Shah Capital | Request Access

Access to www.shahcapital.com is restricted to authorized persons only. In order to obtain access, please complete and submit this form. You will be contacted by a member of our Investor Relations team to verify the information you submit, and then a login to access the site will be provided to you. This website shall not constitute an offer to sell or the solicitation of an offer to purchase any securities in any jurisdiction.

All information provided on this questionnaire will be held in confidence in accordance with Shah's Disclaimer as in effect from time to time.

All fields marked with an asterisk (*) are required.

Personal Information

* Name:

Title:

* Occupation:

* Phone:

Fax:

* Email:

* Company:

Address:

City:

State/Province:

Zip/Postal Code:

Country:

* 1. You are completing this information on behalf of:

Yourself
Your Organization
Both

* 2. Are you an accredited investor in accordance with Rule 501(a) of Regulation D of the Securities Act of 1933? See definition below.

Yes No

If yes, please complete the following information:

An “accredited investor” is any person who comes within any of the following categories. Please indicate, by checking, one or more of the following categories which are applicable to you. If no category is applicable, please check Item Number 10, “None.”

Any 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; any broker or dealer registered pursuant to Section 15 of the Securities Exchange Act of 1934; any insurance company as defined in Section 2(13) of the 1933 Act; any investment company registered under the Investment Company Act of 1940 as amended (the “1940 Act”) or Business Development Company as defined in Section 2(a)(48) of the 1940 Act; any Small Business Investment Company licensed by the U.S. Small Business Administration under Section 301(c) or (d) of the Small Business Investment Act of 1958;

Any ERISA Plan if the investment decision is made by a plan fiduciary, as defined in section 3(21) of such Act, 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 $5,000,000, or, if a self-directed plan, with investment decisions made solely by persons that are accredited investors;

Any 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 such plan has total assets in excess of $5,000,000;

Any private business development company as defined in Section 202(a)(22) of the 1940 Act;

Any organization described in Section 501(c)(3) of the Internal Revenue Code of 1986, as amended (the “Code”), corporation, Massachusetts or similar business trust, or partnership (which may include endowments or foundations), not formed for the specific purpose of acquiring the securities offered, with total assets in excess of $5,000,000;

Any natural person whose individual net worth, or joint net worth with that person’s spouse, at the time of such Investor’s purchase, exceeds $1,000,000 (excluding the value of the primary residence of such natural person)¹;

Any natural person who had an individual income in excess of $200,000 in each of the two most recent years or joint income with that person’s spouse in excess of $300,000 in each of those years and has a reasonable expectation of reaching the same income level in the current year;

Any trust (which may include endowments or foundations), with total assets in excess of $5,000,000, not formed for the specific purpose of acquiring the securities offered, whose purchase is directed by a sophisticated person as described in Rule 506(b)(2)(ii) under the 1933 Act;

Any entity in which all of the equity owners are accredited investors; or

None of the above apply.

* 3. Are you a qualified client as defined under Rule 205-3(d)(i) under the Investment Advisers Act of 1940?

Yes No

If yes, please complete the following information:

A “qualified client” is any person or entity who comes within any of the following categories. Please indicate, by checking, one or more of the following categories that are applicable to you. If no category is applicable, please check Item Number 5, “None.”

a natural person who or a company that has at least $750,000 under the management of Shah Capital Management, Inc.; or

any natural person or company² (other than a company that is required to be registered under the 1940 Act but is not registered) that has a net worth (together, in the case of a natural person, with assets held jointly with a spouse) of more than $1,500,000; or

any natural person or company (other than a company that is required to be registered under the 1940 Act but is not registered) that is a “qualified purchaser” as defined in Section 2(a)(51)(A) of the 1940 Act; or

a private investment company, such that the company would be defined as an investment company under section 3(a) of the 1940 Act, but for the exception provided from that definition by section 3(c)(1) of the 1940 Act, an investment company registered under the 1940 Act or a business development company as defined in the 1940 Act, and each equity owner of such entity satisfies one of the above conditions.

None of the above apply.

* 4. Are you a qualified purchaser in accordance with Section 2(a)(51) of the Investment Company Act of 1940?

Yes No

If yes, please complete the following information:

A “qualified purchaser” is any person or entity who comes within any of the following categories. Please indicate, by checking, one or more of the following categories which are applicable to you. If no category is applicable, please Item Number 5, “None”.

any natural person (including any person who holds a joint, community property, or other similar shared ownership interest in an issuer that is excepted under section 3(c)(7) of the 1940 Act with that person's qualified purchaser spouse) who owns not less than $5,000,000 in investments, as defined by the U.S. Securities and Exchange Commission;

any company that owns not less than $5,000,000 in investments and that is owned directly or indirectly by or for 2 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;

any trust that is not covered by Item 2 above and that was not formed for the specific purpose of acquiring the securities offered, 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 Items 1 or 2 above or Item 4 below; or

any 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.

