual or entity treated as an individual for purposes of
Section 542(a)(2) of the Code? 
  ̈    
Yes             ̈     No 

  
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 If the above question was answered “Yes,” please indicate the type of entity
below: 
  

			
	 	  	  

  

	3.	This question is for U.S. Investors only. If the Investor is a non-U.S. Investor, please skip this question 3. 

If the Investor is a pass-through entity for U.S. federal tax purposes, please list as an attachment the following: 

(i) the legal forms of entity of the owners of the Investor (by percentage interest); 

(ii) the residence, for tax purposes, of the owners of the Investor (by percentage interest); 

(iii) the entity classification (e.g., corporation, partnership, disregarded entity, trust or estate) for U.S. federal income tax purposes
of the owners of the Investor; 
 (iv) the aggregate percentage interest of owners of the Investor that are exempt from federal
income taxation (please separately indicate what percentage of such owners are exempt from tax under Sections 115 or 892 of the Code); and 
 (v) for each owner of the Investor that is a pass through entity for U.S. federal tax purposes, the information specified in this question 6.b(i)-(iv), to the extent such information is known, or
reasonably available to the Investor. 
 4. This question is for Non-U.S. Investors only (including Investors acting for beneficial owners that
are Non-U.S. persons). If the Investor is a U.S. Investor, please skip this question 4. 
 4.a. Does the Investor qualify as an integral part or
a controlled entity of a foreign government for purposes of Section 892 of the Code (for example, certain sovereign wealth funds)? 
  ̈    
Yes             ̈     No 
 If “Yes,” please furnish an executed copy of form W-8EXP. 
 4.b. Does the Investor
qualify as a pension fund entitled to an exemption from withholding tax on dividends under an applicable tax treaty? 
  ̈     Yes             ̈     No 

If “Yes,” please indicate the relevant treaty below and on an executed copy of form W-8BEN. 

Applicable Treaty:
                                         
                                         
                                       

  
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 4.c. Does the Investor qualify for a reduced rate of withholding tax on dividends under any applicable
tax treaty? 
  ̈    
Yes             ̈     No 
 If “Yes,” please indicate the relevant treaty below and on an executed copy of form W-8BEN. 
 Applicable Treaty:
                                         
                                         
                                         
              
 4.d. If the Investor is acting as a custodian, nominee, or
in another capacity other than as the sole beneficial owner, or if the Investor is a partnership or other fiscally transparent entity for tax purposes in the United States, the Investor’s country or place of organization or the country of
residence of a partner or interest holder, please provide information (as an attachment) regarding the tax status of the relevant beneficial owners, partners or other interest holders, including: 

(i) the legal forms of the relevant beneficial owners, partners or other interest holders (by percentage interest); 

(ii) the residence, for tax purposes, of the relevant beneficial owners, partners or other interest holders (by percentage interest);

 (iii) the entity classification (e.g., corporation, partnership, disregarded entity, trust or estate) for U.S. federal tax
purposes of the relevant beneficial owners, partners or other interest holders; 
 (iv) the aggregate percentage interest of the
relevant beneficial owners, partners or other interest holders that are exempt from federal income taxation (please separately indicate what percentage of such owners are exempt from tax under Section 892 of the Code); and 

(v) for each owner of an Investor that is a pass-through entity for U.S. federal tax purposes, the information specified in Question
4.d(i)-(iv), to the extent such information is known, or reasonably available, to the Investor. 
 5.a. Please indicate whether or not the
Investor is, or is acting (directly or indirectly) on behalf of, (i) an employee benefit plan (within the meaning of Section 3(3) of ERISA), whether or not such plan is subject to Title I of ERISA, (ii) a plan, individual retirement
account or other arrangement that is described in Section 4975 of the Code, whether or not such plan, account or arrangement is subject to Section 4975 of the Code, (iii) 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 Code under Section 401(c)(1)(A) of ERISA or the regulations
promulgated thereunder, or (iv) an entity which is deemed to hold the assets of any of the foregoing types of plans, accounts or arrangements (each of the foregoing described in clauses (i), (ii), (iii) and (iv) being referred to as a
“Plan Investor”). 
  ̈    
Yes             ̈     No 

  
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 5.b. If the Investor is, or is acting (directly or indirectly) on behalf of, such a Plan Investor,
please indicate whether or not the Plan Investor is subject to Title I of ERISA or Section 4975 of the Code. 
  ̈     Yes             ̈     No 

5.c. If the answer to question 5 b. above is “Yes”, please indicate what percentage of the Plan Investor’s assets invested in the Entities
are the assets of “benefit plan investors” within the meaning of Section 3(42) of ERISA as modified by 29 CFR 2510.3-101(f): 
 Percentage:              
 5.d.
If the Investor is investing the assets of an insurance company general account, please indicate what percentage of the insurance company general account’s assets invested in the Entities are the assets of “benefit plan investors”
within the meaning of Section 401(c)(1)(A) of ERISA or the regulations promulgated thereunder: 
 Percentage:
             
 5.e. If the Plan Investor is not subject to Title I of ERISA
or Section 4975 of the Code, please indicate whether or not such Plan Investor is subject to any other federal, state, local, non-U.S. or other laws or regulations that could cause the underlying assets of the Company to be treated as assets of
the Plan Investor by virtue of its investment in the Company and thereby subject the Company and the Adviser (or other persons responsible for the investment and operation of the Company’s assets) to laws or regulations that are similar to the
fiduciary responsibility or prohibited transaction provisions contained in Title I of ERISA or Section 4975 of the Code. 
  ̈     Yes             ̈     No 

6.a. Is the Investor a private investment company which is not registered under the 1940 Act in reliance on: 

Section 3(c)(1)
thereof?                                        
     ̈     Yes             ̈     No

 Section 3(c)(7)
thereof?                                        
     ̈     Yes             ̈     No

 6.b. Does the amount of the Investor’s subscription for Shares in the Company exceed 40% of the total assets (on a consolidated basis
with its subsidiaries) of the Investor? 
  ̈    
Yes             ̈     No 
 6.c. If either part of question 9.a. was answered “Yes,” please indicate whether or not the Investor was formed on or before April 30, 1996. 

 ̈    
Yes             ̈     No 

 

  
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 6.d. If question 6.c. was answered “Yes,” please indicate whether or not the Investor has
obtained the consent of its direct and indirect beneficial owners to be treated as a “qualified purchaser” as provided in Section 2(a)(51)(C) of the 1940 Act and the rules and regulations thereunder. 

