Request Access Form

Request for Access

Access to the Highline Capital website is restricted. In order to obtain access, please complete and submit this form. You may be contacted to verify the information submitted. Upon approval, a username and password will be activated for you.

This website does not constitute an offer to sell or the solicitation of an offer to buy any security which may only be made pursuant to the terms of the constituent documents of the relevant fund, including their respective, current offering memoranda, which contain important information, including risk factors. In the event of any inconsistency between the descriptions or terms contained in this website and the constituent documents, the constituent documents shall control. These securities shall not be offered for sale in any jurisdiction in which such an offer, solicitation or sale would be unlawful until the requirements of the laws of such jurisdiction have been satisfied.

All information provided on this questionnaire will be held in confidence in accordance with Highline Capital Partners’ Privacy Policy as in effect.

* First Name:
* Last Name:
* Email:
* Password:
Company Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Country:
* Phone:
Cell Phone:
1. You are completing this information on behalf of:
Yourself
Your Organization
Both
2. Are you an accredited investor in accordance with Rule 501(a) of Regulation D of the Securities Act of 1933?
No
Yes
If yes, please select one:
Individual - I am a natural person whose individual net worth, or joint net worth with my spouse, as of the date hereof exceeds $1,000,000 excluding the individual’s primary residence AND/OR I am a natural person who had an individual income in excess of $200,000 in each of the two most recent years or joint income with my spouse in excess of $300,000 in each of those years and I have a reasonable expectation of reaching the same income level in the current year.
Entity Not Formed For The Specific Purpose Of Acquiring The Security Offered - I am an organization described in Section 501(c)(3) of the Internal Revenue Code of 1986, as amended, a corporation, a similar business trust, or partnership, not formed for the specific purpose of acquiring any specific security, with total assets in excess of $5,000,000.
Regulated Entity - I am (i) a U.S. bank or any banking institution organized under the laws of any state, territory or the District of Columbia, the business of which is substantially confined to banking and is supervised by the State or Territorial banking commission or similar official agency, (ii) a U.S. savings and loan association or other similar institution, whether acting in its individual or fiduciary capacity; (iii) a broker or dealer registered pursuant to Section 15 of the Securities Exchange Act of 1934; (iv) a U.S. insurance company; or (v) an investment company registered under the Investment Company Act of 1940.
Business Development Company - I am a
Private Business Development Company - I am a
Small Business Investment Company - I am a
Employee Benefit Plan - I am an
State Plan - I am a plan established and maintained by a State, its political subdivisions, or any agency or instrumentality of a State or its political subdivisions, for the benefit of its employees, if such plan has total assets in excess of $5,000,000.
Trust - I am a trust with total assets in excess of $5,000,000, not formed for the specific purpose of acquiring any specific security, whose purchase is directed by a sophisticated person as described in Regulation D.
Recovable Trust - I am a
3. What is your investment horizon?
Long Term (>5 years)
Med Term (2-5 years)
Short Term (<2 years)
4. What is your risk tolerance?
High (Aggressive)
Moderate
Low (Conservative)
5. Do you invest in hedge funds?
Yes
No
How many years have you been investing in hedge funds?
Approximately how many hedge funds are you invested in?
What percentage do hedge funds comprise of your portfolio?
What is the approximate total value (in US$) of your hedge fund portfolio?
6. Please choose the category that best describes you:
7. You heard about Highline Capital through:

Anti-Money Laundering Certification

This section must be completed.

By submitting this form, I hereby represent and certify that I am not involved in any anti-money laundering scheme and that my investment funds, including any investment funds over which I have investment authority, have not been directly or indirectly derived from activities that may contravene U.S. or international laws, rules and regulations designed to avoid money laundering, including, without limitation, the provisions of the Bank Secrecy Act of 1970, as amended. Neither I nor any person controlling, controlled by, or under common control with me, nor any person having a beneficial interest in my investments is a country, territory, person or entity named on the U.S. Department of Treasury’s Office of Foreign Asset Control list, or is a person or entity that resides or has a place of business in a country or territory named in such lists. I agree to notify you promptly should I become aware of any changes to the information set forth in this statement. I hereby agree to hold Highline Capital Partners and each of its principals, members, directors, officers, and employees harmless and to indemnify the same against any loss arising as a result of an inaccuracy in the foregoing or any other statement in this questionnaire.

If I am (I) acting as trustee, agent, representative or disclosed nominee for another person or entity, or (II) an entity investing on behalf of underlying investors, including a fund-of-funds, other than a publicly traded company listed on an organized exchange (or a subsidiary or a pension fund of such a company) based in a Financial Action Task Force (“FATF”) Compliant Jurisdiction (the persons, entities and underlying investors referred to in (I) and (II) being referred to collectively as the (“Beneficial Owners”)), I represent and warrant that:

  • I understand and acknowledge the representations, warranties and agreements made herein are made by me (A) with respect to me, and (B) with respect to the Beneficial Owners
  • I have all requisite power and authority from the Beneficial Owners to execute and perform the obligations under this Request for Access Agreement
  • I have adopted and implemented anti-money laundering policies, procedures and controls that comply with, and will continue to comply in all respects with, the requirements of applicable anti-money laundering laws and regulations
  • I have established or have access to the identity of all Beneficial Owners, hold evidence of or have access to such identities and will make such information available to a fund upon request and have procedures in place to ensure that the Beneficial Owners are not Prohibited Investors.

We will review the information you have submitted and contact you directly with any follow-up questions we may have.

Thank you very much for your time. By pressing the "Submit/I Agree" button below, you agree that you have filled in this questionnaire completely, truthfully and to the best of your ability and that you also have read and agree to the Terms of Use which you should review carefully.