SBA Form 2181 SBIC Subsequent Fund MAQ

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Overview

Instructions
Subsquent Fund Certification
Info Release
Overview
Narrative
Attachment Checklist
Investment Track Record
Historical Cash Flows
Principal Bios
Small Business Impact
Covenant Defaults
Applicant Economics and Time
Firm and Service Providers
Applicant Principals
References
Labels

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Sheet 1: Instructions

MAQ Subsequent Fund Form 2181 Instructions

OMB Approval No. ####-####

Expiration Date MM/DD/YYYY

Application Instructions

SBA invites eligible private entitites considering the Small Business Investment Company (SBIC) program to submit an application for License (Form 2181). For an initial application to be considered complete and ready for review, all elements and attachments listed in the Management Assessment Questionnaire (MAQ) and related exhibits must be submitted along with the requisition application fee paid. SBA requires all license application fees be remitted via the Pay.Gov website: https://www.pay.gov/public/home. Select "Small Business Administration" under "See All Agencies", then click on "SBIC Fees" and fill out the pop-up form. You will be contacted by SBA when your fee payment has cleared. All forms are available on SBA.gov/partners/sbics/forms-guides. Applications are emailed to [email protected]. All applicants will receive confirmation of receipt of an application within 2 - 4 business days of submission.

Potential applicants may submit an optional one-time Short Form 2181 ("Pre-screen") and request a pre-screen interview without paying the initial licensing fee. The Short Form 2181 and pre-screen interview request should be emailed to [email protected] with "Pre-Screen Request" in the email subject line. The Short Form 2181 is also available on SBA.gov/partners/sbics/forms-guides.

Qualifying Subsequent Fund License Applications

SBA invites qualified subsquent fund license applicants to submit an alternative Subsequent Funds MAQ along with Exhibits for expedited subsequent fund licensing. For application to be considered complete and ready for review, all elements and attachments listed in the Subsequent Fund MAQ and Exhibit As through Exhibit D along with the requisition application fee paid at https://www.pay.gov/public/home. All forms are available on SBA.gov/partners/sbics/forms-guides. Applications are emailed to [email protected]. All applicants will receive confirmation of receipt of an application within 2 - 4 business days of submission.

Licensing Process

After SBA reviews the application materials and completes operational and investment due diligence, the Applicant will be invited to interview before the investment committee or notified of the Agency's decision to decline to proceed with an interview. Following the interview, the Investment Committee will vote to "Green Light" the applicant to raise capital and proceed to submit final legal documents and final licensing fee when prepared to hold a first close. The Investment Committee will recommend its "Green Light" decision to SBA Agency Licensing Committee for concurrence or non-concurred. If Agency Licensing Committee and the SBA Administrator concur with a decision by the Investment Committee to grant a "Green Light", the Applicant will be notified of the decision along with the Agency's maximimum leverage commitment available to the Applicant following licensure. When the Green Lit Applicant is ready to hold a first close, it should submit all final versions of legal documents including redline copies of any draft documents submitted with the MAQ. Additionally, the Applicant must submit Exhibit E, the Legal Document Certification, and Exhibit F, the Capital Certificate, along with the Final Licensing fee.

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Sheet 2: Subsquent Fund Certification

Subsequent Fund Application

OMB Approval No. ####-####

OMB Approval No. ####-####

As of Date:

dd/mm/yyyy

Expiration Date MM/DD/YYYY

Expiration Date MM/DD/YYYY

This subsequent fund "Certification" page must be signed by all principals of the applicant. The entire Subsequent Fund Application MAQ and all requested attachments must be completed in full by all applicants qualifying for expedited subsequent fund processing.

Name of Applicant:

Name of Applicant:

License no.: 01/23-4567

Management Teams that are already operating one or more licensed SBICs ("Management Team") must be in good operational and regulatory compliance standing with SBA in order to submit a license application for a subsequent fund. Subsequent fund license applicants must have at least two full years of operations from date of licensing of the most recently licensed SBIC (a longer or shorter operating history may be merited based on track record and prior performance). The financial performance and portfolio valuations of the current licensee(s) must demonstrate adequate coverage for any outstanding SBA Leverage. The current licensee(s) must also be able to present a clean audit opinion from the SBIC’s independent public accountant, covering the most recent, full year of operations, and no unresolved regulatory violations for the most recent SBA exam covering a period ended within 12 months of the request being filed. SBA will consider a series of factors when determining whether a subsequent fund applicant has demonstrated a commitment to best practices within the SBIC program. Please note that existing license holders applying for an SBICCT license for the first time are not eligible for expedited subsequent fund processing.

The applicant certifies that all of the information provided in the Form 2181, related exhibits and any other information submitted in connection with this application is true, correct and complete to the best of the applicant's knowledge. By selecting "✓" next to each of the 11 items listed below related to eligibility for expedited subsequent fund license processing, each principal and Control Person of the applicant certifies that, to the best of their knowledge, they meet all elements of such item to be considered for expedited subsequent fund license processing. The applicant represents and warrants that if the applicant, principals, and/or Control Persons become aware of any facts or of the occurrence or impending occurrence of any event that would cause one or more of applicant's representations and warranties contained below to be or to become untrue, the applicant shall immediately notify SBA in writing. The applicant understands that knowingly making a false statement is a violation of Federal law and could result in criminal prosecution under 18 USC §§ 287, 371, 1001, 1006, and 1014, including fines of up to $1 million and up to 30 years imprisonment, 15 USC §§ 645 and 687(f), civil penalties under 31 U.S.C. § 3729, government-wide debarment or suspension, and denial, suspension, or revocation of a Small Business Investment Company license.

1

Consistent strategy and fund size—the Management Team’s targeted Regulatory Capital to be raised is ≤133% the size of their most recent SBIC fund (inflation adjustments will be considered), and will have the same asset class and investment strategy as the most recent SBIC license issued to the Management Team.