 ̈    
Yes             ̈     No 
 If question 6.d. was answered “No,” please contact the Company for additional information that will be required. 
 7. Is the Investor an “investment company” registered or required to be registered under the 1940 Act or a “business development company,” as defined in Section 202(a)(22) of the
Advisers Act? 
  ̈    
Yes             ̈     No 
 If the box above was checked “Yes,” please contact the Company for additional information that will be required. 
 8. Is the Investor a “BHC Investor”?1 
  ̈    
Yes             ̈     No 
 9. If the Investor’s tax year ends on a date other than December 31, please indicate such date below: 
  

 
 10. Is the Investor subject to
the U.S. Freedom of Information Act, 5 U.S.C. § 552, (“FOIA”), any state public records access laws, any state or other jurisdiction’s laws similar in intent or effect to FOIA, or any other similar statutory or regulatory
requirement that might result in the disclosure of confidential information relating to the Company? 
  ̈     Yes             ̈     No 

If the question above was answered “Yes,” please indicate the relevant laws to which the Investor is subject and provide any
additional explanatory information in the space below: 
  

			
	 	  	  

	 	  	  

	 	  	  

  

 

	1 	 A “BHC Investor” is defined as an Investor that is a bank holding company, as defined in Section 2(a) of the Bank Holding Company Act of
1956, as amended (the “BHC Act”), a non-bank subsidiary (for purposes of the BHC Act) of a bank holding company, a foreign banking organization, as defined in Regulation K of the Board of Governors of the Federal Reserve System (12 C.F.R.
§ 211.23) or any successor regulation, or a non-bank subsidiary (for purposes of the BHC Act) of a foreign banking organization which subsidiary is engaged, directly or indirectly in business in the United States and which in any case holds
Shares for its own account. 

  
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 11. Was the Investor organized for the specific purpose of acquiring Shares? 

 ̈    
Yes             ̈     No 
 If the above question was answered “Yes,” please contact the Company for additional information that will be required. 

 

	E.	Related Parties/Other Beneficial Parties: 

1. To the best of the Investor’s knowledge, does the Investor control, or is the Investor controlled by or under common control with, any other
investor or prospective investor in the Company? 
  ̈    
Yes             ̈     No 
 If the question above was answered “Yes,” please indicate the name of such other investor in the space below: 

 
  
 2. Will any other person or persons have a beneficial interest in the Shares to be acquired hereunder (other than as a shareholder, partner, policy owner or other beneficial owner of equity interests in
the Investor)? (By way of example, and not limitation, “nominee” Investors or Investors who have entered into swap or other synthetic or derivative instruments or arrangements with regard to the Shares to be acquired herein would check
“Yes”) 
  ̈    
Yes             ̈     No 
 If either question above was answered “Yes,” please contact the Company for additional information that will be required. 

 

	F.	Qualified Purchaser or Knowledgeable Employee Status: 

 The Investor represents and warrants that the Investor is either (i) a “qualified purchaser” within the meaning of Section 2(a)(51) of the 1940 Act or (ii) a “knowledgeable
employee” under Rule 3c-5 under the 1940 Act and has checked the box or boxes below which are next to the category or categories under which the Investor qualifies as a qualified purchaser or knowledgeable employee. In order to complete the
following information, Investors must read Annexes 1 and 2 to this Investor Questionnaire for the definition of “investments” and for information regarding the “valuation of investments,” respectively. The Investor agrees to
provide such further information and execute and deliver such documents as the Company may reasonably request to verify that the Investor qualifies as a “qualified purchaser.” 

  
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 Qualified Purchaser Status 
 FOR ENTITIES: 
  

					
	  ̈    
	 	(i)  	 	A company, partnership or trust that owns not less than $5,000,000 in “investments” and that is owned directly or indirectly by or for two or more natural persons who are
related as siblings or spouse (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 (a “Family Company”).
			
	  ̈    
	 	(ii)  	 	A trust that is not covered by (i) above and that was not formed for the specific purpose of acquiring Shares, as to which the trustee or other person authorized to make decisions
with respect to the trust, and each settlor or other person who has contributed assets to the trust, is a person described in clause (i), (iii) or (vi) of this Section F.
			
	  ̈    
	 	(iii)  	 	A person, acting for its own account or the accounts of other qualified purchasers, who in the aggregate owns and invests on a discretionary basis, not less than $25,000,000 in
“investments.”
			
	  ̈    
	 	(iv)  	 	A qualified institutional buyer as defined in paragraph (a) of Rule 144A under the 1933 Act, acting for its own account, the account of another qualified institutional buyer, or the
account of a qualified purchaser; provided, that (i) a dealer described in paragraph (a)(1)(ii) of Rule 144A shall own and invest on a discretionary basis at least $25 million in securities of issuers that are not affiliated persons of the
dealer; and (ii) a plan referred to in paragraph (a)(l)(i)(D) or (a)(l)(i)(E) of Rule 144A, or a trust fund referred to in paragraph (a)(l)(i)(F) of Rule 144A that holds the assets of such a plan, will not be deemed to be acting for its own account
if investment decisions with respect to the plan are made by the beneficiaries of the plan, except with respect to investment decisions made solely by the fiduciary, trustee or sponsor of such plan.
			
	  ̈    
	 	(v)  	 	A company, partnership or trust, each beneficial owner of the securities of which is a qualified purchaser.

  
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 FOR INDIVIDUALS, INDIVIDUAL IRAS, JOINT IN TENANCY: 

 ̈             (vi) A natural person (including
any person who holds a joint, community property or other similar shared ownership interest in the Company with that person’s qualified purchaser spouse) who owns not less than $5,000,000 in “investments”. 

Knowledgeable Employee Status 
  

					
	  ̈    
	 	(i)  	 	An “executive officer” or director, or person serving in a similar capacity, of the Company or an “affiliated management person” of the Company.
			
		 		 	For these purposes, an “executive officer” includes president, any vice president in charge of a principal business unit, division or function (such as sales,
administration or finance), any other officer who performs a policy-making function, or any other person who performs similar policy-making functions for the Company or an affiliated management person of the Company.
			
		 		 	“Affiliated management person” means an “affiliated person” of the Company that manages the investment activities of the Company or any other company that would
be an investment company but for the exclusion provided by Section 3(c)(1) or 3(c)(7) of the 1940 Act, where “affiliated person” of the Company means (i) any person directly or indirectly owning, controlling, or holding with power to vote,
5 per centum or more of the outstanding voting securities of the Company; (ii) any person 5 per centum or more of whose outstanding voting securities are directly or indirectly owned, controlled, or held with power to vote, by the Company; (iii) any
person directly or indirectly controlling, controlled by, or under common control with, the Company; (iv) any officer, director, partner, copartner, or employee of the Company; and (v) any investment adviser of the Company or any member of an
advisory board thereof.

