Financial Stocks, Inc.

Financial Stocks, Inc.

Financial Stocks, Inc.

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Web Site Access Qualification Form

For regulatory purposes, please fill out the requested information below, choose a username and password, and select the items that best apply to you. Items starred ( * ) are required to process your request.

Personal Information
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Username and Password
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Accredited Investor Status:
Check the appropriate space on the following page indicating the basis upon which you qualify as an accredited investor under Regulation D. For Individual Investors Only
	(1) I certify that I am an accredited investor because I have an individual net worth, or my spouse and I have a combined net worth, in excess of $1,000,000. For purposes of this questionnaire, "net worth" means the excess of total assets at fair market value, including home, home furnishings and automobiles, over total liabilities.
	(2) I certify that I am an accredited investor because I had individual income (exclusive of any income attributable to my spouse) of more than $200,000 in each of the past two years, or joint income with my spouse of more than $300,000 in each of those years, and I reasonably expect to reach the same income level in the current year.
For Corporations, Foundations, Endowments or Partnerships
	(3) The Investor hereby certifies that it is an accredited investor because it has total assets in excess of $5,000,000 and was not formed for the specific purpose of acquiring the securities offered.
	(4) The Investor hereby certifies that it is an accredited investor because all of its equity owners are accredited investors. The General Partner, in its sole discretion, may request information regarding the basis on which such equity owners are accredited.
Qualified Purchasers:
Check the appropriate space on the following page indicating the basis upon which you qualify as an accredited investor under 1940 Act.
	(A) A natural person (including any person who holds a joint, community property or similar shared ownership interest, with that person’s qualified purchaser spouse, in an issuer that is exempt from registration as an investment company under Section 3(c)(7) of the 1940 Act) who owns not less than $5,000,000 in Investments (see definition below), after deducting the amount of any outstanding indebtedness incurred to acquire such Investments.
	(B) A company (including a partnership, corporation or limited liability company) that owns not less than $5,000,000 in Investments, after deducting the amount of any outstanding indebtedness incurred to acquire such Investments, and that is owned directly or indirectly by or for two 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. However, if such company would be required to register as an investment company under 1940 Act but for the exemptions from registration contained in Securities 3(c)(1) or 3(c)(7) thereof, then either (1) all beneficial owners of its outstanding securities that acquired such securities on or before April 30, 1996 including all beneficial owners of the outstanding securities of an excepted investment company that is itself a beneficial owner, or (2) all of its directors or general partners must have consented to its treatment as a “qualified purchaser”.
	(C) A trust that is not covered by item b. above and that was not formed for the specific purpose of acquiring Units, as to which the trustee or other person authorized to make decisions for the trust, and each settlor or other person who has contributed assets to the trust, is a person described in any items a., b. or d. hereof and, if such trust would be required to register as an investment company under the 1940 Act but for the exemptions from registration contained in Sections 3(c)(1) or 3(c)(7) thereof, all of its trustees have consented to its treatment as a “qualified purchaser”.
	(D) A person, including a corporation, partnership, LLC, trust or other entity, acting for its own account or the accounts of the qualified purchasers, who in the aggregate owns and invests on a discretionary basis not less than $25,000,000 in Investments, after deducting the amount of any outstanding indebtedness incurred to acquire such Investments.
	(E) A person who is a “qualified institutional buyer” as defined under Regulation 144A pursuant to the Act when acting according to Regulation 270.2a51-1(g) under the 1940 Act.
	(F) An entity all of the securities of which are owned beneficially by qualified purchasers as defined in sections a through e above.
