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    The undersigned’s total proposed investment in the Units does not represent more than:

    Investor

    Name:

    Email:

    Home Address:

    City:

    State:

    Zip Code:

    Home Phone:

    Name of Business:

    Position / Title:

    Business Address:

    City:

    State:

    Zip Code:

    Business Phone:

    I prefer to have correspondence sent to:

    NASD Affiliation or Association, if any:

    Co-investor, if any

    Name:

    Email:

    Home Address:

    City:

    State:

    Zip Code:

    Home Phone:

    Name of Business:

    Position / Title:

    Business Address:

    City:

    State:

    Zip Code:

    Business Phone:

    I prefer to have correspondence sent to:

    NASD Affiliation or Association, if any:

    THE UNDERSIGNED REPRESENTS AND AGREES THAT THE EXECUTION OF THIS OMNIBUS SIGNATURE PAGE CONSTITUTES THE EXECUTION OF EACH OF THE FOLLOWING ADDITIONAL PAGES (3-22) OF THE CONFIDENTIAL INVESTMENT SUMARY AND MEMORANDUM (Download here) and, in addition, acknowledges, certifies, represents and agrees as follows:

    1. Investor Questionnaire

    The information contained in the Investor Questionnaire, including the social security number, is complete and accurate as of the date hereof and may be relied upon by you, and the undersigned will notify you immediately of any material change in any of such information which may occur prior to the acceptance of the undersigned’s subscription and will promptly send you written confirmation thereof.

    2. Subscription Information

    Amount of investment (minimum $100,000 for new accounts):

    Number of Units purchased shall be calculated based upon the Fund’s Net Asset Value (as defined in the Memorandum) as of the close of business on the last day of the month in which this subscription is received divided by the total number of Membership Interests outstanding.

    Name(s) in which Units are to be registered:

    If the Units hereby subscribed for are to be owned by more than one person in any manner, the undersigned understands and agrees that all of the co-investors in such Units must sign this Omnibus Signature Page and complete the personal information requested above in order for this subscription to be accepted.

    If form of joint ownership is joint tenants, tenants-in-common or tenants-by entirety, both the investor and co-investor must both sign all documents.

    The undersigned investor and co-investor represent(s), under penalty of perjury, that the foregoing statements are true and correct and that he or she has (they have) executed the Investor Questionnaire, the Subscription Agreement and the Omnibus Signature Page. By signing the Omnibus Signature Page, I (we) also certify the following (or, if I am purchasing Units with a co-investor, each of us certifies the following): (a) that I am at least 21 years of age; and (b) that the name, home address and social security number or taxpayer identification number as set forth in this Questionnaire are true, correct and complete; and that the following is true:

    Date:

    Investor Name:

    Investor Signature:

    Co-Investor Name:

    Co-Investor Signature:

    After completing this application, please remit your investment funds by wire or check. Ensure the subscriber name as used in the application is included.

    WIRE OR MAIL YOUR INVESTMENT

    Wiring Information

    Capitalistpig Hedge Fund LLC

    Account # 3805066881

    Wintrust Bank

    Routing # 071925444

    231 South LaSalle, Chicago, IL 60604

    Mailing Address

    Capitalistpig Hedge Fund LLC

    PO BOX 1658

    Chicago, IL 60690–1658

    Payable to Capitalistpig Hedge Fund LLC

    Clear

    Please Note: During this online session only, you may download a completed application for your records.


    THE UNITS HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE “ACT”), OR THE SECURITIES LAWS OF ANY STATE AND MAY NOT BE OFFERED, SOLD OR OTHERWISE TRANSFERRED UNLESS SUCH SECURITIES ARE INCLUDED IN AN EFFECTIVE REGISTRATION STATEMENT UNDER THE ACT AND ARE QUALIFIED UNDER APPLICABLE STATE SECURITIES LAWS OR AN OPINION OF COUNSEL, CONCURRED WITH BY COUNSEL TO THE FUND, HAS BEEN DELIVERED TO THE EFFECT THAT SUCH REGISTRATION AND QUALIFICATION OF SUCH SECURITIES ARE NOT REQUIRED.