  
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	  ̈    
	 	(ii)  	 	An employee of the Company or an “affiliated management person” (as defined above) of the Company (other than an employee performing solely clerical, secretarial or
administrative functions with regard to such company or its investments) who, in connection with his or her regular functions or duties, participates in the investment activities of the Company, another company that would be an investment company
but for the exclusion provided by section 3(c)(1) or 3(c)(7) of the 1940 Act, or investment companies the investment activities of which are managed by such affiliated management person of the Company, provided that such employee has been performing
such functions and duties for or on behalf of the Company or the affiliated management person of the Company, or substantially similar functions or duties for or on behalf of another company, for at least 12 months.

  

	G.	Financing of Acquisition 

Please indicate whether you are borrowing or are otherwise financing your acquisition of Shares hereunder. 

 ̈    
Yes             ̈     No 
 If the above question was answered “Yes,” please indicate the amount financed and what, if any, collateral was given to secure the financing: 

 
  
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 The Investor understands that the foregoing information will be relied upon by the
Company for the purpose of determining the eligibility of the Investor to purchase and own Shares in the Company. The Investor agrees to notify the Company immediately if any representation or warranty contained in this Subscription Agreement or any
of the information in the Investor Questionnaire becomes untrue at any time. The Investor agrees to provide, if requested, any additional information that may reasonably be required to substantiate the Investor’s status as an accredited
investor, a qualified purchaser or to otherwise determine the eligibility of the Investor to purchase Shares in the Company. To the fullest extent permitted by law, the Investor agrees to indemnify and hold harmless the Company and the Administrator
and each partner or member thereof, from and against any loss, damage or liability due to or arising out of a breach of any representation, warranty or agreement of the Investor contained herein. 

 

			
	 Signatures:
		
		 	 INDIVIDUAL, JOINT IN TENANCY, INDIVIDUAL IRA:

 

		 	(Signature)
		
		 	 
		 	(Print Name)

  

			
	
	 PARTNERSHIP, CORPORATION, LIMITED LIABILITY COMPANY, TRUST, CUSTODIAL ACCOUNT,
OTHER:
  
  

		 	(Name of Entity)
		
	By:	 	 
		 	(Signature)
		
	 	 	 
		 	(Print Name and Title)

  
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 Annex 1 to Investor Questionnaire 

DEFINITION OF “INVESTMENTS” 
 The term “investments” means: 
  

	1.	Securities, other than securities of an issuer that controls, is controlled by, or is under common control with, the Investor that owns such securities, unless the
issuer of such securities is: 

  

	 	(i)	An investment company or a company that would be an investment company but for the exclusions or exemptions provided by the 1940 Act, or a commodity pool; or

  

	 	(ii)	a Public Company (as defined below); 

  

	 	(iii)	A company with shareholders’ equity of not less than $50 million (determined in accordance with generally accepted accounting principles) as reflected on the
company’s most recent financial statements; provided, that such financial statements present the information as of a date within 16 months preceding the date on which the Investor acquires Interests; 

 

	2.	Real estate held for investment purposes; 

  

	3.	Commodity Interests (as defined below) held for investment purposes; 

  

	4.	Physical Commodities (as defined below) held for investment purposes; 

  

	5.	To the extent not securities, Financial Contracts (as defined below) entered into for investment purposes; 

 

	6.	In the case of an Investor that is a company that would be an investment company but for the exclusions provided by Section 3(c)(1) or 3(c)(7) of the 1940 Act, or
a commodity pool, any amounts payable to such Investor pursuant to a firm agreement or similar binding commitment pursuant to which a person has agreed to acquire an interest in, or make capital contributions to, the Investor upon the demand of the
Investor; and 

  

	7.	Cash and cash equivalents (including foreign currencies) held for investment purposes. 

Real estate that is used by the owner or a Related Person (as defined below) of the owner for personal purposes, or as a place of
business, or in connection with the conduct of the trade or business of such owner or a Related Person of the owner, will NOT be considered real estate held for investment purposes; provided, that real estate owned by an Investor who is
engaged primarily in the business of investing, trading or developing real estate in connection with such business may be deemed to be held for investment purposes. However, residential real estate will not be deemed to be used for personal purposes
if deductions with respect to such real estate are not disallowed by Section 280A of the Code. 

  

			
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 A Commodity Interest or Physical Commodity owned, or a Financial Contract entered into,
by the Investor who is engaged primarily in the business of investing, reinvesting, or trading in Commodity Interests, Physical Commodities or Financial Contracts in connection with such business may be deemed to be held for investment purposes.

 “Commodity Interests” means commodity futures contracts, options on commodity futures contracts, and options on
physical commodities traded on or subject to the rules of: 
  

	 	(i)	Any contract market designated for trading such transactions under the U.S. Commodity Exchange Act, as amended (the “Commodity Exchange Act”) and the rules
thereunder; or 

  

	 	(ii)	Any board of trade or exchange outside the United States, as contemplated in Part 30 of the rules under the Commodity Exchange Act. 

“Financial Contract” means any arrangement that: 

 

	 	(i)	takes the form of an individually negotiated contract, agreement, or option to buy, sell, lend, swap, or repurchase, or other similar individually negotiated
transaction commonly entered into by participants in the financial markets; 

  

	 	(ii)	is in respect of securities, commodities, currencies, interest or other rates, other measures of value, or any other financial or economic interest similar in purpose
or function to any of the foregoing; and 

  

	 	(iii)	is entered into in response to a request from a counter- party for a quotation, or is otherwise entered into and structured to accommodate the objectives of the
counterparty to such arrangement. 

 “Physical Commodities” means any physical commodity with respect to
which a Commodity Interest is traded on a market specified in the definition of Commodity Interests above. 
 “Public
Company” means a company that: 
  

	 	(i)	files reports pursuant to Section 13 or 15(d) of the Exchange Act; or 

 

	 	(ii)	has a class of securities that are listed on a Designated Offshore Securities Market, as defined by Regulation S of the Securities Act. 

“Related Person” means a person who is related to the Investor as a sibling, spouse or former spouse, or is a direct lineal
descendant or ancestor by birth or adoption of the Investor, or is a spouse of such descendant or ancestor, provided that, in the case of a Family Company, a Related Person includes any owner of the Family Company and any person who is a Related
Person of such an owner. “Family Company” means a company, partnership or trust that owns not less than $5,000,000 in investments and that is owned directly or indirectly by or for two or more natural persons who are related as siblings or
spouse (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 for the benefit of such persons. 