Regulatory Capital for most recent SBIC (at final close):

$-

Targeted Regulatory Capital for proposed fund:

$-

2

Clean Regulatory History—no major findings, significant “other matters” or unresolved “other matters” related to any licensees managed by the Management Team in the previous ten years.

3

Consistent LP-GP Dynamics—no new limited partner will represent ≥33% of the Private Capital of the licensee upon reaching final close at target fund size or hard cap. The two largest investors (in terms of committed capital) in the Management Team’s most recent SBIC have verbally committed to invest in the new fund pending receipt of license. The most recent Limited Partnership Agreement of the active Licensee and all Side Letters will have no substantive changes for the applicant fund.

4

Investment Performance Stability—the most recent licensee net distributions to paid-in capital (DPI) and net total value to paid-in capital (TVPI) are at or above median vintage year and strategy performance benchmarks for the prior three quarters. The principals of the applicant are not managing a licensee in default or with Capital Impairment (CIP) exceeding the amount specified in 13 C.F.R. § 107.1830(c).

5

Consistent or Reduced Leverage Management— the applicant is requesting a leverage to Private Capital ratio ≤ the Management Team’s current or most recent SBIC licensee at target fund size or hard cap.

6

Firm stability—subject to SBA’s determination, no material changes to the broader firm, to include resignations, terminations, or retirements by members of the Management Team, investment committee, broader investment team, or key finance and operations personnel that have a material adverse impact on the stability of the SBIC.

7

Promotions from within—demonstration of a commercially reasonable effort of promoting internal investment team talent from within the firm/organization sponsoring the license.

8

Inclusive equity—demonstration of a commercially reasonable effort of the appropriate/increased sharing of carry and/or management company economics with promoted talent or distribution of equitable or increasingly equitable economics among the partnership.

9

FBI Criminal and IRS Background Check No Findings—the sponsoring entity and all principals of the Licensee do not have an FBI criminal record and do not have IRS violations from the date of their most recent SBIC fund licensure.

10

No Outstanding or Unresolved Material Litigation Matters—no outstanding or unresolved litigation matters involving allegations of dishonesty, fraud, or breach of fiduciary duty or otherwise requiring a report under § 107.660(c) or (d) as to a prior Licensee, the prospective Applicant’s general partner, or any other person who was required by SBA to complete a personal history statement in connection with the license application.

11

No Outstanding Tax Liens—on the principals applying to manage the licensee, on the most recent or active licensee, and on the sponsoring entity of the licensee.

INSTRUCTIONS

This form must be signed by all principals of the applicant certifying the information provided related to expedited subsequent fund qualification is true, correct and complete to the best of the applicant's knowledge. SBA will accept an encrypted digital signature available by going to "Info" --> "Protect Workbook" --> "Digital Signature." Alternatively, SBA will accept a PDF version with approved digital signatures along with the completed Excel workbook. If all 11 statements above are answered in the affirmative as indicated by a "✓", the applicant may: - proceed to answer the following subsequent fund narrative questions in lieu of the full "Narrative" tab. - complete the "investment track record" tab for only new principals of the applicant not previously named in the most recent license application. - submit bios on the "Principal Bios" tab for only new principals of the applicant not previously named in the most recent license application. - skip the "Small Business Impact" and "Covenant Default" tabs. - complete the "Firm and Service provider" tab for only new service providers or changes of address and/or contact information. - complete the "References" tab for only new principals of the applicant not previously named in the most recent license application.

Printed Name

Title

Signature

Date

Printed Name

Title

Signature

Date

Printed Name

Title

Signature

Date

Printed Name

Title

Signature

Date

Printed Name

Title

Signature

Date

Printed Name

Title

Signature

Date

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Sheet 3: Info Release

Applicant Fund Name
Authorization to Release Information to Interested Investors
From time to time, the SBIC Program receives inquiries from parties who may wish to consider investing in an SBIC license applicant. Information is shared ONLY for those applicants that have received a "green light" letter. If your fund receives a “green light” letter and you would like SBA to share your fund's name, contact information, target fund size, and the Applicant Overview Information with interested investors, please make an indication below. If no indication is made, SBA will NOT share your information with interested investors. The information in the fund profile below is being pulled from other parts of this workbook. However, you are welcome to edit the profile on this page as you see fit.
				Yes, we authorize SBA to share the information included below and on the 'Overview' PAGE ONLY with interested investors.
				No, we do not authorize SBA to provide information about our fund to interested investors.
Fund Profile for Release:
Applicant Name:	Applicant Fund Name
Contact Person:
Main Phone:
Main E-mail:
Website:
Target Fund Size:
License Type:
SBIC Critical Technology Initiative Applicants ONLY Statement of Notice and Consent
Applicant for SBIC Critical Technologies Initiative (SBICCT)
This Applicant to the SBIC Critical Technologies Initiative (SBICCT) and its Principals acknowledge that this SBIC license application, as well as information, documents, exhibits and correspondence submitted with and in support of this license application will be shared with the U.S. Department of Defense and its agents (collectively, “DoD”) for the purpose of evaluating this license application. Additionally, pursuant to the SBA’s System of Records Notice, information gathered by and reports submitted to SBA during licensure will also be shared with DoD for oversight and compliance evaluation purposes.

