Ivy Asset Management Corp. - A Registered Investment Adviser.


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Investor Qualification Questionnaire and Agreement

The information contained in this Investor Qualification Questionnaire and Agreement is being furnished by you in connection with determining whether you will be granted access to certain password-protected areas of the web site of Ivy Asset Management.

denotes required fields.

First Name:

Last Name:

Company:

Address:

City:

State/Province:

Zip/Postal Code:

Country:

Phone:

Fax:

Email:

Comments/Requests:

Type of Investor:

Accredited Investors:

Yes No

My net worth, or joint net worth with my spouse exceeds $1,000,000.

Yes No

I had an individual income in excess of $200,000 in each of the last two calendar years, or joint income with my spouse in excess of $300,000 in each of those years and I have a reasonable expectation of reaching the same income level in this calendar year.

Yes No

I possess such knowledge and experience in financial and business matters that I am capable of evaluating, alone, or together with a purchaser representative that I have engaged for this purpose, the merits and risks of a prospective investment in any private investment opportunities that I may become aware of through this account.

Qualified Purchasers:

Yes No

I own at least $5 million in investments, including investments (a) held in an IRA or similar account, the investments of which are directed by and held for the benefit of me, (b) held jointly with my spouse or (c) in which I share a community property or similar shared ownership interest with my spouse. Spouses who subscribe jointly may combine their investments for purposes of meeting the $5 million threshold, whether or not the investments are held jointly or individually.

Yes No

I act for my own account or the accounts of other "qualified purchasers" who in the aggregate own and invest on a discretionary basis at least $25 million in investments.

Affiliation Status:

Yes No

Either I, or a member of my household, is affiliated with a U.S. based financial securities firm.

If so, specify firm name and relationship:

Firm Name:

Relationship:

Employment and Business Information:

Employer (include most current information):

Business Address:

City:

State/Province:

Zip/Postal Code:

Country:

Business Phone:

Position:

Nature of Duties:

Period Employed:

Educational Background (Beginning with College):

School Major Degree and Year (if any)

Investment Experience:

I currently have or have previously made investments in (please check all that apply):

stocks or bonds

mutual funds

futures, commodities, options or other derivative instruments

real estate

private investment funds (hedge funds, private equity funds, commodity pools, etc.)

other (please describe):

Miscellaneous

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

(b) You agree that your rights and interests in gaining access to the information posted in the Ivy web site are not transferable or assignable.

(c) Upon receipt of a written request from Ivy, you shall provide such information and execute and deliver such documents as Ivy may deem reasonably necessary to comply with any and all laws and ordinances to which Ivy is or may be subject.

(d) Ivy does not warrant or insure that its web site will be free from errors, omissions, interruptions, delays, losses or defects, whether human or mechanical. Ivy does not make any warranties, express or implied, of any kind whatsoever as to its web site, including, but not limited to, any warranties of merchantability or fitness for a particular purpose. In no event will Ivy be liable for any indirect, consequential, special, exemplary or incidental damages relating to the adequacy, accuracy or completeness of any information on its web site or the use of any information retrieved from its web site.

(e) You acknowledge that in order to make an investment in an investment fund managed by Ivy, you will be required to comply with the fund's investment requirements.

(f) You agree to provide such further information as Ivy may reasonably require.

(g) For purposes of this Agreement, Ivy shall include Ivy and its affiliates.

(h) This Agreement shall be governed by, and construed in accordance with, the laws of the State of [New York].

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

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