  

			
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 For purposes of determining the amount of investments owned by a company, there may be
included investments owned by majority-owned subsidiaries of the company and investments owned by a company (“Parent Company”) of which the company is a majority-owned subsidiary, or by a majority-owned subsidiary of the company and other
majority-owned subsidiaries of the Parent Company. 
 In determining whether a natural person is a qualified purchaser, there
may be included in the amount of such person’s investments any investment held jointly with such person’s spouse, or investments in which such person shares with such person’s spouse a community property or similar shared ownership
interest. In determining whether spouses who are making a joint investment in the Partnership are qualified purchasers, there may be included in the amount of each spouse’s investments any investments owned by the other spouse (whether or not
such investments are held jointly). There shall be deducted from the amount of any such investments any amounts specified by paragraph 2(a) of Annex 2 incurred by such spouse. 
 In determining whether a natural person is a qualified purchaser, there may be included in the amount of such person’s investments any investments held in an individual retirement account or similar
account the investments of which are directed by and held for the benefit of such person. 

  

			
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 Annex 2 to Investor Questionnaire 

VALUATION OF INVESTMENTS 
 The general rule for determining the value of investments in order to ascertain whether a person is a qualified purchaser is that the value of the aggregate amount of investments owned and invested on a
discretionary basis by such person shall be their fair market value on the most recent practicable date or their cost. This general rule is subject to the following provisos: 

 

	(1)	In the case of Commodity Interests, the amount of investments shall be the value of the initial margin or option premium deposited in connection with such Commodity
Interests; and 

  

	(2)	In each case, there shall be deducted from the amount of investments owned by such person the following amounts: 

 

	 	(a)	The amount of any outstanding indebtedness incurred to acquire or for the purpose of acquiring the investments owned by such person. 

 

	 	(b)	A Family Company, in addition to the amounts specified in paragraph (a) above, shall have deducted from the value of such Family Company’s investments any
outstanding indebtedness incurred by an owner of the Family Company to acquire such investments. 

  

			
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 APPENDIX E 
 TRANSFER RESTRICTIONS 
 No Transfer of the Investor’s Capital Commitment or all or any
fraction of the Investor’s Shares may be made without (i) registration of the Transfer on the Company books and (ii) the prior written consent of the Company. In any event, the consent of the Company may be withheld (x) if the
creditworthiness of the proposed transferee, as determined by the Company in its sole discretion, is not sufficient to satisfy all obligations under the Subscription Agreement or (y) unless, in the opinion of counsel (who may be counsel for the
Company or the Investor) satisfactory in form and substance to the Company: 
 such Transfer would not violate the 1933 Act, the
1940 Act or any state (or other jurisdiction) securities or “Blue Sky” laws applicable to the Company or the Shares to be Transferred; and 
 such Transfer would not be a “prohibited transaction” under ERISA or the Code or the regulations promulgated thereunder or cause all or any portion of the assets of the Company to constitute
“plan assets” under ERISA, certain Department of Labor regulations or Section 4975 of the Code. 
 The Investor agrees that it
will pay all reasonable expenses, including attorneys’ fees, incurred by the Company in connection with any Transfer of its Capital Commitment or all or any fraction of its Shares, prior to the consummation of such Transfer. 

Any person that acquires all or any fraction of the Shares of the Investor in a Transfer permitted under this Appendix E shall be obligated to pay to the
Company the appropriate portion of any amounts thereafter becoming due in respect of the Capital Commitment committed to be made by its predecessor in interest. The Investor agrees that, notwithstanding the Transfer of all or any fraction of its
Shares, as between it and the Company, it will remain liable for its Capital Commitment and for all payments of any Drawdown Purchase Price required to be made by it (without taking into account the Transfer of all or a fraction of such Shares)
prior to the time, if any, when the purchaser, assignee or transferee of such Shares, or fraction thereof, becomes a holder of such Shares. 

The Company shall not recognize for any purpose any purported Transfer of all or any fraction of the Shares and shall be entitled to treat the transferor
of Shares as the absolute owner thereof in all respects, and shall incur no liability for distributions or dividends made in good faith to it, unless the Company shall have given its prior written consent thereto and there shall have been filed with
the Company a dated notice of such Transfer, in form satisfactory to the Company, executed and acknowledged by both the seller, assignor or transferor and the purchaser, assignee or transferee, and such notice (i) contains the acceptance by the
purchaser, assignee or transferee of all of the terms and provisions of this Subscription Agreement and its agreement to be bound thereby, and (ii) represents that such Transfer was made in accordance with this Subscription Agreement, the
provisions of the Memorandum and all applicable laws and regulations applicable to the transferee and the transferor. 

  

			
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 APPENDIX F 
 

 
 Form W-8ECI (Rev. February 2006) Department of the Treasury Internal Revenue Service
Certificate of Foreign Person’s Claim That Income Is Effectively Connected With the Conduct of a Trade or Business In the United States Section references are to the Internal Revenue Code. See separate Instructions. Give this form to the
withholding agent or payer. Do not send to the IRS. OMB No. 1 545-1621 Note: Persons submitting this form must fife an annual U.S. income tax return to report income claimed to be effectively connected with a U.S. trade or business (see
instructions). Do not use this form for: Instead, use Form: A beneficial owner solely claiming foreign status or treaty benefits W-8BEN A foreign government, international organization, foreign central bank of issue, foreign tax-exempt organization,
foreign private foundation, or government of a U.S. possession claiming the applicability of section(s) 115(2), 501(c), 692. 395, or 1443(b) W-8EXP Note: These entities should use Form W-8ECI if they received effectively connected income (e.g.,
income from commercial activities). A foreign partnership or a foreign trust (unless claiming an exemption from U.S. withholding on income effectively connected with the conduct of a trade or business in the United States) W-8BEN or W-8IMY * A
person acting as an intermediary W-8IMY Note: See instructions for additional exceptions. Part I Identification of Beneficial Owner (See instructions.) 1 Name of individual or organization that is the beneficial owner 2 Country of incorporation or
organization 3 Type of entity (check the appropriate box): Individual Partnership Simple trust Government Grantor trust ? Private foundation International organization Corporation Complex trust Central bank of issue Disregarded entity Estate
Tax-exempt organization 4 Permanent residence address (street, apt. or suite no., or rural route). Do not use a P.O. box. City or town, state or province. Include postal code where appropriate. Country (do not abbreviate) 5 Business address in the
United States (street, apt. or suite no., or rural route). Do not use a P.O. box. City or town, state, and ZIP code 6 U.S. taxpayer identtfication number (required—see instructions) SSn or ITIN EIN 7 Foreign tax identifying number, if any
(optional) Reference number(s) (see instructions) 9 Specify each item of income that is, or is expected to be. received from the payer that is effectively connected with the conduct of a trade or business in the United States (attach statement if
necessary) Certification Under penalties of perjury. I declare that I have examined the information on this form and to the best of my knowledge and belief it is true, correct, and complete. I further certify under penalties of perjury that: * I am
the beneficial owner (or I am authorized to sign for the beneficial owner) of all the income to which this Form relates, * The amounts for which this certification is provided are effectively connected with the conduct oF a trade or business in the
United States and are includible in my gross income (or the beneficial owner’s gross income) for the taxable year, and * The beneficial owner is not a US. person. Furthermore. I authorize this form to be provided to any withholding agent that
has control, receipt, or custody of the income of which I am the beneficial owner or any withholding agent that can disburse or make payments of the income of which I am the beneficial owner. Copy No.: For the Exclusive Use of: Signature oF
beneficial owner (or individual authorized to sign For the beneficial owner) Date (MM-DD-YYYY) Capacity in which acting For Paperwork Reduction Act Notice, see separate Instructions. Cat No 250450 Form W-8ECI (Rev-2-2006) 