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Sheet 4: Overview

Applicant Fund Name: Fund Overview
Applicant Overview Information
License Type Requested	Accrual SBIC
Requesting SBICCT Consideration?	Yes
SBICCT Areas Covered
Investment Vehicle	Applicant Fund Name
Investment Firm/Organization	[Applicant Firm Name]
Manager Registered RIA?	No
Fund Vintage Year	20xx
Fund Jurisdication / Fund Structure	Delaware				Limited Partnership
Minimum Fund Size to Close
Target Fund Size / Hard Cap	$ Target				$ Hard Cap
Amount Raised	$									Enter this info for Final License Application
Paid in Capital	$
Number of Closings Completed
Date of First Close	dd/mm/yyyy
Minimum L.P. Investment Size	$
Investment from Sponsor % | $	%				$
Investment Period (years)	x
Fund Term (years)	x
Target First Close Date	dd/mm/yyyy
Target Final Close Date	dd/mm/yyyy
Fund Style	Private Equity
Fund Strategy	Hybrid Growth
Security Allocation Targets	(i.e. 30% equity co-investment, 30% direct equity, 40% debt)
Geographic/Regional Focus	U.S. Nationwide
Industry(s) of Focus	Healthcare
	Pharma, Biotech & Life Sciences
Target Fund Return (Net)	Net IRR Range	Low %	High %		Net MOIC Range		Low #.#X	High #.#X
Target Fund Leverage (Requested Leverage)	Dollars	$			Ratio to Private Capital %		%
Annual Management Fee	Example: Initial Investment Period = 2% of Unreduced Regulatory Capital plus Assumed Leverage; After the Initial Investment Period = 2% of the cost of loans and investments for all “active” portfolio companies.
Other Fees	description and %
Carried Interest	%
Preferred Return (if applicable)	%
Fund's Primary Benchmark
Investment Principals	Last Name, First Name ; Last Name, First Name
Key Person(s)	Last Name, First Name ; Last Name, First Name
SUBMISSION DATES
Pre-screen Submission Date	dd/mm/yyyy
MAQ Submission Date	dd/mm/yyyy
FOR INTERNAL SBA USE ONLY -- Applicant Preliminary Summary
Preliminary Advantages
Preliminary Issues

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Sheet 5: Narrative

Subsequent Fund Application

OMB Approval No. ####-####

OMB Approval No. ####-####

As of Date:

dd/mm/yyyy

Expiration Date MM/DD/YYYY

Expiration Date MM/DD/YYYY

The subsequent fund application sheet and all requested attachments must be completed in full by all applicants qualifying for expedited subsequent fund processing.

Name of Applicant:

Name of Applicant:

License no.: 01/23-4567

1

Investment Strategy

1.1

Investment Strategy, Allocation and Transaction Types

Asset class and strategy is the same as previously licensed fund.

Investment mix (funds, directs, equity, debt etc.)s is the same as the previously licensed fund.

Geographic and industry focus is the same as the previously licensed fund.

Stage of investment is the same as the previously licensed fund.

Target portfolio company size is the same as previously licensed fund.

Investment deal size is the same as the previously licensed fund.

Ownership/control approach is the same as the previously licensed fund.

Lead, Co-Lead, Co-investor, Sole investor approach is the same as the previously licensed fund.

Investment pace is the same as the previously licensed fund.

For all of the above for which you did not select "✓", please describe the differences and the rationale for the changes below.

Response here. Limit to 500 words.

1.2

Approach to Portfolio Construction

Allocation Policy is the same as previously licensed fund

Targeted range for the number of portfolio company investments is the same as the previously licensed fund.

Approach to follow-on investments (if applicable) is the same as the previously licensed fund.

Approach to reserves management and recycling is the same as the previously licensed fund.

For all of the above for which you did not select "✓", please describe the differences and the rationale for the changes below.

Response here. Limit to 500 words.

1.3

Restricted Use of Federal Funds

The following categories would result in either criminal liability for the SBIC and its managers or are otherwise prohibited under the program: Human Trafficking, Pornography, Tobacco, Federally Illegal Substances, and International Reinvestment. Will you restrict from investing in the following areas?

2

Firm and Team

2.1

Firm Dynamics

If applicable, please describe any material changes to your firm since the approval of your last SBIC license.

2.2

Team

Briefly describe changes to the team including departures, new joiners, and promotions since receipt of the last SBIC license, if applicable. Please include approximate dates when changes occurred and the context surrounding the changes.

2.3

Team Cohesion

Are there any known conditions (health, litigation, financial, personal, etc.) of any of the Principals that might affect their ability to execute their duties to the firm or the SBIC? If yes, please provide an explanation below.

3

Investment Process

3.1

Investment Process Changes

If applicable, please describe any changes to your investment process adopted since receipt of the most recent license or changes you intend to implement in this subsequent fund. Clearly indicated whether changes described are already in place or you intend to implement. If already in place, when did the changes take effect?

3.2

Rationale for Process Changes

If changes are described in 3.1, please describe the context and rationale for implementing changes.

4

Portfolio Management & Monitoring

4.1

Investment Monitoring

Since receipt of your most receipt license, have you made changes to or do you intent to make changes to your process for monitoring investments? Please select "no change", "change implemented", "intend to change" for each item listed below. Describe in the space below the rationale for any changes. For changes already implemented, please provide approximate dates changes when into effect.

Reporting required of portfolio companies

Firm’s approach to board representation

Number of deals each principal will be responsible for at peak

Periodicity of portfolio reviews

Level of engagement with portfolio company management

Consulting services to or value-added support to portfolio companies

4.2

Underperforming Investments

Describe in the space below all underperforming investments, if applicable. Explain the measures you are taking to turn around poor-performing investments, decline follow-on funding or sell-off your position.

5

Fund Economics

5.1

Carried Interest

If applicable, please describe changes to the applicant fund's carried interest provisions including calculation changes, vesting policy and allocation of carried interest. Explain how these provisions compare with your previous funds and rationale for any changes.

5.2

Management Fee

If applicable, describe changes to the formula you will use to calculate the management fee that the SBIC will be charged and rationale for the changes.

If requesting the inclusion of portfolio services charges in the management fee offset, please include the scope of the request in the space below as well.

5.3

Other Compensation

Please describe any changes with respect to compensation, including bonuses, the principals earn outside this fund.

5.4

Fee Allocation

If applicable, describe any changes to your policy on the allocation of fees, such as transaction fees, investment banking fees,

monitoring fees, directors’ fees, etc., between the SBIC and any management or other affiliated entities.

6

Capitalization

6.1

Minimum Fundraising Threshold

Identify your minimum to close, and discuss how your investment strategy, fund operations or other SBIC-related activities would change

if you fail to reach your target fundraising level and must operate with this lower amount of capital.

