Fondsstad Financial Market Experience Questionnaire

Client Financial Market Experience

Introduction

As a provider of the financial services “Discretionary Fund Management (DFM)” and “order execution”, Fondsstad is obligated to gather information about you, as a customer. The information you provide in this form will be used in connection with the provision of the aforementioned services. It is therefore important that the information you give Fondsstad is correct.

When providing an “order execution” service, Fondsstad is required to carry out an assessment of your knowledge and experience of the financial instrument in question (“appropriateness test”). Prior to providing an “DFM” service, Fondsstad is required to gather information about your knowledge and experience of the investment area in question, as well as your financial situation and investment goals. The information will be used to determine which investments are suitable for you as a customer.

Please complete the following:

Client Name:____________________________________________________________________________ Client Age:___________________________

Account Number (if known):____________________________________________________________________________________________________

Portfolio Advisor or Portfolio Manager:___________________________________________________________________________________________

Date:______________________________________________________________________________________________________________________

Personal Information

Last Name/middle name: First name:

Nationality: Nationality ID number:

Address: Country:

Postal Code: Town/City: E-mail:

Mobile Number: Telephone Number: Telefax:

Marital status (married/single/cohabitant): Employment (permanent/part-time/temp): Number of children under 18:

Knowledge & Experience

Please answer the questions below to help us form an accurate picture of your knowledge and experience. Simply check “not relevant” for any product groups that are not relevant for your customer relationship with Fondsstad.

Do you have any experience with financial instruments in a professional context? Yes No

If yes, have you worked in the financial sector for at least one year in a positionthat requires knowledge of the transactions or investment services? Yes No

Level of education (check only one). Primary school Secondary school College/university degree Post degree

Products: do you have knowledge/experience of any of these product categories?

Do you have Knowledge?

If yes to knowledge, what experience do you have?

Not relevantNo experience Some experience High experience

Equity related instruments and derivatives

Listed shares/primary capital certificates

Unlisted shares (OTC)

Subscription rights

Equity derivatives (options, forwards, futures)

Securities loans and short selling

Yes No

Yes No

Yes No

Yes No

Yes No

Knowledge & Experience

Please answer the questions below to help us form an accurate picture of your knowledge and experience. Simply check “not relevant” for any product groups that are not relevant for your customer relationship with Fondsstad.

Products: do you have knowledge/experience of any of these product categories?

Do you have Knowledge?

If yes to knowledge, what experience do you have?

Not relevantNo experience Some experience High experience

Other financial instruments

Mutual fund and Exchange-traded funds (ETF)

Exchange traded notes or similar diverse assets

Listed warrants

Unlisted warrants

Contract for difference

Debt instruments

Investment-grade bonds (rating AAA to BBB) and certificates

High-yield bonds (rating BB to C)

Interest-rate, currency and commodity instruments

Foreign exchange (spot)

Foreign exchange forwards and other currency derivatives

Interest-rate derivatives (e.g. interest-rate swaps and FRAs)

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Knowledge & Experience

Please answer the questions below to help us form an accurate picture of your knowledge and experience. Simply check “not relevant” for any product groups that are not relevant for your customer relationship with Fondsstad.

Products: do you have knowledge/experience of any of these

product categories?

Do you have

Knowledge?

If yes to knowledge, what experience do you have?

Not relevantNo experience Some experience High experience

Other financial instruments (continue…)

Commodity derivatives

Direct investments

Investments in real estate syndicated projects and shipping

projects, shares in general and limited partnerships or similar

Yes No

Yes No

Financial Situation (Current investments and wealth)

Please specify the estimated amount/market value in whole numbers, with no decimal places “.

Choose one of the following currencies (check one only):

Bank deposits

Holdings of listed shares

Holdings of mutual funds

Other, less liquid financial instruments

Other significant wealth

Value (EUR, CHF, GBP, USD, Others)

Knowledge & Experience

Please answer the questions below to help us form an accurate picture of your knowledge and experience. Simply check “not relevant” for any product groups that are not relevant for your customer relationship with Fondsstad.

Financial Situation (Current investments and wealth) continue…

Please specify the estimated amount/market value in whole numbers, with no decimal places “. Choose one of the following currencies (check one only):

Bonds

Debt

Fixed obligations/annual expenses (insurance premiums, loans etc.)

Last year’s income

Value (EUR, CHF, GBP, USD, Others)

Investment goals

Investment goals and willingness in connection with investment(Check the box that you consider most suitable for you)

The products/risk specified below are only indicative. The risk attached to individual financial instruments can vary substantially:

Low return / low risk – I have low return expectations. Low risk normally means a limited potential for loss. Examples of low risk investments include bank deposits, money market funds and government bonds.

Knowledge & Experience

Please answer the questions below to help us form an accurate picture of your knowledge and experience. Simply check “not relevant” for any product groups that are not relevant for your customer relationship with Fondsstad.

Investment goals (continue…)

Moderate return / moderate risk – I am willing to take more risk to increase the potential return. Examples of moderate risk investments include ordinary equity funds, ungeared ETFs and investment grade bonds.

The high risk category has been split into three to reflect the different levels of risk attached to products in this category.

High return / high risk – I want high returns and am willing to take a high risk in order to achieve this. I can also tolerate substantial fluctuations of value/losses.

High risk – Listed shares on the Main Indices or the equivalent in other market places, high yield bonds with ratings of BB+ to B and ungeared currency futures.

Higher risk – Listed shares that are not in the Main Indices or the equivalent in other market places, unlisted shares, ungeared ETNs, ungeared commodity derivatives and high yield bonds with ratings of B- or lower.

Highest risk – Equity derivatives, margin accounts, short selling, geared ETFs, geared ETNs (Bull/Bear certificates), warrants, subscription rights, CFD, geared currency forwards, geared interest rate derivatives, geared commodity derivatives and currency trading.

Investment horizon - on – how long the funds will be invested in the market (not individual transactions) (answer only if object is investment)

Less than 1 year 1-2 years 3-4 years 5-10 years >10 years

Confirmation

I have read and accept Fondsstad ordinary business terms.

I agree to and accept Fondsstad prevailing guidelines for order execution at all times.

I agree that customer orders may be executed outside a regulated market or Multilateral Trading Facility (MTF) to the extent this is permitted according to the guidelines for order execution.

I confirm that the provided information is correct and complete. I also confirm that I will inform Fondsstad of any noteworthy changes.

Place/Date: Signature:

Terms & Conditions of using Fondsstad Investor Questionnaire

This questionnaire is designed to help you decide how to allocate your assets among different asset classes (stocks, bonds, and short-term reserves). You are under no obligation to accept the suggested allocations provided by this questionnaire.

The suggestions provided are based on generally accepted investment principles. There is no guarantee, however, that any particular asset allocation or mix of funds will meet your investment objectives or provide you with a given level of retirement income. All investing is subject to risk, and fluctuations in the financial markets and other factors may cause the value of your plan account to decline. Investments in bond funds are subject to interest rate, credit, and inflation risk.

You should carefully consider all of your options before investing.

This investment-planning tool is provided to you at no charge by Fondsstad. Please note the questionnaire does not provide comprehensive investment or financial advice. In applying the suggestions to your particular situation, you should consider your other assets and investments. As your financial circumstances or goals change, it may be helpful to complete the Investor Questionnaire again to see if your suggested asset allocation has changed. By using this investment-planning tool, you acknowledge that you have read and understood the information above and that you agree to these terms and conditions.