			
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 Fom W-8EXP (Rev. February 2006) Department of the Treasury Internal Revenue Service
Certificate of Foreign Government or Other Foreign Organization for United States Tax Withholding (For use by foreign governments, international organizations, foreign central banks of issue, foreign tax-exempt organizations, foreign private
foundations, and governments of U.S. possessions.) Section references are to the Internal Revenue Code. See separate instructions. Give this form to the withholding agent or payer. Do not send to the IRS. OMB No. 1545-1621 Do not use this form for:
Instead, use Form: Any foreign government or other foreign organization that is not claiming the applicability of section(s) 115(2). 501(c), 892, 895, or 1443(b) W-8BEIM or W-8ECI A beneficial owner solely claiming foreign status or treaty benefits
W-8BEN A foreign partnership or a foreign trust W-8BEN or W-8IMY A person claimimg that income is effectively connected with the conduct of a trade or business in the United States W-8ECI A person acting as an intermediary W-8IMY Part I
Identification of Beneficial Owner (See instructions before completing this part.) 1 Name of organization 2 Country of incorporation or organization 3 Type of entity I I 1 international organization Foreign central bank of issue Foreign government
International organization Foreign central bank of issue (not wholly own by the Government of a U.S. possession foreign sovereign) Foreign tax-exempt organization Foreign private foundation 4 Permanent address (street, apt. or suite no., or rural
route). Do not use a P.O. box. City or town, state or province. Include postal code where appropriate. Country (do not abbreviate) 5 Mailing address (if different from above) City or town, state or province. Include postal or ZIP code where
appropriate. Country (do not abbreviate) 6 U.S. taxpayer identification number, if required (see instructions) 7 Foreign tax identifying number, if any (optional) 8 Reference number(s) (see instructions) Qualification Statement 9 For a foreign
government: a I certify that the entity identified in Part I is a foreign government within the meaning of section 892 and the payments are within the scope of the exemption granted by section 892. Check box 9b or box 9c, whichever applies: b ? The
entity identified in Part I is an integral part of the government of c ? The entity identified in Part I is a controlled entity of the government of 10 For an international organization: ? I certify that: The entity identified in Part I is an
international organization within the meaning of section 7701(a)(18) and The payments are within the scope of the exemption granted by section 892. 11 For a foreign central bank of issue (not wholly owned by the foreign sovereign): ? I certify that:
The entity identified in Part I is a foreign central bank of issue, The entity identified in Part I does not hold obligations or bank deposits to which this form relates for use in connection with the conduct of a commercial banking function or
other commercial activity, and The payments are within the scope of the exemption granted by section 895. (Part 11 and required certification continued on page 2) For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 25401F Form
W-8EXP (Rev. 2-2006) 

			
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 Form W-8EXP (Rev. 2-2006) Page 2 Qualification Statement (continued) 12 For a foreign
tax-exempt organization, including foreign private foundations: If any of the income to which this certification relates constitutes income includible under section 512 in computing the entity’s unrelated business taxable income, attach a
statement identifying the amounts. Check either box 12a or box 12b: a I certify that the entity identified in Part I has been issued a determination letter by the IRS dated that is currently in effect and that concludes that it is an exempt
organization described in section 501(c). b I have attached to this form an opinion from U.S. counsel concluding that the entity identified in Part I is described in section 501(c) For section 501 (c)(3) organizations only, check either box 12c or
box 12d: c If the determination letter or opinion of counsel concludes that the entity identified in Part I is described in section 501(c)(3), I certify that the organization is not a private foundation described in section 509. I have attached an
affidavit of the organization setting forth sufficient facts for the IRS to determine that the organization is not a private foundation because it meets one of the exceptions described in section 509(a)(1), (2), (3), or (4). d If the determination
letter or opinion of counsel concludes that the entity identified in Part I is described in section 501(c)(3), I certify that the organization is a private foundation described in section 509. 13 For a government of a U.S. possession: I certify that
the entity identified in Part I is a government of a possession of the United States, or is a political subdivision thereof, and is claiming the exemption granted by section 115(2). Certification Under penalties of perjury, I declare that I have
examined the information on this form and to the best of my knowledge and belief it is true, correct, and complete. I further certify under penalties of perjury that: The organization for which I am signing is the beneficial owner of the income to
which this form relates, The beneficial owner is not a U.S. person, For a beneficial owner that is a controlled entity of a foreign sovereign (other than a central bank of issue wholly owned by a foreign sovereign), the beneficial owner is not
engaged in commercial activities within or outside the United States, and For a beneficial owner that is a central bank of issue wholly owned by a foreign sovereign, the beneficial owner is not engaged in commercial activities within the United
States. Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the income of which I am the beneficial owner or any withholding agent that can disburse or make payments of the income of
which I am the beneficial owner. Sign Here Signature of authorized official Date (MM-DD-YYYY) Capacity in which acting 