6.2

Placement Agent

Have you hired or do you intend to hire a Placement Agent? If "Yes", please enter the information under the "Service Providers" section of this Form 2181.

If this is a new relationship or there is a change in duties or compensation, describe the duties of the agent and compensation structure below.

6.3

Investors

List the names for investors who have "soft circle" committed to invest in the fund pending License approval. Note all new investors who did not invest in the most recently licensed fund.

6.4

Third-Party Borrowing and Capital Call Lines

Do you have or do you intend to have any third party borrowing arrangements in place at any time prior to being licensed? "Yes" or "No"

If “Yes,” please provide a description of your current or expected capital call and/or borrowing arrangements. If this is a leveraged licensing application, provide any associated borrowing agreements.

(Please review 13 CFR 107.550)

7

Governance

7.1

Organizational Chart

Are there any changes to the entities and persons related to the SBIC including any parent funds(s) or side-car vehicles if relevant? If yes, please describe the changes below.

List the ownership percentages for the Applicant’s management company and General Partner.

7.2

Associates and Affiliated Entities – Service Providers

Read the definition of Associate (13 CFR 107.50) and Affiliate (13 CFR 121.103). If there are new Associates or Affiliates, identify and describe these Associates

and Affiliated individuals and entities that will provide services to the Applicant in connection with the

Applicant’s activities as an SBIC, such as working capital, due diligence, deal sourcing, administration, or portfolio

consulting, and explain how they will be compensated. If any individual or entity identified is an Associate or Affiliate of any other SBIC applicant or current licensed SBIC, please identify the relationship(s) and describe the nature of the relationship(s).

7.3

Advisory Committee or LPAC

Are you making changes to your LP Advisory Committee?

Do you intend to have any other type of new corporate, advisory or governance committee?

If “Yes” to either question, please provide a brief description of the changes and other new committees.

Explain the role and responsibilities of each committee, and any compensation you expect to provide to its members.

7.4

Personal Co-Investments

If you are changing policies related to personal investments by principals and/or other employees in portfolio

companies, please describe.

7.5

Limited Partner Co-Investments

If you are changing policies regarding co-investments made by limited partners, please describe.

7.6

Other Co-Investments

If you are changing policies regarding co-investments by any Affiliates and/or Associates, as defined in 13 CFR 107.50 and 13 CFR

121.103, respectively, please describe.

7.7

Responsible Investing and Non-Discrimination Policies and Practices (Voluntary)

7.7.1

Do you maintain a formal ESG or Responsible Investing Policy?

7.7.2

If yes, what year was it established?

7.7.3

Do you maintain a formal Diversity, Equity and Inclusion Policy?

7.7.4

If yes, what year was it established?

7.7.5

As the mandate of the SBIC Program is to solve for capital access inadequacies for small businesses, SBA seeks address persistent shortfalls in access to capital for small businesses and startups across industries, geographies and communities. While not a requirement for licensing to invest in these areas, please check the box of all that apply to your investment strategy and focus.

Responsible Investment Themes

Challenges Address by Investing in Companies Developing Solutions in These Areas:

Climate Change

Mitigate and adapt to climate change

Clean Energy

Accelerate the energy transformation to a low-carbon economy

Biotech

Treatment and care of rare diseases

Domestic Supply Chain & Manufacturing

Supply chain disruptions and a fragile domestic manufacturing ecosystem

Cyber Security

Improved cyber and data security

Inclusive Workforce and Non-discrimination

Persistent systemic racism has denied access and opportunities to build equity and participate in the labor force for many Americans

Water

Global water scarcity and water quality crisis

Nutrition

Reducing the global food production imbalance

Health and Wellness

Improved mental and physical health

Education

Equality of access to information and educational technologies and services

Financial Inclusion

Improving financial wellness and building equity for all Americans

Rural, LMI, and Opportunity Zone Businesses

Expanding access and opportunities to jobs, equity, services and technology

Affordable Housing-Related Businesses

Largest shortfall in U.S. housing in 50 years

8

Attachments

Please refer to the "Attachment Checklist" tab and submit the documents listed and check the box next to each item you have submitted.

9

SBIC Critical Technologies Initiative (SBICCT) Applicants Only

9.1

SBIC Critical Technologies (SBICCT) Applicants Only

The SBICCT Initiative's mission is to increase investment opportunities in technology companies, critical industries, and capital-intensive small businesses addressing today’s most pressing national security supply chain needs. Please discuss the impact you expect your investment strategy will have on US national security and please justify your response.

9.2

The SBICCT Initiative requires at least 60% of all private capital and SBA leverage finance companies in one or multiple DoD Critical Technology Areas. Please detail the Critical Technology areas the proposed fund intends to invest in. If there are allocation targets by area, please describe. If you plan to invest in other technology areas, please describe these industries or technology verticals and the intended allocation.

9.3

The SBICCT Initiative is in support of U.S. national security. Do you intend to accept investment from non-U.S. entities and/or individuals? If yes, please list the countries you will consider.

9.4

Does your firm currently maintain relationships in other firm managed funds with non-U.S. investor entities and/or individuals? If yes, please list the countries and the number of investor and $ assets by country.

9.5

Are all Principals, Investors and Associates of the Applicant willing to undergo a U.S. Department of Defense background check?

10

Drop-Down Funds and Business Development Company (BDC) SBIC Applicants ONLY

Is this a drop-down SBIC?

10.1

Capital

How much capital do you intend to drop-down from the parent fund to the SBIC?

$

10.2

Parent Fund

Describe the types of investments the parent currently makes or plans to make. Discuss how those

investments and future investments may either be different from the SBIC’s investment strategy or how

they will be similar. State what criteria will be utilized for determining into which fund an investment

will be placed. Will you maintain a formal allocation policy to govern such decisions?

