Please return by: 20thMarch2013
Firm:
Fund:
Location of advisory team of fund:
Vintage Year (date of first drawdown):
Amount Raised to date (Mil):
Currency:
Units (e.g. 000s / Mil):
Valuation method (e.g. IPEV):
Type of fund: Independent closed-end fund Evergreen open-ended vehicle
Fund Stage: Seed Early Later Balanced Buyouts Generalist Mezzanine Other PE (incl. Turnaround/Distressed Debt/Special Situation/Energy)
Industry:Communications and MediaComputer Hardware Computer Software and Services
Internet Specific Semiconductors/Other Elect.BiotechnologyMedical/Health
Consumer-related Industrial/Energy Other Products Other, please specify:
*To indicate applicable fund stage and industry, please double click the applicable tickbox; then click the “checked” box under default value.
*All Flow should be reported net of fees, expenses, and carried interest.,
* Please provide Residual Value / NAV of fund on a quarterly basis, where available.Please reconfirm your Residual value (NAV of fund) as of 31 December 2012 on the first lineof thetable, if applicable.
Date / Drawdown fromLimited Partners / Cash Distribution to Limited Partners / Stock Distribution to Limited Partners / Residual Value /
NAV of fund
Please contact our Contributor Relations Team at or Jelena Marinovic at with any questions.
*All Flow should be reported net of fees, expenses, and carried interest.
* Please provide Residual Value / NAV of fund on a quarterly basis, where available. Please reconfirm your Residual value (NAV of fund) as of 31December 2012 on the first line of the table, if applicable.
Date / Drawdown fromLimited Partners / Cash Distribution to Limited Partners / Stock Distribution to Limited Partners / Residual Value /
NAV of fund
Please contact our Contributor Relations Team at or Jelena Marinovic at with any questions
Note:The data which you have supplied will NOT be made available to any person or organization other than Thomson Reuters unless first aggregated with other data so as to preserve the anonymity of any individual response.