			
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 Copy No.: For the Exclusive Use of: Form W-8BEN (Rev. February 2006) Department of the
Treasury Internal Revenue Service Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding J” Section references are to the Internal Revenue Code. I” See separate instructions. jii Give this form to the
withholding agent or payer. Do not send to the IRS. OMB No. 1545-1621 Do not use this form for: Instead, use Form: A U.S. citizen or other U.S. person, including a resident alien individual W-9 A person claiming that income is effectively connected
with the conduct of a trade or business in the United States W-8ECI A foreign partnership, a foreign simple trust, or a foreign grantor trust (see instructions for exceptions) W-8ECI or W-8IMY A foreign government, international organization,
foreign central bank of issue, foreign tax-exempt organization, foreign private foundation, or government of a U.S. possession that received effectively connected income or that is claiming the applicability of section(s) 115(2), 501(c), 892. 895,
or 1443(b) (see instructions) W-SECi or W-8EXP Note: These entities should use Form W-8BEN if they are claiming treaty benefits or are providing the form only to claim they are a foreign person exempt from backup withholding. A person acting as an
intermediary W-8IMY Note: See instructions for additional exceptions. Part I Identification of Beneficial Owner (See instructions.) 1 Name of individual or organization that is the beneficial owner 2 Country of incorporation or organization 3 Type
of beneficial owner: Grantor trust Central bank of issue Partnership Simple trust International organization Part II Claim of Tax Treaty Benefits (if applicable) 9 I certify that (check all that apply): a The beneficial owner is a resident of within
the meaning of the income tax trealy between the United States and that country. b If required, the U.S. taxpayer identification number is stated on line 6 (see instructions). c The beneficial owner is not an individual, derives the item (or items)
of income for which the treaty benefits are claimed, and, if applicable, meets the requirements of the treaty provision dealing with limitation on benefits (see instructions). d The beneficial owner is not an individual, is claiming treaty benefits
for dividends received from a foreign corporation or interest from a U.S. trade or business of a foreign corporation, and meets qualified resident status (see instructions). e The beneficial owner is related to the person obligated to pay the income
within the meaning of section 267(b) or 707(b), and will file Form 8833 if the amount subject to withholding received during a calendar year exceeds, in the aggregate. $500,000. 10 Special rates and conditions (if applicable—see instructions):
The beneficial owner is claiming the provisions of Article of the treaty identified on line 9a above to claim a % rate of withholding on (specify type of income): . Explain the reasons the beneficial owner meets the terms of the treaty article: Copy
No.: For the Exclusive Use of: Part III Notional Principal Contracts Copy No.: For the Exclusive Use of: 11 I have provided or will provide a statement that identifies those notional principal contracts from which the income is not effectively
connected with the conduct of a trade or business in the United States. I agree to update this statement as required. Copy No.: For the Exclusive Use of: Part IV Certification Under penalties of perjury, I declare that I have examined the
information on this form and to the best of my knowledge and belief it is true, correct, and complete. I further certify under penalties of perjury that: 1 I am the beneficial owner (or am authorized to sign for the beneficial owner) of all the
income to which this form relates, 2 The beneficial owner is not a U.S. person, 3 The income to which this form relates is (a) not effectively connected with the conduct of a trade or business in the United States, (b) effectively connected but is
not subject to tax under an income tax treaty, or (c)the partner’s share of a partnership’s effectively connected income, and 4 For broker transactions or barter exchanges, the beneficial owner is an exempt foreign person as defined in the
instructions. Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the income of which I am the beneficial owner or any withholding agent that can disburse or make payments of the income
of which I am the beneficial owner. Sign Here Signature of beneficial owner (or individual authorized to sign for beneficial owner) Date (MM-DD-YYYY) Capacity in which acting For Paperwork Reduction Act Notice, see separate instructions. Cat. No.
25047Z Form W-8BEN (Rev. 2-2006) Printed on Recycled Paper © 

			
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 (Rev. February 2006) Department of the Treasury Internal Revenue Service Certificate of
Foreign Intermediary. Foreign Flow-Through Entity, or Certain U.S. Branches for United States Tax Withholding Section references are to the Internal Revenue Code. See separate instructions. Give this form to the withholding agent or payer. Do not
send to the IRS. OMB No. 1545-1621 Do not use this form for: Instead, use Form: A beneficial owner solely claiming foreign status or treaty benefits W-8BEN A hybrid entity claiming treaty benefits on its own behalf W-8BEN A person claiming that
income is effectively connected with the conduct of a trade or business in the United States W-SECI A disregarded entity. Instead, the single foreign owner should use , , W-8BEN or W-8EC! A foreign government, international organization, foreign
central bank of issue, foreign tax-exempt organization, foreign private foundation, or government of a U.S. possession claiming the applicability of section(s) 115(2), 501(c), 892, 895, or 1443(b) W-8EXP Part I Identification of Entity Copy No.: For
the Exclusive Use of: 1 Name of individual or organization that is acting as intermediary 2 Country of incorporation or organization 3 Type of entity—check the appropriate box: Qualified intermediary. Complete Part II. Nonqualified
intermediary. Complete Part III. U.S. branch. Complete Part IV. Withholding foreign partnership. Complete Part V. Withholding foreign trust. Complete Part V. Nonwithholding foreign partnership. Complete Part VI. Nonwithholding foreign simple trust.
Complete Part VI. Nonwithholding foreign grantor trust. Complete Part VI. Copy No.: For the Exclusive Use of: 4 Permanent residence address (street, apt. or suite no., or rural route). Do not use P.O. box. City or town, state or province. Include
postal code where appropriate. Country (do not abbreviate) 5 Mailing address (if different from above) City or town, state or province. Include postal code where appropriate. Country (do not abbreviate) 6 U.S. taxpayer identification number (if
required, see instructions) ? ? SSN or ITIN ? EIN ? QI-EIN 7 Foreign tax identifying number, if any (optional) 8 Reference number(s) (see instructions) Qualified Intermediary 9a (All qualified intermediaries check here) i certify that the entity
identified in Part I; Is a qualified intermediary and is not acting for its own account with respect to the account(s) identified on line 8 or in a withholding statement associated with this form and Has provided or will provide a withholding
statement, as required. b ? (If applicable) I certify that the entity identified in Part I has assumed primary withholding responsibility under Chapter 3 of the Code with respect to the account(s) identified on this line 9b or in a withholding
statement associated with this form c ? (If applicable) I certify that the entity identified in Part I has assumed primary Form 1099 reporting and backup withholding responsibility as authorized in its withholding agreement with the IRS with respect
to the account(s) identified on this line 9c or in a withholding statement associated with this form Part III Nonqualified Intermediary 10a ? (All nonqualified intermediaries check here) I certify that the entity identified in Part I is not a
qualified intermediary and is not acting for its own account. b ? (if applicable) I certify that the entity identified in Part I is using this form to transmit withholding certificates and/or other documentary evidence and has provided or will
provide a withholding statement, as required. For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 25402Q Form W-8IMY (Rev 2-2006) 

