KYC Application Form for Placements

RMG CAPITAL GROUP STAT. TRUST
KYC Application Form for Placements

Subscription Overview
ACCREDITED & SOPHISTICATED INVESTORS, AND INSTITUTIONS ONLY

This KYC - Application form Placement will be filled out, executed, and returned to RMG Capital Group Stat. Trust, a Delaware Statutory Trust (“DST”) (the “Fund Manager”). You should consult an attorney, accountant, investment advisor, or other advisors regarding an investment or deposit. Please fill out, sign, and return the documents pertinent to you, as listed under each of the headings below at the following address: Office@rmg-capital.com, or request for an electronic signature version to be sent to you by the Fund Manager.
CLIENT INFORMATION SHEET FOR INDIVIDUALS
1. Name of the Applicant*

First NameLast Name
1a. Gender*

MaleFemale
1b. Marital Status*

SingleMarried
2. Nationality*
3. Date of Birth*

MonthDayYear
Date
4. Passport Information
4a. Passport No. *
4b. Date of Issue*

MonthDayYear
Date
4c. Issued by*
Issuing Country
4d. Expiration Date*

MonthDayYear
Date
5. Home Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
6. Mobile Number*
Please enter a valid phone mobile number.
7. Email*
example@example.com
8. Copy of Identity Submitted

PassportIDDriving LicenseLatest Electricity BillOther
File Upload

Please upload related photographs and documents.
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INVESTOR SUITABILITY STATEMENTS

INVESTOR SUITABILITY STATEMENTS
(If your investment is not made as an individual, go to “ENTITIES.”)
INITIAL TO INDICATE IF THE STATEMENT IS TRUE OR FALSE, OR COMPLETE THE STATEMENT, AS APPROPRIATE.

Verification of Status as “Accredited Investor” under Regulation D, Rule 501 et seq.

	True	False
1. You are a natural person (individual) whose own net worth, taken together with the net worth of your spouse, exceeds $1,000,000. Net worth for this purpose means total assets (Excluding your primary residence) in excess of total liabilities. For purposes of this question, “excluding your personal residence” means: (A) Your primary residence shall not be included as an asset; (B) Indebtedness that is secured by your primary residence, up to the estimated fair market value of your primary residence at the time of your subscription, shall not be included as a liability (except that if the amount of such indebtedness outstanding at the time of your subscription exceeds the amount outstanding 60 days before such time, other than as a result of the acquisition of your primary residence, the amount of such excess shall be included as a liability.
2. You are a natural person (individual) who had an individual income in excess of $200,000 in each of the two previous years, or joint income with your spouse in excess of $300,000 in each of those years, and who reasonably expects to reach the same income level in the current year.
3. You are an executive officer of the Fund or a manager or executive officer of the Manager of the Fund.
4. You have such knowledge and experience in financial and business matters that you are capable of evaluating the merits and risks of investing in the Units.

Disclosure of Foreign Citizenship.

	True	False
1. You have such knowledge and experience in financial and business matters that you are capable of evaluating the merits and risks of investing in the Strategies funds.
2. You are not a citizen of the United States. If the answer to the preceding question is true, specify the country of which you are a citizen:

Country
country of which you are a citizen
Supporting Documentation
1. INDIVIDUALS.
A. I am an INDIVIDUAL that checked eligibility on the basis of income and: (please check at least one of the following)