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Sheet 6: Attachment Checklist

Attachment Checklist

As of Date: 12/31/2021

This sheet lists all required attachments which must be submitted along with the MAQ Form 2181 for an application to be considered complete. As a reference, attachments and required later, at the time of Final License application are listed

Name of Applicant:

Applicant Fund Name

✓

Required

✓¹

Submit final clean version and tracked changes version of documented submitted as part of the MAQ.

Required Item

Submit with MAQ

Submit with License Application

Guidance

1

Private Placement Memorandum (PPM)

✓

✓¹

submit redline version noting changes between most recent fund licensed and applicant fund.

2

Limited Partnership Agreement (LPA)

✓

✓¹

submit redline version noting changes between most recent fund licensed and applicant fund.

3

General Partner Operating Agreement

✓

✓¹

submit redline version noting changes between most recent fund licensed and applicant fund.

4

Side Letters

✓

✓¹

submit redline version noting changes between most recent fund licensed and applicant fund.

5

Allocation Policy (if established)

✓

✓¹

submit redline version noting changes between most recent fund licensed and applicant fund.

6

ESG Policy (if established)

✓

✓¹

submit redline version noting changes between most recent fund licensed and applicant fund.

7

Diversity, Equity and Inclusion Policy (if established)

✓

✓¹

submit redline version noting changes between most recent fund licensed and applicant fund.

8

Valuation Policy

✓

✓¹

submit redline version noting changes between most recent fund licensed and applicant fund.

9

Distribution Policy

✓

✓¹

submit redline version noting changes between most recent fund licensed and applicant fund.

10

Management Agreement

✓

✓¹

submit redline version noting changes between most recent fund licensed and applicant fund.

11

Investor Pitchbook

✓

12

Contractual Agreements with Affiliated Entities

✓

✓¹

submit redline version noting changes between most recent fund licensed and applicant fund.

13

Third-Party Debt Agreement(s)

✓

✓¹

submit redline version noting changes between most recent fund licensed and applicant fund.

14

Placement Agent Agreement(s)

✓

✓¹

submit redline version noting changes between most recent fund licensed and applicant fund.

15

10-year Licensee Cash Flow Forecast Model

✓

16

Organizational Chart

✓

✓¹

submit redline version noting changes between most recent fund licensed and applicant fund.

17

MAQ Exhibits:

(1) Exhibit A Activties Relationships Certification (2) Exhibit B Individual Declarations (3) Exhibit C Significant Investor Declarations (4) Exhibit D Individual Legal Questionnaire (5) Exhibit G Transferor's Liability Certificate

✓

✓¹

18

MAQ Workbook tabs:

(1) Info Release, (2) Overview, (3) Narrative, (4) Investment Track Record (for new principals only), (5) Principal Bios (for new principals only), (6) Small Business Impact, (7) Covenant Defaults, (8) Applicant Economics and Time, (9) Firm and Service Providers (10) Applicant Principals, (11) References (for new principals only)

✓

✓¹

19

MAQ Application Fee

✓

20

License Application Exhibits:

(1) Exhibit E Legal Document Certification (2) Exhibit F Capital Certificate (3) Guaranty Agreement(s)

✓

21

Final Licensing Fee

✓

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Sheet 7: Investment Track Record

Investment Track Record

As of Date:

dd/mm/yyyy

Name of Applicant:

Applicant Fund Name

Company Financials at Time of Full Exit OR as of Valuation Date

Other Key Personnel Involved in Deal

Firm name

Investment Vehicle (Fund)

Vintage Year

Size of Vehicle (if applicable)

Fund Style

Type of Investment

Deal Name (Company or Fund Investment)

Portfolio Company or Fund EIN #

Industry

State (Geography)

Sponsor (Name)

Lead Investor

Co-investors (Equity)

Co-Creditors (Debt)

Strategy

Venture/Expansion Stage

Equity Security

Debt Security / Loan

Purpose of Financing

Date of Inv.

Date of Full or Partial Exit

Invested Capital

Distributed (Realized) Value

Unrealized Value

Current Reported Value

Total Value

Cash Multiple (MOIC)

IRR

Sourced By

Led/Co-led Deal

Board or Board Observer Seat

Data as of MM/DD/YYYY

Transaction Type

Valuation Methodology

Number of Employees

Enterprise Value

LTM Revenue

LTM EBITDA

Cash & Equivalents

Total Debt/Loans

Ownership % at Full Exit or as of Valuation Date

Financial Analysis/Market Research

Lead Structuring

Lead Due Diligence

Made Recommendation to Investment/Credit Committee

Investment/Credit Committee

Negotiation

Officer of the company

Board of Directors

Board Observer

Exit Process

if applicable

if applicable

if applicable

if applicable

if applicable

2-digit Abbreviation

Firm or Fund Name

Firm or Fund Name

Firm or Fund Name

Firm or Fund Name

The amount of capital distributed to Fund from the investment to date.

Current reported value for the investment (based on current fair market value / mark-to-market value).

"Total Value" is equal to "Current Reported Value" + "Amount Distributed".

Last Name, First Name

if applicable

fully diluted

Last Name, First Name (if applicable)

Last Name, First Name (if applicable)

Last Name, First Name (if applicable)

Last Name, First Name (if applicable)

Last Name, First Name (if applicable)

Last Name, First Name (if applicable)

Last Name, First Name (if applicable)

Last Name, First Name (if applicable)

Last Name, First Name (if applicable)

Last Name, First Name (if applicable)

Washington Widgets

Manufacturing

Mezzanine

Sub-Debt

Dec-05

Jun-09

$2.5 M

$3.1 M

$0.0 M

1.24x

15.4%

Lincoln Group

Business Services

Special Situations

Sub-Debt

Mar-06

Oct-10

$1.8 M

$2.4 M

$0.0 M

1.33x

14.2%

Jefferson Trucks

Trucking

Growth Stage

Common Equity

Apr-06

Jun-07

$5.3 M

$3.5 M

$0.0 M

0.66x

(15.0%)