			
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 W-9 Form (Rev. December 2011) Department ofthe Treasury Internal Revenue Service
Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. Name (as shown on your income tax return) Business name/disregarded entity name, if different from above Check appropriate box for
federal tax classification: ^ Individual/sole proprietor ; C Corporation | S Corporation Partnership | | Trust/estate | | Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) If | | Other
(see instructions) ? Exempt payee Copy No.: For the Exclusive Use of: Address (number, street, and apt. or suite no.) Requester’s name and address (optional) Copy No.: For the Exclusive Use of: City, state, and ZIP code List account number(s)
here (optional) Taxpayer Identification Number (TIN) Social security number Enter your TIN in the appropriate box. The TIN provided must match the name given on the ‘Name’ line to avoid backup withholding. For individuals, this is your
social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, seethe Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to
get a TIN on page 3. Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter. Employer identification number Part II Certification Under penalties of perjury, I certify that: 1. The number shown
on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the
Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. I am a U.S. citizen or
other U.S. person (defined below). Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on
your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally,
payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 4. Copy No.: For the Exclusive Use of: Sign Here Signature of U.S. person ** Date ? Copy
No.: For the Exclusive Use of: General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Purpose of Form A person who is required to file an information return with the IRS must obtain your correct taxpayer
identification number (TIN) to report, for example, income paid to you, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA Use Form W-9 only
if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be
issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership
income from a U.S. trade or business is not subject to the withholding tax on foreign partners’ share of effectively connected income. Note. If a requester gives you a form other than Form W-9 to request your TIN, you must use the
requester’s form if it is substantially similar to this Form W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are: An individual who is a U.S. citizen or U.S. resident alien, - A partnership,
corporation, company, or association created or organized in the United States or under the laws of the United States, * An estate (other than a foreign estate), or -A domestic trust (as defined in Regulations section 301.7701-7). Special rules for
partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax on any foreign partners’ share of income from such business. Further, in certain cases where a Form W-9 has not
been received, a partnership is required to presume that a partner is a foreign person, and pay the withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide
Form W-9 to the partnership to establish your U.S. status and avoid withholding on your share of partnership income. Cat. No. 10231X Form W-9 (Rev. 12-2011) 

			
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 Copy No.: For the Exclusive Use of: Form W-9 (Rev. 12-2011) Page 2 The person who gives
Form W-9 to the partnership for purposes of establishing its U.S. status and avoiding withholding on its allocable share of net income from the partnership conducting a trade or business in the United States is in the following cases: - The U.S.
owner of a disregarded entity and not the entity, - The U.S. grantor or other owner of a grantor trust and not the trust, and - The U.S. trust (other than a grantor trust) and not the beneficiaries of the trust. Foreign person. If you are a foreign
person, do not use Form W-9. Instead, use the appropriate Form W-8 (see Publication 515, Withholding of Tax on Nonresident Aliens and Foreign Entities). Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual
may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of income. However, most tax treaties contain a provision known as a “saving clause.” Exceptions specified in the saving clause may permit an exemption from
tax to continue for certain types of income even after the payee has otherwise become a U.S. resident alien for tax purposes. If you are a U.S. resident alien who is relying on an exception contained in the saving clause of a tax treaty to claim an
exemption from U.S. tax on certain types of income, you must attach a statement to Form W-9 that specifies the following five items: 1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a
nonresident alien. 2. The treaty article addressing the income. 3. The article number (or location) in the tax treaty that contains the saving clause and its exceptions. 4. The type and amount of income that qualifies for the exemption from tax. 5.
Sufficient facts to justify the exemption from tax under the terms of the treaty article. Example. Article 20 of the U.S.-China income tax treaty allows an exemption from tax for scholarship income received by a Chinese student temporarily present
in the United States. Under U.S. law, this student will become a resident alien for tax purposes if his or her stay in the United States exceeds 5 calendar years. However, paragraph 2 of the first Protocol to the US-China treaty (dated April 30,
1984) allows the provisions of Article 20 to continue to apply even after the Chinese student becomes a resident alien of the United States. A Chinese student who qualifies for this exception (under paragraph 2 of the first protocol) and is relying
on this exception to claim an exemption from tax on his or her scholarship or fellowship income would attach to Form W-9 a statement that includes the information described above to support that exemption. If you are a nonresident alien or a foreign
entity not subject to backup withholding, give the requester the appropriate completed Form W-8. What is backup withholding? Persons making certain payments to you must under certain conditions withhold and pay to the IRS a percentage of such
payments. This is called “backup withholding.” Payments that maybe subject to backup withholding include interest, tax-exempt interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee pay, and certain
payments from fishing boat operators. Real estate transactions are not subject to backup withholding. You will not be subject to backup withholding on payments you receive if you give the requester your correct TIN, make the proper certifications,
and report all your taxable interest and dividends on your tax return. Payments you receive will be subject to backup withholding if: 1. You do not furnish your TIN to the requester, 2. You do not certify your TIN when required (see the Part II
instructions on page 3 for details), 3. The IRS tells the requester that you furnished an incorrect TIN, 4. The IRS tells you that you are subject to backup withholding because you did not report all your interest and dividends on your tax return
(for reportable interest and dividends only), or 5. You do not certify to the requester that you are not subject to backup withholding under 4 above (for reportable interest and dividend accounts opened after 1983 only). Certain payees and payments
are exempt from backup withholding. Seethe instructions below and the separate Instructions for the Requester of Form W-9. Also see Special rules for partnerships on page 1. Updating Your Information You must provide updated information to any
person to whom you claimed to be an exempt payee if you are no longer an exempt payee and anticipate receiving reportable payments in the future from this person. For example, you may need to provide updated information if you are a C corporation
that elects to be an S corporation, or if you no longer are tax exempt. In addition, you must furnish a new Form W-9 if the name or Tl N changes for the account, for example, if the grantor of a grantor trust dies. Penalties Failure to furnish TIN.
If you fail to furnish your correct TIN to a requester, you are subject to a penalty of $50 for each such failure unless your failure is due to reasonable cause and not to willful neglect. Civil penalty for false information with respect to
withholding. If you make a false statement with no reasonable basis that results in no backup withholding, you are subject to a $500 penalty. Criminal penalty for falsifying information. Willfully falsifying certifications or affirmations may
subject you to criminal penalties including fines and/or imprisonment. Misuse of TINs. If the requester discloses or uses TINs in violation of federal law, the requester may be subject to civil and criminal penalties. Specific Instructions Name If
you are an individual, you must generally enter the name shown on your income tax return. However, if you have changed your last name, for instance, due to marriage without informing the Social Security Administration of the name change, enter your
first name, the last name shown on your social security card, and your new last name. If the account is in joint names, list first, and then circle, the name of the person or entity whose number you entered in Part I of the form. Sole proprietor.
Enter your individual name as shown on your income tax return on the “Name” line. You may enter your business, trade, or “doing business as (DBA)” name on the “Business name/disregarded entity name” line. Partnership, C
Corporation, or S Corporation. Enter the entity’s name on the “Name” line and any business, trade, or “doing business as (DBA) name” on the “Business name/disregarded entity name” line. Disregarded entity. Enter
the owner’s name on the “Name” line. The name of the entity entered on the “Name” line should never be a disregarded entity. The name on the “Name” line must be the name shown on the income tax return on which the
income will be reported. For example, if a foreign LLC that is treated as a disregarded entity for U.S. federal tax purposes has a domestic owner, the domestic owner’s name is required to be provided on the “Name” line. If the direct
owner of the entity is also a disregarded entity, enter the first owner that is not disregarded for federal tax purposes. Enter the disregarded entity’s name on the “Business name/disregarded entity name” line. If the owner of the
disregarded entity is a foreign person, you must complete an appropriate Form W-8. Note. Check the appropriate box for the federal tax classification of the person whose name is entered on the “Name” line (Individual/sole proprietor,
Partnership, C Corporation, S Corporation, Trust/estate). Limited Liability Company (LLC). if the person identified on the “Name” line is an LLC, check the “Limited liability company” box only and enter the appropriate code for
the tax classification in the space provided. If you are an LLC that is treated as a partnership for federal tax purposes, enter “P” for partnership, if you are an LLC that has filed a Form 8832 or a Form 2553 to be taxed as a corporation,
enter “C” for C corporation or “S” for S corporation. If you are an LLC that is disregarded as an entity separate from its owner under Regulation section 301.7701-3 (except for employment and excise tax), do not check the LLC box
unless the owner of the LLC (required to be identified on the “Name” line) is another LLC that is not disregarded for federal tax purposes. If the LLC is disregarded as an entity separate from its owner, enter the appropriate tax
classification of the owner identified on the “Name” line. Form W-9 (Rev. 12-2011) 