I will deliver to the Company copies of each (i) Form W-2, (ii) Form 1099, (iii) Schedule K-1 of Form 1065, and/or (iv) Form 1040, showing my income, or my joint income with my spouse, for the two most recent years. I understand I may redact such forms as to disclose only information about annual income and to avoid disclosure of personally identifiable information not relevant to the determination of a person’s annual income. (e.g., social security numbers).I will deliver to the Company copies of each (i) Form W-2, (ii) Form 1099, (iii) Schedule K-1 of Form 1065, and/or (iv) Form 1040, showing my income, or my joint income with my spouse, for the two years immediately preceding last year AND I represent and confirm that (i) no such IRS forms for the last year are available and (ii) my individual income is in excess of $200,000, or my joint income together with my spouse exceeds $300,000, in the last year. I understand I may redact such forms as to disclose only information about annual income and to avoid disclosure of personally identifiable information not relevant to the determination of a person’s annual income (e.g., social security numbers).I will deliver to the Company non-U.S. tax forms showing my income, or my joint income with my spouse, for the two most recent years. I understand I may redact such forms as to disclose only information about annual income and to avoid disclosure of personally identifiable information not relevant to the determination of a person’s annual income (e.g., social security numbers).My salary, or my joint salary with my spouse, is publicly available information that has been reported in a filing with a federal, state or local regulatory body (including, without limitation, a proxy statement filed with the Securities and Exchange Commission (“SEC”)).I will deliver to the Company all such information showing my income, or my joint income with my spouse, for the two most recent years.I will engage (i) a broker-dealer registered under the Exchange Act, (ii) an investment adviser registered with the SEC, (iii) a licensed attorney in good standing under the laws of the jurisdictions in which it is admitted to practice law, or (iv) a certified public accountant duly registered and in good standing under the laws of the place of its residence or principal office, to deliver to the Company [and the Placement Agent] a written confirmation, in such form and substance as acceptable to the Company, of my status as an accredited investor on the basis of my income, or my joint income together with my spouse.
B. I am an INDIVIDUAL that checked eligibility on the basis of net worth and: (please check at least one of the following)

I will deliver to the Company copies of (i) recent bank statements, brokerage statements, and other statements of securities holdings, certificates of deposit, tax assessments, or appraisal reports issued by independent third parties, showing my assets, or my joint assets together with my spouse, and (ii) a recent consumer or credit report from at least one of the nationwide consumer reporting agencies (such as Experian, Equifax, or TransUnion) showing my liabilities, or my joint liabilities together with my spouse. Each of these documents will be dated within three months prior to the closing of the Offering. I understand I may redact such documents as to disclose only information about my assets or liabilities and to avoid disclosure of personally identifiable information not relevant to the determination of a person’s net worth (e.g., social security numbers). I represent and warrant that such documents will constitute full and accurate disclosure of all liabilities that are required to be included in the calculation of my net worth pursuant to Rule 501(a)(5).I will engage (i) a broker-dealer registered under the Exchange Act, (ii) an investment adviser registered with the SEC, (iii) a licensed attorney in good standing under the laws of the jurisdictions in which it is admitted to practice law, or (iv) a certified public accountant duly registered and in good standing under the laws of the place of its residence or principal office, to deliver to the Company [and the Placement Agent] a written confirmation, in such form and substance as acceptable to the Company, of my status as an accredited investor on the basis of my net worth, on an individual basis or joint basis together with my spouse.
C.

I am an INDIVIDUAL that checked any other section above and I agree to provide such reasonable information as the Company may require to determine my status as an accredited investor.
2. INDEMNITY.

I understand that the Fund and its advisors will rely on the contents of this Subscription Agreement, as well as all supporting documentation that I will submit, to determine my eligibility to participate in the Offering. On this basis, I agree to indemnify and hold harmless the Fund and its directors, officers, employees, agents, stockholders, and affiliates from and against all claims, demands, actions, suits, damages, liabilities, losses, settlements, judgments, costs and expenses (including but not limited to reasonable attorney’s fees and costs), whether or not involving a third party claim, which arises out of or relates to any misstatement or omission in this letter or any supporting documentation that I submit.

3. CONFIDENTIALITY.

I understand the Fund agrees to keep this Subscription Agreement and any supporting documentation I provide confidential, except (i) it may provide such documents to its financial, legal, and accounting advisors for the purposes outlined in this letter, provided that such advisors shall also keep my information confidential; (ii) where disclosure to a governmental entity is required; or (iii) where disclosure is ordered by a court of competent jurisdiction.
Signature Pages
I hereby declare that the information provided in this form is accurate and complete. I confirm that any information found incorrect and/or incomplete that leads to a violation of regulations may initiate legal action, and I accept that I am the responsible party for any and all charges, penalties, and violations.
Choose the Placement
Amount for the Investment*
In US Dollars
Name of the Applicant*

First NameLast Name
Signature of the Applicant*

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Date Signed

MonthDayYear
Date
For Office Use Only
Type a question

Originals verified and Self-Attested Document copies received
Name of the Authorized Signatory

First NameLast Name
Signature of the Authorized Signatory

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Date Signed

MonthDayYear
Date
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RMG CAPITAL GROUP STAT. TRUST

KYC Application Form for Placements

CLIENT INFORMATION SHEET FOR INDIVIDUALS

File Upload

INVESTOR SUITABILITY STATEMENTS

Supporting Documentation

Signature Pages

For Office Use Only