Investor Qualifier

Clarety Global Investments, LLC Accredited Investor Questionnaire The purpose of this document is to determine whether you meet the standards for participation in a non-public offering under Section 4(2) of the Securities Act of 1933, as amended ("Act"), and under the laws of the various States. In particular, The Global Biopharm Opportunity Fund-1 (GBOF-1) is capitalized by an investment in Clarety Explorer, LP, a fund organized in the United States by Clarety Global Investments, LLC, as well as an offshore fund domiciled in Bermuda. Please provide the information below to receive documentation supporting due diligence on Clarety Explorer and GBOF-1. We do not use your confidential information for any purpose other than determining that you meet the definition of Accredited Investor as required by State and Federal law; however, each individual who completes and submits this Questionnaire thereby agrees that Clarety Global Investments, LLC, or its affiliates, may present his responses to this Questionnaire to such parties as Clarety Global Investments, LLC, or its affiliates, deems appropriate for verification in order to assure itself and future issuers that the subsequent offer and sale of securities will not result in a violation of the provisions of State or Federal securities laws. Please complete this form as thoroughly as possible and submit it. If the answer to any question is "None" or "Not Applicable", please so state, do not leave blanks. If you wish to fill out a PDF of this form and send it to us with your signature, please send a request to paul.ward@claretyglobalinvestments.com

Name*

Occupation*

Birth Month

Birth Day (1-31)

Birth Year

Residential Address

City of residence

State of residence

Residential ZIP

Business Address

Business City

Business State

Business ZIP

Natural person information

If this Questionnaire is being completed to identify a natural person as the Accredited Investor

Accredited Person Voting State*

Please indicate the State in which the person is registered to vote.

Accredited Person Drivers License Issuing State*

Please indicate the State in which the person holds a valid Driver's License.

Accredited Person Residency for Tax Purposes*

Please indicate the State of residence that the person identifies on their personal income tax return.

Type of entity or person

Please initial the appropriate response to the following statements. ARE YOU:

Bank*

Any bank as defined in section 3(a)(2) of the Act, or any savings and loan association or other institution as defined in section 3(a)(5)(A) of the Act whether acting in its individual or fiduciary capacity?

Select or enter value

Broker or dealer*

Any broker or dealer registered pursuant to section 15 of the Securities Exchange Act of 1934?

Select or enter value

Insurance company*

Any insurance company as defined in section 2(13) of the Act?

Select or enter value

Investment company or business development company*

Any investment company registered under the Investment Company Act of 1940 or any business development company as defined in section 2(a)(48) of that Act?

Select or enter value

SBIC*

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?

Select or enter value

Employee benefit plan*

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?

Select or enter value

ERISA fiduciary*

Any employee benefit plan within the meaning of the Employee Retirement Income Security Act of 1974 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 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?

Select or enter value

Trust

Any organization described in section 501(c)(3) of the Internal Revenue Code, corporation, Massachusetts or similar business trust, or partnership, not formed for the specific purpose of acquiring the securities offered, with total assets in excess of $5,000,000?

Select or enter value

Private business development company*

Any private business development company as defined in section 202(a)(22) of the Investment Advisors Act of 1940?

Select or enter value

Entity with assets >$5M*

Select or enter value

Director, officer, or partner*

Any director, executive officer, or general partner of the issuer of the securities being offered or sold, or any director, executive officer, or general partner of a general partner of that issuer?

Select or enter value

Natural person of high net worth*

Any natural person whose individual net worth or joint net worth with that person's spouse, at the time of his purchase exceeds $1,000,000?

Select or enter value

High salary person*

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?

Select or enter value

Entity of accredited investors*

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

Select or enter value

Make the appropriate selection.

Personal account only*

With respect to any investment by me, I hereby represent that I am investing for my personal account and not for resale or re-syndication. Furthermore, I have not entered into any contract, undertaking, arrangement, or agreement with any other person or entity to sell or transfer, or to have any person or entity sell all or any portion of the investment interest. I have adequate means to provide for current financial needs and contingencies and there is no current or immediate need to resell any interests purchased by me.

Select or enter value

Risk of loss acknowledged*

I understand that all investments involve risk that could result in the loss of capital and that there is no guarantee or representation made by anyone regarding the likelihood of profitable operation of this investment.

Select or enter value

Disclosure documents are the only source relied upon*

I represent that the issuer, nor any of its affiliates or representatives, have not made any representations or warranties with respect to the performance of this investment and I am making my investment decision solely in reliance upon the information contained in the disclosure documents and any other investigations I, or my representatives, have made.

Select or enter value

Bona fide resident of state*

I am a bonafide resident of the state indicated on the signature page. The address and federal tax identification number set forth thereon is my true and correct residence and social security number or federal tax identification number.

Select or enter value

Adequate experience to evaluate*

I have business and financial experience adequate to evaluate any potential investment and to protect my own interest in such activity.

Select or enter value

Understand SEC has not endorsed*

I understand that neither the SEC nor any state regulator has made any finding or determination relating to the fairness or suitability for this investment, and that neither the SEC nor state regulators have recommended or endorsed this investment.

Select or enter value

Afforded time with issuer for questions*

I have been afforded an opportunity, if requested by me, to ask questions of the issuer, its affiliates or representatives, regarding this investment.

Select or enter value

Indemnify*

I agree to indemnify and hold harmless, the issuer, Clarety Explorer, LP, and its affiliated companies and representatives from and against any and all claims, demands, losses, damages, expenses, or liabilities (including attorney’s fees) due to or arising out of a breach of any the representations I have made above.

Select or enter value

Seeking counsel/advisory*

I intend to have an attorney, accountant, investment advisor (other than the selling FINRA registered representative), or other consultant act as my Purchaser’s Representative in connection with this potential investment.

Select or enter value

Clarification of "purchaser's representative"

Note: The Selling FINRA registered representative is not the “Purchaser’s Representative” as that term relates to private placement offerings, but is an attorney, accountant, investment advisor, or other consultant who provides tax, investment, or other advice regarding the investment decision.

Not investing because of general solicitation*

I represent that I am not investing as a result of any general public solicitation or public advertising.

Select or enter value

Referror

How did you learn about the availability of this investment opportunity?

Your email*

Your daytime phone number*

Private fax number

Today's date*

Note

If after reviewing your Questionnaire we cannot reasonably believe that you are an Accredited Investor, or if we have not yet completed the required filings in your state, we will so notify you promptly. Please Mail The Completed Questionnaire To: Clarety Global Investments, LLC 2 Wisconsin Avenue Suite 700 Chevy Chase MD 20815 Alternatively: E-mail: paul.ward@claretyglobalinvestments.com or e-Fax: +1-240-804-1844

Send me a copy of my responses

Privacy Notice|Report Abuse