Page 38 - TCP, LLC - Sustainable Island Prosperity Fund

Telephone: _____________________________________________________________
Date and State of incorporation or organization: _____________________________
Taxpayer Identification Number: __________________________________________
Nature of Business: ______________________________________________________
(b) Individual Authorized to Execute this Questionnaire (Name and Title): _______________________________________________________________________
(c) Name of record and beneficial owner of entity (10% ownership or more): _______________________________________________________________________
3. FORALLINVESTORS
(a) Relationship to the Company or managers of the Company: ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________
(b) The undersigned is an officer or director of a publicly held company (circle one): Yes No If yes, specify: ___________________________________________________________
(c) I [have] [have not] personally invested in investments sold by means of private placements within the past five years.
The Caribbean Project, L.L.C.’s - Sustainable Island Prosperity Fund