Kennedy Textiles

Textiles

Hybrid Debt/Equity

Sub-Debt

Jun-06

$1.5 M

$0.8 M

$2.0 M

1.87x

21.0%

VanBuren Windows

Manufacturing

Later Stage

Second Lien

Feb-07

$2.4 M

$1.0 M

$1.5 M

1.04x

8.0%

Cleveland Communications

Communications

Later Stage

Sub-Debt w/Warrants

Aug-07

$3.1 M

$2.1 M

$1.8 M

1.26x

16.0%

Wilson Components

Electronics

Later Stage

Senior Debt

Aug-07

$2.0 M

$1.8 M

$0.5 M

1.15x

6.0%

(Note: If you need to insert additional rows, please do so above the last line)

TOTAL:

$18.6 M

$14.7 M

$5.8 M

1.10x

7.5%

<-- Gross IRR

2.5%

<-- Net IRR (Gross IRR net of fees)

Description

Please describe the investment experience presented above and why it is relevant to the SBIC proposal

Please describe your role in making the investments described above.

Footnotes:

Include any footnotes below.

---

Sheet 8: Historical Cash Flows

	Historical Cash Flows
	As of Date:	dd/mm/yyyy
	Name of Applicant:	Applicant Fund Name
		Err:507	Err:507	Err:507	Err:507	Err:507	Err:507	Err:507	Err:507	Err:507	Err:507	Err:507	Err:507
	Realized (R) or Unrealized (U):															Realized Investments	Unrealized Investments	TOTAL (Gross)
	Company Name:
	Date of Initial Investment (Month-YY):
	Date of Exit (Month-YY):
	Loan/Debt/Equity/Other:
	Security Type:
	CALENDAR YEAR
	YYYY	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0
	YYYY															0	0	0
	YYYY															0	0	0
	YYYY															0	0	0
	YYYY															0	0	0
	YYYY															0	0	0
	YYYY															0	0	0
	YYYY															0	0	0
	YYYY															0	0	0
	YYYY															0	0	0
	YYYY															0	0	0
	YYYY															0	0	0
	YYYY															0	0	0
Enter Valuation Quarter Here:	12/31/2012	0	0	0	0	0	0	0	0	0	0	0	0		Total Residual Value	0	0	0
	Value of Outstanding Warrants (if applicable):	0	0	0	0	0	0	0	0	0	0	0	0		Outstanding Warrants	0	0	0
	Realized (R) or Unrealized (U):
	Company Name:	0	0	0	0	0	0	0	0	0	0	0	0		#REF!
	Debt/Equity/Other:														Portfolio Summary Statistics
	Security Type:															Realized	Unrealized	Total Gross	Total Net
															IRR:				0.0%
	IRR:														MOIC:	#DIV/0!	#DIV/0!		0.00x
	Multiple of Invested Capital:														Proceeds/IC:	#DIV/0!	#DIV/0!	#DIV/0!	0.00x
															Residual/IC:	#DIV/0!	#DIV/0!	#DIV/0!	0.00x
	Invested Capital:	0	0	0	0	0	0	0	0	0	0	0	0
	Percent of Cost:														No. of Companies:	0	0	0
															No. of Financings:	0	0	0
	Total Cash and Non-Cash Proceeds:	0	0	0	0	0	0	0	0	0	0	0	0		Invested Capital:	$0.0 M	$0.0 M	$0.0 M
	Residual Value:	0	0	0	0	0	0	0	0	0	0	0	0		% of Cost:	#DIV/0!	#DIV/0!	#DIV/0!
	Gain / (Loss):	0	0	0	0	0	0	0	0	0	0	0	0		Gross Receipts:	$0.0 M	$0.0 M	$0.0 M
															Gross Residual Value:	$0.0 M	$0.0 M	$0.0 M
	Deal Lead:														Total Gross Gain/(Loss):	$0.0 M	$0.0 M	$0.0 M
	Deal Co-Lead:
	Deal Source:														Avg. Investment per Co.:	#DIV/0!	#DIV/0!	#DIV/0!
															Avg. Financing Size:	#DIV/0!	#DIV/0!	#DIV/0!
	Hold Period (Years):														Med. Financing Size:	Err:507	Err:507	#VALUE!
	Current Pay (CP/NCP):
	% Ownership:														Inv w/Current Pay (%):	#DIV/0!	#DIV/0!	#DIV/0!
	Leverage Multiple:														Inv w/o Current Pay (%):	#DIV/0!	#DIV/0!	#DIV/0!
	Stage:														Volatility:
	Industry:														Downside Volatility:			0.0%
	Location:														Loss Rate:	#DIV/0!	#DIV/0!	#DIV/0!
	Initial Revenue:														Avg. Hold:
	Initial EBITDA:
	Small Business:
	Toggle:
Company:	<>#
Realized (R) or Unrealized (U):	<>#	R	U
Deal Lead:	<>#
Deal Co-Lead:	<>#
Deal Source:	<>#
Instrument:	<>#
Debt/Equity/Other:	<>#	Debt	Equity	Other
CP/NCP	<>#	CP
Industry:	<>#
Stage:	<>#
State of Co's Primary Offices:	<>#
Small Business:	<>#	Y	N
Min. Investment Size (= or >):	$0 M	$0.5 M	$1.0 M	$1.5 M	$2.0 M	$2.5 M	$3.0 M	$3.5 M	$4.0 M	$4.5 M	$5.0 M	$5.5 M	$6.0 M
Max. Investment Size (= or <):	$150 M	$150 M	$149 M	$149 M	$148 M	$148 M	$147 M	$147 M	$146 M	$146 M	$145 M	$145 M	$144 M
Min. Initial Revenue (= or >):	$0 M	$10 M	$20 M	$30 M	$40 M	$50 M	$60 M	$70 M	$80 M	$90 M	$100 M	$110 M	$120 M
Max. Initial Revenue (= or <):	$2,000 M	$1,990 M	$1,980 M	$1,970 M	$1,960 M	$1,950 M	$1,940 M	$1,930 M	$1,920 M	$1,910 M	$1,900 M	$1,890 M	$1,880 M
Min. Initial EBITDA (= or >):	($500 M)	($490 M)	($480 M)	($470 M)	($460 M)	($450 M)	($440 M)	($430 M)	($420 M)	($410 M)	($400 M)	($390 M)	($380 M)
Max. Initial EBITDA (= or <):	$2,000 M	$1,990 M	$1,980 M	$1,970 M	$1,960 M	$1,950 M	$1,940 M	$1,930 M	$1,920 M	$1,910 M	$1,900 M	$1,890 M	$1,880 M
Min. Hold Period (= or >):	0	0.5	1	1.5	2	2.5	3	3.5	4	4.5	5	5.5	6
Max Hold Period (= or <):	150	149.5	149	148.5	148	147.5	147	146.5	146	145.5	145	144.5	144
Toggle:	<>#	X	<>X