None of the above apply.

5. What investment styles suit your particular interest in hedge funds?

6. What are your return objectives?

* 7. What is your investment horizon?

Long Term (>5 years)

Med Term (2-5 years)

Short Term (<2 years)

* 8. What is your risk tolerance?

High (Agressive)

Moderate

Low (Conservative)

* 9. Do you invest in hedge funds?

Yes No

If yes, please complete the following information.

How many years have you been investing in hedge funds?

Approximately how many hedge funds are you invested in?

What percentage do hedge funds comprise of your portfolio?

Do you typically use leverage in hedge fund investments?
If so, how much?

What is the approximate total value (in US$) of your hedge fund portfolio?

What is your average investment size?

Once you invest, how long does it take to get to your average investment size?

What is your turnover in hedge fund investments?

10. Please choose the category that best describes you:

Fund-of-Funds

Bank

Individual

Fund Manager

Pension Fund

Broker-Dealer

Endowment

Insurance Co.

Family office

Consultant

Foundation

Registered Investment Adviser

Third-Party Marketer

11. If you selected Fund-of-Funds:

What percentage of your assets are institutional investors versus high-net worth?

Do you have lock-up money?

What is your average investment size?

Once you invest, how long does it take to get to your average investment size?

12. You heard about Shah Capital Management through
(please describe in detail):

News Article:

Conference:

Database/Index:

Current Investor:

Third Party:

Other (Referral):

Anti-Money Laundering Certification

This section must be completed for you/beneficial investor. For this section, please see Definitions.

By checking this box, I hereby represent and certify that I am not involved in any anti-money laundering scheme and that my investment funds have not been directly or indirectly derived from activities that may contravene U.S. or international laws, rules and regulations designed to avoid money laundering, including, without limitation, the provisions of the Bank Secrecy Act of 1970, as amended. Neither I nor any person controling, controlled by, or under common control with me, nor any person having a beneficial interest in my investments is a country, territory, person or entity named on the U.S. Department of Treasury Office of Foreign Asset Control list, or is a person or entity that resides or has a place of business in a country or territory named in such lists. I agree to notify you promptly should I become aware of any changes to the information set forth in this statement. I hereby agree to hold Shah Capital Management, Inc and each of its principals, members, directors, officers, and employees harmless and to indemnify the same against any loss arising as a result of a inaccuracy in the foregoing or any other statement in this questionnaire.

If I am (I) acting as trustee, agent, representative or disclosed nominee for another person or entity, or (II) an entity investing on behalf of underlying investors (including a fund-of-funds), other than a publicly traded company listed on an organized exchange (or a subsidiary or a pension fund of such a company) based in a Financial Action Task Force (FATF) Compliant Jurisdiction (the persons, entities and underlying investors referred to in (I) and (II) being referred to collectively as the (Beneficial Owners), I represent and warrant that:

I understand and acknowledge the representations, warranties and agreements made herein are made by me (A) with respect to me, and (B) with respect to the Beneficial Owners

I have all requisite power and authority from the Beneficial Owners to execute and perform the obligations under this Questionnaire and Registered User's Agreement

I have adopted and implemented anti-money laundering policies, procedures and controls that comply with, and will continue to comply in all respects with, the requirements of applicable anti-money laundering laws and regulations

I have established or have access to the identity of all Beneficial Owners, hold evidence of or have access to such identities and will make such information available to a fund upon request and have procedures in place to ensure that the Beneficial Owners are not Prohibited Investors.

Thank you very much for your time. By pressing the "Submit/I Agree" button below, you agree that you have filled in this questionnaire completely, truthfully and to the best of your ability and that you also have read, agree to the terms and conditions set forth in the Terms of Use Agreement which you should review carefully.

¹ Indebtedness secured by the primary residence, up to the residence’s fair market value, may also be excluded; however, indebtedness secured by the residence in excess of the value of the residence should be considered a liability and deducted from the Investor’s net worth.

² “Company” means a corporation, a partnership, an association, a joint-stock company, a trust, a fund, or any organized group of persons whether incorporated or not; or any receiver, trustee in bankruptcy or similar official or any liquidating agent for any of the foregoing, in his capacity as such.