Examination Information Request List
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1 Examination Information Request List Examination Period Information is requested for the period 03/14/2012 through 03/31/2013 (the "Examination Period") unless otherwise noted. Organizing the Information to be Provided In order to efficiently process the material assembled for the staff's review, please label the information so that it corresponds to the item number in the request list. If information provided is responsive to more than one request item, you may provide it only once and refer to it when responding to the other request item numbers. If any request item does not apply to your business, please indicate N/A (not applicable). Information to be Provided by April 15, 2013 General Information 1. A copy of the Adviser s organization chart showing ownership percentages of the Adviser and control persons, and a schedule or chart of all affiliated entities. Include all entities that are commonly controlled by, or under common control with, the Adviser. Please indicate any changes in ownership that occurred during the Examination Period. 2. A list of the Adviser s current employees, including their names, titles, and areas of responsibility. 3. Names of any of the Adviser s employees, officers, and/or directors who resigned during the Examination Period and information regarding the reason for their departure. 4. A list of the names if any employees who were disciplined and/or terminated during the Examination Period and information regarding the reason for the action. 5. A list of the names of any joint ventures or any other businesses in which the Adviser or any employee, officer, and/or director participates or has any interest, including the inception date and a description of each relationship. 6. A list of names of employees and companies for which employees of the Adviser or its affiliates serve as officers and/or on board of directors, creditors committees, etc. 7. A list of service providers used by the Adviser, or any private fund managed by the Adviser, during the Examination Period and a description of the services they provide. 8. A copy of Form ADV, Part 2B or any brochure supplements not filed on the IARD system. 9. A list of all completed RFPs provided to prospective investors or consultants.
2 Compliance Program, Risk Management, and Internal Controls 10. A copy of the Adviser s compliance policies and procedures in effect during the Examination Period. 11. A copy of the Adviser s code of ethics and insider trading policies and procedures currently in use. 12. A record of any breach of the Adviser s compliance policies and procedures during the Examination Period and of any action taken as a result of such non-compliance. 13. Any client complaints, and information about the process used for monitoring client correspondence and/or complaints, including the name of any third-party service provider used and the Adviser s oversight of the service provider. 14. A list and description of all committees and the names of all committee members. Please provide copies of any committee charters and minutes for each committee. Financial Records 15. A copy of the Adviser s balance sheet, trial balance, general ledger, cash receipts and disbursements journal, income statement, and cash flow statements as of the end of its most recent fiscal year and the most current year to date. 16. A copy of the most recent audited financial statements for each fund managed by the Adviser. 17. A copy of all agreements between the Adviser or an affiliate and a portfolio company held by a fund during the Examination Period, including any expense and fee agreements. 18. A list of all fees earned or compensation received by the Adviser or affiliate, besides management and performance fees and including from portfolio companies, in the following format: a. Date received; b. Payer; c. Amount; d. Type (transaction fee, monitoring fee, monitoring fee acceleration, Board/Director Fee, other fee (please explain)); and e. Amount credited to investors/fund. 19. A schedule of the total expenses reimbursed by each portfolio company for the Examination Period. Provide the year, total amount reimbursed, and portfolio company for each reimbursed expense. 20. A list of broken deals, associated expenses, and the clients or other entities to which the expenses were allocated.
