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General instructions

AIFMs[1] notifying pursuant to article 2:66 section 3 and 2:70 Wft shall provide all the information requested in this notification form. This notification form must be emailed to . Please include the name of the AIFM, the AIF and their country of origin in the heading of the email. Only complete notification forms are accepted by the Netherlands Authority for Financial Markets (“AFM”). Please do not forget to include the required declaration by the AIFM that it will comply with the specific Dutch rules applicable when offering to non-professional investors in the Netherlands or when managing an European AIF in which Dutch non-professional investors are participarting (‘top-up’ retail requirements pursuant to article 4:37p Wft).

Prior to sending this notification form to the Dutch Authority on Financial Markets (“AFM”) the passporting procedure pursuant to article 2:70 section 1 Wft (article 32 or 33 AIFMD) must have been completed.

This notification is for informational purposes only. The AIFM itself is responsible for ensuring that all applicable Wft requirements are met. Upon emailing the notification form the AIFM is required to fulfill all requirements as laid down in article 2:66 section 3 and 2:70 Wft and further rules and regulations based thereon (also if amended) on an ongoing basis. Additionally the AIFM must comply with the specific Dutch rules which apply when offering to non-professional investors in the Netherlands (article 4:37p Wft).

After emailing this complete notification form to the AFM and after completing the passporting procedure pursuant to article 2:70 section 1 Wft (article 32 or 33 AIFMD), the AIFM may start offering units in an European AIF to non-professional investors in the Netherlands or may manage European AIF in which the Dutch non-professional investors are participating.

GENERAL INFORMATION AIFM

1  Name of AIFM
2  Address
3  Postal code and place of residence
4  Country
5  P.O. Box
6  Postal code of P.O. Box
7  Telephone number
8  Telefax number
9  E-Mail
10  Website
11  Contactperson and contactdetails AIFM

GENERAL INFORMATION ON THE RELEVANT AIF

16  Name of AIF
17  Address
18  Postal code and place of residence
19  Country
20  P.O. Box
21  Postal code of P.O. Box
22  Telephone number
23  Telefax number
24  E-Mail
25  Select the AIF type:
□  Fund of funds
□  Real estate
□  Private equity
□  Hedge fund
□  Collective investment vehicle in financial instruments
□  Other: describe the AIF type
(multiple selections possible)


The signatories declare that they are aware of the conditions and requirements as imposed by article 2:66 section 3 and 2:70 Wft and further rules and regulations based thereon (also if amended) and will fulfill those conditions and requirements on an ongoing basis. They furthermore declare that they will comply on an ongoing basis with the specific rules, as laid down in article 4:37p Wft and rules and regulations based thereon, applicable when offering European AIFs to non-professional investors in the Netherlands or when managing European AIFs in which Dutch non-professional investors are participating.

The signatories declare having answered the questions in this notification form and annex completely and truthfully and that they are authorized persons to represent the AIFM.

(The notification form shall be signed by at least two authorized signatories of the AIFM. The signatories shall state their full names and capacity, and shall ensure the confirmation is dated.)

Place: Date:

Signature person 1: Signature person 2:

Name person 1: Name person 2:

Capacity person 1: Capacity person 2:


Annex

A declaration signed by authorized representatives of the AIFM must be attached in which the AIFM confirms that it will comply with the rules applicable when offering European AIFs to Dutch non-professional investors in the Netherlands or when managing European AIFs in which Dutch non-professional investors are participating (article 4:37p Wft and further rules and regulations based thereon (also if amended)).

[1] The notion AIFM also covers the AIF which is managed internally.