Capital Lift – Qualified Investor Assessment Form

This form is intended for individuals or entities seeking to be classified as *Qualified investors (view disclaimer)

Investor Information

First name

Last name

Date of Birth

Day

Month

Year

Nationality

Residence

Phone

Classification Criteria

Please confirm which of the following applies to you:

I am a MiFID professional client (e.g. financial institution, pension fund, etc.)

I commit to investing EUR 125,000 or more and acknowledge the risks involved

I have sufficient financial knowledge and prior investment experience in AIFs or similar

I am interested to learn more about being a Qualified Investor and would like to be personally contacted via email:

Yes

Risk acknowledgement

By signing this form, I confirm that:

I understand the characteristics and risks of investing in alternative investment funds.
I am capable of bearing potential financial losses associated with such investments.
I wish to be treated as a qualified investor under the Czech AIF Act.
I agree to the processing of my personal data specified above.

Date

Day

Month

Year

Signature

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Under the Czech Act on Investment Companies and Investment Funds (ZISIF) — Act No. 240/2013 Coll. — a qualified investor (kvalifikovaný investor) is defined as an investor who meets at least one of the following conditions:

Qualified Investor Criteria under ZISIF (§ 272):

*Professional Client under MiFID II
- This includes entities such as:
  - Banks
  - Insurance companies
  - Pension funds
  - Investment firms
  - Large corporates meeting certain balance sheet or turnover thresholds
  - Government bodies or central banks
*Individual or Legal Entity Investing ≥ EUR 125,000
- The investor must invest at least EUR 125,000 (or CZK equivalent) in the fund.
- They must confirm in writing that they understand the risks associated with the investment.
Investor with Proven Knowledge or Experience (Semi-qualified)
- An individual may be classified as qualified even with less than EUR 125,000 invested if:
  - They demonstrate adequate knowledge of alternative investments.
  - The fund manager confirms and documents the investor’s ability to make informed decisions.
  - This is generally formalized through a suitability or knowledge assessment.

DISCLAIMER:

Capital Lift, osoba rizikového kapitálu s.r.o. (manager of an alternative investment fund), is registered in the list maintained by the Czech National Bank pursuant to Section 15 of Act No. 240/2013, on Investment Companies and Investment Funds (ZISIF). The company’s activities are not subject to supervision by the Czech National Bank. The company’s investment services are intended exclusively for a limited group of pre-selected investors who qualify as qualified investors under the ZISIF. This is not a public offering and is not intended for the general public.