3 21. Any documents (including newsletters, capital account statements, or other documents) disclosing fees paid by portfolio companies. 22. A list of all parties to whom cash referral fees were paid during the Examination Period for soliciting investors and the total compensation paid to each solicitor. In addition, copies of any agreements executed with any third party solicitors, any correspondence with such solicitors, and any separate disclosure documents disseminated by such solicitors. 23. Policies and procedures regarding disclosing, calculating and testing fees, if not otherwise included in the compliance manual. 24. A list of all third-party consultants to whose clients the Adviser made a presentation in an effort to obtain or retain such individual or entity as an advisory client or investor. 25. A copy of the Adviser s brokerage and bank statements for the Examination Period. 26. A copy of each managed funds brokerage and bank statements for the Examination Period. Advisers Managing Privately Offered Funds 27. Information regarding each private investment fund managed by the Adviser during the period of 03/14/2012 and 03/31/2013, including: a. Name as shown in organizational documents (as amended); b. Domicile (country); c. Investment strategy (e.g., buyout, venture, mezzanine etc.); d. If funds are part of a master/feeder fund structure, full name and domicile of each fund; e. Number of investors and total assets as of 03/31/2013; f. Amount, if any, of the Adviser s equity interest in each fund as of 03/31/2013; g. Amount, if any, of the Adviser s affiliated persons interest as of 03/31/2013; h. Date the fund began accepting unaffiliated investors; i. Whether the fund is currently closed to new investors and when it closed; j. Lock-up periods for both initial and subsequent investors; k. Specific exemption(s) from registration under the Securities Act of 1933 and/or the Investment Company Act of 1940 upon which each fund relies; l. The stage of the lifecycle the fund is in as of 03/31/2013; m. Services the Adviser or an affiliate (e.g., general partner, Adviser, managing member) is providing; n. Amount of leverage, both explicit (on-balance sheet) and off-balance sheet (futures and certain other derivatives), used by the fund as of 3/31/13 as measured by the Adviser for risk-management purposes; o. The value of each fund s account that was used for purposes of calculating its most recently paid advisory fee; p. The advisory fee charged for the most recent billing period; q. Whether the fund pays carried interest and whether the fund is currently in-themoney or out-of-the-money for earning carried interest; and r. Whether the fund is currently in a clawback position and the amount of the clawback.
4 28. For each private fund the Adviser manages or previously managed, please provide the organization documents, including the limited partnership agreement, private placement memorandum, and the operating agreement (between Adviser and fund). 29. A copy of any side letters between any fund managed by the Adviser and any investor or beneficial owner. 30. A list of investors in the funds managed by the Adviser as of 03/31/2013 including: a. Name and current balance, as of 03/31/2013; b. Whether the investor is a related person, affiliated person, or a proprietary account; c. The type of account (e.g., individual, defined benefit retirement plan, registered fund, or unregistered fund); d. The name of the fund and strategy the investor is invested in; e. The value of each investor s account that was used for purposes of calculating its advisory fee for the most recent billing period; and f. Dates and amounts of any additions, redemptions, and gain distributions during the Examination Period. 31. A list of investors obtained during the Examination Period, inception dates, and identity of any third party consultants instrumental in the Adviser obtaining a particular account. 32. A list of investors lost during the Examination Period, their effective dates of termination, and the reason for termination. 33. A list of current and former investments made by each advised fund as of the 03/31/2013. a. Investment name; b. Ticker symbol (if available); c. The asset class(es) in the company s capital structure invested by the fund; d. Date of original investment; e. Amount of original investment; f. Dates of additional investments; g. For each additional investment, the amount of the investment; h. Percentage of equity owned, or amount of debt owned, by the fund; i. Name(s) and amount(s) of any co-investment(s); j. Date of first realization from the investment; k. Realized amount; l. Value of remaining investment/unrealized amount (if any); m. Investment level gross IRR (if available); and n. Fund(s) in which investment was made. 34. A list of each investment where an employee of the Adviser provides board oversight. If the employee or the Adviser is compensated, please describe the compensation and if such compensation has been returned to the respective Private Fund owning the investment. Please provide proof of such reimbursement.
5 35. A list of any private equity investment that underwent an initial public offering (or secondary offering) during the Examination Period. Please also indicate if any proprietary accounts or access persons participated. Include the trade date, security, symbol, total number of shares, and participating accounts, and indicate whether shares traded at a premium when secondary market trading began. 36. A list of co-investments made by any of the Adviser s employees, affiliates, or other related parties in any portfolio holdings together with the funds. Please include in the list, the name of the investment, date of agreement to co-invest, co-investment amount contributed, and any subsequent contributions or withdrawals in the investment. 37. Any investment allocation policies and procedures, if not otherwise included in the compliance manual. 38. The Adviser s five most profitable and five least profitable (including unrealized gain or loss) investment decisions based on total return of positions opened and/or closed for each fund offered to clients during the examination period. Please include the purchase date, sale date, percentage of gain and/or loss, and dollar amount of the gain and/or loss. Other 39. Any correspondence with the staff of the Commission or other regulatory agencies. 40. Description of any past or current litigation or arbitration involving the Adviser, the Private Funds, related persons of the Adviser, or any other person associated with the Private Funds.
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