---

Sheet 9: Principal Bios

Principal Biographies

As of Date:

dd/mm/yyyy

Name of Applicant:

Applicant Fund Name

For each principal please provide a brief biography and a description of his/her role within the team. Use the suggested format below, ensuring you include all previous employment and associated time periods. Enter this information on the "Principal bios" tab in this workbook.

Template

First Name Last Name

Title

First Name Last Name is one of three General Partners at XYZ Capital and a member of the investment team. S/he joined XYZ Capital in 1995 as an Associate, was promoted to Partner in 2002 and General Partner in 2005. Prior to joining XYZ Capital, Last Name was an Associate with ABC Asset Management, where s/he worked from 1993 to 1995. S/he began her/his career as an Investment Banking Analyst at DEF Associates in 1990. Last Name earned a B.A. in Economics from ABC College in 1990 and an MBA from GHI University in 1993.

1

First Name

Last Name

Title

2

First Name

Last Name

Title

3

First Name

Last Name

Title

4

First Name

Last Name

Title

5

First Name

Last Name

Title

6

First Name

Last Name

Title

7

First Name

Last Name

Title

8

First Name

Last Name

Title

9

First Name

Last Name

Title

---

Sheet 10: Small Business Impact

Small Business Impact

As of Date:

dd/mm/yyyy

This sheet should be completed to the best of the applicants knowledge. Only include deals attributable to principals of the applicant.

Name of Applicant:

Applicant Fund Name

All dollars in millions

Ownership* - "✓" all that apply *Ownership defined as owning >50% of the equity in the business or possessing voting control prior to investment.

Founders - "✓" all that apply

CEO or Equivalent - "✓" all that apply

Gender

Ethnicity

Race

Gender

Ethnicity

Race

Gender

Ethnicity

Race

Type of Investment

Deal Name (Company or Fund Investment)

Portfolio Company or Fund EIN #

Primary Industry NAICs Code

Industry

State (Geography)

Purpose of Financing

Date of Investment

Invested Capital

Distributed (Realized) Value

Unrealized Value

Current Reported Value

Total Value

Company Primary Contact Email Address

Website

Outside Entity

Prefer Not to Disclose

Prefer Not to Disclose

Prefer Not to Disclose

Veteran

Persons with Disabilities

Prefer Not to Disclose

Prefer Not to Disclose

Prefer Not to Disclose

Veteran

Persons with Disabilities

Prefer Not to Disclose

Prefer Not to Disclose

Prefer Not to Disclose

Veteran

Persons with Disabilities

0

Washington Widgets

0

Manufacturing

0

0

12/10/2005

$2.5 M

$3.1 M

$0.0 M

$0.0 M

$0.0 M

0

Lincoln Group

0

Business Services

0

0

3/3/2006

$1.8 M

$2.4 M

$0.0 M

$0.0 M

$0.0 M

0

Jefferson Trucks

0

Trucking

0

0

4/14/2006

$5.3 M

$3.5 M

$0.0 M

$0.0 M

$0.0 M

0

Kennedy Textiles

0

Textiles

0

0

6/30/2006

$1.5 M

$0.8 M

$2.0 M

$0.0 M

$0.0 M

0

VanBuren Windows

0

Manufacturing

0

0

2/15/2007

$2.4 M

$1.0 M

$1.5 M

$1.0 M

$0.0 M

0

Cleveland Communications

0

Communications

0

0

8/5/2007

$3.1 M

$2.1 M

$1.8 M

$0.0 M

$0.0 M

0

Wilson Components

0

Electronics

0

0

8/8/2007

$2.0 M

$1.8 M

$0.5 M

$0.0 M

$0.0 M

0

0

0

0

0

0

12/30/1899

$0.0 M

$0.0 M

$0.0 M

$0.0 M

$0.0 M

0

0

0

0

0

0

12/30/1899

$0.0 M

$0.0 M

$0.0 M

$0.0 M

$0.0 M

0

0

0

0

0

0

12/30/1899

$0.0 M

$0.0 M

$0.0 M

$0.0 M

$0.0 M

0

0

0

0

0

0

12/30/1899

$0.0 M

$0.0 M

$0.0 M

$0.0 M

$0.0 M

0

0

0

0

0

0

12/30/1899

$0.0 M

$0.0 M

$0.0 M

$0.0 M

$0.0 M

0

0

0

0

0

0

12/30/1899

$0.0 M

$0.0 M

$0.0 M

$0.0 M

$0.0 M

0

0

0

0

0

0

12/30/1899

$0.0 M

$0.0 M

$0.0 M

$0.0 M

$0.0 M

0

(Note: If you need to insert additional rows, please do so above the last line)

0

0

0

0

0

0

---

Sheet 11: Covenant Defaults

Covenant Defaults

OMB Approval No. ####-####

As of Date:

dd/mm/yyyy

Expiration Date MM/DD/YYYY

This sheet must be completed by applicants submitting a business plan which includes loans or debt investments. Include any portfolio company investments which encounted a convent violation. Include for all principals of the applicant.