“Investments” are defined as (A) securities (as defined by Section 2(a)(1) of the Act), other than securities of an issuer that controls, is controlled by or is under common control with the Investor (i.e., stock of closely-held business controlled by Investor are not Investments unless its shareholders equity exceeds $50,000,000), unless the issuer of the securities is a public company, a private investment company, a company that would be an investment company but for the exclusions provided by sections 3(c)(1) through 3(c)(9) of the 1940 Act of the exemptions provided by regulations 270.3a-6 or 270.3a-7 under the 1940 Act, a commodity pool or a company with shareholders’ equity of not less than $50,000,000 as reflected on its most recent financial statements (which may not be as of a date more than 16 months preceding the date of this Questionnaire); (B) real estate held for investment purposes and not used a residence or a place of business by the Investor or a natural person related to the Investor; (C) commodity interests of commodities held for investments; (D) to the extent not securities, financial contracts (as defined in Section 3(c)(2)(B)(ii) of the 1940 Act) entered into for investment purposes; (E) in the case of an Investor that is a private investment company exempt pursuant to Section 3(c)(1) or 3(c)(7) of the 1940 Act or a commodity pool, any amounts payable to the Investor pursuant to a firm agreement or other binding commitment pursuant to which a person has agreed to acquire an interest in, or make capital contributions to, Investor upon the demand of the Investor; (F) cash and cash equivalents (including foreign currencies) held for investment purposes, including bank deposits, certificates of deposit and bankers acceptances; and (G) the net cash surrender value of an insurance policy.
Terms and Conditions
Note: Prospective investors are strongly advised to read this page before proceeding; it contains warnings that you should bear in mind before making an investment decision. This Website provides general information only. Access to and the contents of this website is being furnished on a confidential basis to the recipient, and does not constitute an offer to sell or a solicitation of an offer to buy any securities, investment product or investment advisory services. Such offer or solicitation may only be made by means of a confidential private offering memorandum or other similar materials which contain a description of material terms relating to such investment or fund. Access to this website is intended for the use of the person who filled out the website�s questionnaire, and it is not to be reproduced or redistributed to any other person without prior consent of COMPANY NAME. Only prospective investors with appropriate knowledge and experience to evaluate the applicable merits and risks should consider an investment in the funds presented herein. If in doubt, prospective investors should obtain independent financial advice. Prospective investors should note that the value of investments may fall as well as rise either in absolute terms or due to fluctuations in exchange rates. In addition, prospective investors are advised to seek their own legal and tax advice on any prospective investment and to make sure that they are not contravening the laws of any country. The COMPANY NAME affiliated funds and companies mentioned at this Website may only transact business in jurisdictions in which they are properly registered or exempt from registration. There are legal requirements in various countries which may restrict the information which the COMPANY NAME affiliated investment managers or pooled investment vehicles general partners (together, the �Managing Entities�) can lawfully provide. Accordingly, the information contained in some sections of the Website may be provided for residents of certain countries only. Persons who receive the Content or who have access to it should inform themselves about and observe any restrictions imposed in the jurisdiction in which this Website is accessed. The Managing Entities do not give legal or tax advice. The information in this Website has been derived from sources believed to be accurate and reliable. Other than for information on the COMPANY NAME affiliate funds, the Managing Entities do not give any representation or warranty of reliability, currency, completeness or accuracy of information in this Website, and such information shall not constitute or form the basis of any contract. The Managing Entities expressly disclaim liability for errors or omissions in the information in this Website and make no commitment to update the information. Any views expressed reflect the current views of the Managing Entities. The views expressed and other content are subject to change without notice. While Managing Entities strive to provide accurate and timely information, there may be inadvertent technical factual inaccuracies and typographical errors. The Managing Entities reserve the right to make changes and corrections at any time, without notice. The Managing Entities expressly disclaim all liability for the use or interpretation by others of information contained in this site. The visitor agrees to hold The Managing Entities and their Officers, Employees, Agents or Affiliates harmless against any claims for damages arising from use of the site or any decisions that the visitor makes based on such information. The visitor further agrees that The Managing Entities shall not be liable for any special or consequential damages that result from access to or use of this site. The Managing Entities maintain the highest possible professional standards in their dealings with investors and comply with, and expect investors to comply with, all relevant laws including those relating to money laundering. Copyright ©2006
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