Request for information

Accredited Investor Questionnaire

As defined by Rule 501(a) of Regulation D under the U.S. Securities Act of 1933, only accredited investors may view information regarding the products of Baltic Capital Management, the general partner of Latvia Realty Fund, LP. Please provide the following information so that we may determine your status as an investor. Upon approval, you will be contacted by a representative of Baltic Capital Management, Inc.


Name:


E-mail:


Title:


Company:


Address: State:
Zip/Postal code:
Telephone:
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Do you currently invest in hedge funds?
Yes
No


Do you currently invest in:
Finland?
Estonia?
Latvia?
Lithuania?
Poland?
Russia?
Sweden?
If yes, what is the approximate size of your real estate investments?

Do you currently have other investments in the
Baltic region?

Please choose the option that best describes you:

In how many hedge funds are you currently invested?

Portfolio size:

I am an individual with a net worth of $1 million (excluding residence).
Yes No

I am an individual with income in excess of $200,000 in each of the last two years.
Yes No

My organization is an entity with total assets in excess of $5 million.
Yes No


Your privacy is important.
We will not disclose or sell the information above without your prior consent.


© 2003 Baltic Capital Management, Inc.