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By agreeing to enter this website, I acknowledge that I received a password from and authorized by DF Burch Advisors, to access the information presented. I accept and agree to abide by the User Agreement in its entirety. The information on this website is not an offer to sell or solicitation of an offer to buy an interest in any investment fund or for the provision of any investment management or advisory services. Any such offer or solicitation will be made only by means of delivery of a confidential private offering memorandum relating to a particular fund or investment management contract to qualified investors in those jurisdictions where permitted by law.

Investor Qualification Questionnaire

For regulatory purposes please fill out the requested information below. You will be contacted by a member of our Investor Relations team to verify the information you submit, and your user ID and password will be activated.

The following information is needed in order that the General Partner may accurately determine (1) whether an investment in the Partnership is suitable in light of the investor's personal, financial and investment needs, and (2) whether the investor has such knowledge and experience in financial and business matters that he is capable of evaluating the merits and risks of the investment.

Personal Information:

* First Name:
* Last Name:
* Email / Username:
* Password:
Business Name:
* Home Address:
Business Address:
* Home Phone:
Cell Phone:
Business Phone:
Employer of Individual:
Position or Title of Individual:
Year of Anticipated Retirement:
Approximate Net Worth: $
Approximate Annual Income: $

Investment History:

ClassificationAmountCheck if managed on a Discretionary or Pooled BasisYears of Experience
Stocks$
Bonds$
Mutual Funds – Stock Oriented$
Mutual Funds – Bond Oriented$
Mutual Funds - Balanced$
Real Estate$
Real Estate Investment Entities$
Oil & Gas Investment Entities$
Other: $

1. Have you had training or experience in financial and business matters?
Yes No
If yes, please give details:
2. Highest educational degree received and date:
3. Do you make your own ultimate decision on your investments?
Yes No
If yes, for how long have you been doing it and what types of investments and amounts have been involved?
4. Are you an “Accredited Investor,” has defined in rule 501(a) of Regulation D Promulgated under the 1933 Act?
Check the space or spaces below that apply.
     (a) Any director, executive officer or general partner of the Partnership, or any director, executive officer or general partner of a general partner of the Partnership;
     (b) Any natural person whose individual net worth, or joint net worth with that person's spouse, excluding the equity value of the primary residence of the Subscriber, at the time of this purchase exceeds $1,000,000;
     (c) Any private business development company as defined in Section 202(a)(22) of the Investment Advisers Act of 1940;
     d) 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;
     (e) 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 LP Investment, with total assets in excess of $5,000,000;
     (f) Any trust, with total assets in excess of $5,000,000, not formed for the specific purpose of acquiring the LP Investment, whose purchase is directed by a sophisticated person as described in Rule 506(b) of Regulation D of the 1933 Act;
     (g) Any entity in which all of the equity owners are accredited investors; or
     (h) 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 the 1933 Act) which is either a bank, savings and loan association, insurance company or registered investment advisor, or if such employee benefit plan has total assets of more than $5,000,000, or if such employee benefit plan is a self-directed plan and the investment decisions are made solely by persons that are accredited investors within the meaning set forth in paragraphs (a)-(g) above.
5. Are you a “Qualified Client,” as defined in Rule 205-3 of the investment advisers Act of 1940?
Check the space or spaces below that apply.
     (a) Any natural person or company (defined below) that has at least $1,000,000 under the management of the General Partner and its affiliates;
     (b) Any natural person or company that has a net worth (together, in the case of a natural person, with assets held jointly with a spouse, excluding the value of their primary residence) of more than $2,000,000;
     (c) Any executive officer, director, trustee, general partner, or person serving in a similar capacity, or a qualified employee (as determined by the General Partner) of the General Partner and its affiliates;
     (d) 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;
     (e) Any trust that is not covered by (d) and that was not formed for the specific purpose of acquiring the LP Investments, 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 either a company or a natural person (with his or her spouse) that (i) owns not less than $5,000,000 in investments, or (ii) meets the definition in (f);
     (f) 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; or
     (g) Any company if each beneficial owner of such company's securities is (i) a 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 Investment Advisers Act of 1940 with that person's qualified purchaser spouse) who owns not less than $5,000,000 in investments, or (ii) described in (d), (e), (f), or (g)(i).

The term "company" means a corporation, a partnership, an association, a joint-stock company, a trust, or any organized group of persons, whether incorporated or not; or any receiver, trustee in a case under title 11 of the United States Code, or similar official, or any liquidating agent for any of the 6 foregoing, in his capacity as such.

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 and agree to the Terms of Use Agreement which you should review carefully.

“The above information represents a realistic representation of my present and anticipated position, of my background, and of my knowledge and experience of the proposed investment. I submit it to the General Partner with the knowledge that he is relying on the accuracy of the information contained herein.”