			
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 Page 3 Other entities. Enter your business name as shown on required federal tax
documents on the “Name” line. This name should match the name shown on the charter or other legal document creating the entity. You may enter any business, trade, or DBA name on the “Business name/ disregarded entity name” line.
Exempt Payee If you are exempt from backup withholding, enter your name as described above and check the appropriate box for your status, then check the “Exempt payee” box in the line following the “Business name/ disregarded entity
name,” sign and date the form. Generally, individuals (including sole proprietors) are not exempt from backup withholding. Corporations are exempt from backup withholding for certain payments, such as interest and dividends. Note. If you are
exempt from backup withholding, you should still complete this form to avoid possible erroneous backup withholding. The following payees are exempt from backup withholding: 1. An organization exempt from tax under section 501(a), any IRA, or a
custodial account under section 403(b)(7) if the account satisfies the requirements of section 401(f)(2), 2. The United States or any of its agencies or instrumentalities. 3. A state, the District of Columbia, a possession of the United States, or
any of their political subdivisions or instrumentalities, 4. A foreign government or any of its political subdivisions, agencies, or instrumentalities, or 5. An international organization or any of its agencies or instrumentalities. Other payees
that may be exempt from backup withholding include: 6. A corporation, 7. A foreign central bank of issue, 8. A dealer in securities or commodities required to register in the United States, the District of Columbia, or a possession of the United
States, 9. A futures commission merchant registered with the Commodity Futures Trading Commission, 10. A real estate investment trust, 11. An entity registered at all times during the tax year under the Investment Company Act of 1940, 12. A common
trust fund operated by a bank under section 584(a), 13. A financial institution, 1 4. A middleman known in the investment community as a nominee or custodian, or 15. A trust exempt from tax under section 664 or described in section 4947. The
following chart shows types of payments that may be exempt from backup withholding. The chart applies to the exempt payees listed above. 1 through 15. Part I. Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. If you are a
resident alien and you do not have and are not eligible to get an SSN, your TIN is your IRS individual taxpayer identification number (ITIN). Enter it in the social security number box. If you do not have an ITIN, see How to get a TIN below. If you
are a sole proprietor and you have an EIN you may enter either your SSN or EIN. However, the IRS prefers that you use your SSN. If you are a single-member LLC that is disregarded as an entity separate from its owner (see Limited Liability Company
(LLC) on page 2), enter the owner’s SSN (or EIN, if the owner has one). Do not enter the disregarded entity’s EIN. If the LLC is classified as a corporation or partnership, enter the entity’s EIN. Note. Seethe chart on page 4 for
further clarification of name and TIN combinations. How to get a TIN. If you do not have a TIN. apply for one immediately. To apply for an SSN, get Form SS-5, Application for a Social Security Card, from your local Social Security Administration
office or get this form online at www.ssa.gov. You may also get this form by calling 1-800-772-1213. Use Form W-7, Application for IRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form SS-4, Application for Employer
Identification Number, to apply for an EIN. You can apply for an EIN online by accessing the IRS website at www.irs.gov/businesses and clicking on Employer Identification Number (EIN) under Starting a Business. You can get Forms W-7 and SS-4 from
the IRS by visiting IRS.govor by calling 1-800-TAX-FORM (1-800-829-3676). If you are asked to complete Form W-9 but do not have a TIN, write “Applied For” in the space for the TIN. sign and date the form, and give it to the requester. For
interest and dividend payments, and certain payments made with respect to readily tradable instruments, generally you will have 60 days to get a TIN and give it to the requester before you are subject to backup withholding on payments. The 60-day
rule does not apply to other types of payments. You will be subject to backup withholding on all such payments until you provide your TIN to the requester. Note. Entering “Applied For” means that you have already applied for a TIN or that
you intend to apply for one soon. Caution: A disregarded domestic entity that has a foreign owner must use the appropriate Form W-8. Part II. Certification To establish to the withholding agent that you are a U.S. person, or resident alien, sign
Form W-9. You may be requested to sign by the withholding agent even if item 1, below, and items 4 and 5 on page 4 indicate otherwise. For a joint account, only the person whose TIN is shown in Part I should sign (when required). In the case of a
disregarded entity, the person identified on the “Name” line must sign. Exempt payees, see Exempt Payee on page 3. Signature requirements. Complete the certification as indicated in items 1 through 3, below, and items 4 and 5 on page 4. 1.
Interest, dividend, and barter exchange accounts opened before 1984 and broker accounts considered active during 1983. You must give your correct TIN, but you do not have to sign the certification. 2. Interest, dividend, broker, and barter exchange
accounts opened after 1983 and broker accounts considered inactive during 1983. You must sign the certification or backup withholding will apply. If you are subject to backup withholding and you are merely providing your correct TIN to the
requester, you must cross out item 2 in the certification before signing the form. 3. Real estate transactions. You must sign the certification You may cross out item 2 of the certification.

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