Name of Applicant:

Applicant Fund Name

License no.: 01/23-4567

Portfolio Company Name

Portfolio Company EIN

Security Type

Covenant Violation, Restructing or Both

Covenant Violation Type

Date of Default (MM/DD/YYYY)

Time in Default (Months)

Default Interest Rate Charged

Principal Lead Last Name, First Name

Discuss the reasoning behind any restructurings, the causes of any covenant violations and the measures taken to address these issues.

x

x

x

x

x

x

---

Sheet 12: Applicant Economics and Time

#VALUE!

As of Date:

dd/mm/yyyy

Name of Applicant:

Applicant Fund Name

Summary Table

Time Dedication to SBIC

Time Dedication: SBIC Activities

In the table below, please list the names of any person or entity which has a carried interest in the profits of the SBIC (parent if a drop-down), general partner, or management entity. List the Principals of the fund first followed by any other individuals or entities. For any non-Principals being allocated carried interest, list them by name, entity or category (such as "Employees" or "Carry Reserve") and provide the remaining requested information if available/relevant.

Select the last name of each principal using the drop-down menu provided in the table below. Adjust the number of rows, if necessary. For each principal, estimate the percentage of time devoted to the SBIC at each of the three time intervals: 90 days after licensing, 18 months after licensing and in subsequent years.

Select the name of each principal using the drop-down menu provided in the table below. Adjust the number of rows, if necessary. For each principal, indicate how the time he/she will dedicate to the SBIC will be distributed across the various activities listed. Each row should sum to 100%.

Individual Name (Last, First) or Entity Name

Category

Carry Percentage Points (%)

LP/GP Contribution (% of Priv. Cap.)

Salary/Bonus

Time Commitment to SBIC (%)

Investment Committee Member

90 Days after Licensing

18 Months after Licensing

Subsequent Years

Deal Sourcing

Deal Execution

Portfolio Monitoring & Management

Fund Operations and Compliance

Fundraising

Investor Relations

Fund Finance and Accounting

Other

Total

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

<--- Insert additional rows, as necessary

---

Sheet 13: Firm and Service Providers

Firm and Service Providers

As of Date:

dd/mm/yyyy

Name of Applicant:

Applicant Fund Name

Firm Information

Enter the requested information. Select from the drop-down menu where available. The EIN should be provided for the fund entity and is required for inclusion in License Applications only, though you may provide it as part of your MAQ submission if it is available.

Full Legal Name of Firm Manaing / Sponsoring Applicant

Firm EIN

Main Telephone ###-###-####

Main E-mail

Website

Address 1

Address 2

City

State

ZIP Code

Country

Headquarters:

Branch Offices (if any):

Service Providers

Please use the table below to list any law firms, accounting firms, placement agents, or consultants you are currently employing or any firm that will be compensated for assisting you in any manner to obtain an SBIC license. If a person, group or entity has made any contributions (whether financial or non-financial) that entitle it or them to any type of equity or economic participation in the SBIC, very briefly describe the nature of such contribution.

Entity/Person Name

Provider Category

City

State

Year Relationship Established

Key Contact First Name

Key Contact Last Name

Key Contact Title

Phone ###-###-####

E-mail

Description of Contribution (If applicable)

---

Sheet 14: Applicant Principals

Principal Information

OMB Approval No. ####-####

As of Date:

dd/mm/yyyy

Expiration Date MM/DD/YYYY

Enter the requested information for the Principals of the fund ONLY, beginning with the Principal serving as the applicant's primary contact with SBA. For the purposes of the SBIC application process, the term "Principal" refers to any individual who engages or proposes to engage in the management of the applicant, and customarily includes officers and directors of a corporation, general partners of a partnership, and managers of a limited liability company. However, it may also include other individuals, especially if they have a vote or a veto in the investment decision-making process.

Name of Applicant:

Applicant Fund Name

Note: Demographic information is provided on a voluntary basis.

Voluntary Demographic Information ("✓" all that apply)

✓- Yes; blank - No

Gender

Ethnicity

Race

Last Name

First Name

Title

U.S. Citizen

Permanent Resident Alien

Role Type

Business Address 1

Business Address 2

Business City

Business State

Business ZIP Code

Business Country

Business Phone

Business Email

Home Address 1

Home Address 2

Home City

Home State

Home ZIP Code

Home Country

Mobile Telephone

Personal E-mail

GP Ownership %

Fund Carry %

Management Company Ownership %

Investment Committee Member

Primary SBA Contact

SBA Mailing List?

Male

Female

X

Prefer Not to Disclose

Non-Hispanic or Latino

Hispanic or Latino

Prefer Not to Disclose

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Prefer Not to Disclose

Veteran

Persons with Disabilities

Smith

Mary

CFO

Finance and Operations

(703) 861-3642

[email protected]

5%

✓

✓

✓

---

Sheet 15: References

References

OMB Approval No. ####-####

As of Date:

dd/mm/yyyy

Expiration Date MM/DD/YYYY

Name of Applicant:

Applicant Fund Name

License no.: 01/23-4567

References

Firm/ Organization

First Name

Last Name

Title

Current Firm

Reference Type

Associated Fund or Co.

Associated Portfolio Company

Start Year of Relationship

Work Phone

Mobile Phone

Home Phone

E-mail 1

E-mail 2

Notes

---

Sheet 16: Labels

Fund Style

Fund Strategy

Industry

SBICCT Areas

Type of Investment

Status

Transaction Type

State/Territory

Venture/Expansion Stage

Equity Security

Debt Security / Loan

Rate Structure

Geo/Regional Focus

Binary

Board Status

Monitoring

Types of Licensees

Limited Partnership

✓

Countries

Carry Econ Category

Fund of Funds

Venture

Diversified

Biotechnology

Equity Fund Investment

Realized

Change of Control

AK

Pre-Seed

Preferred Equity

Senior Secured Debt

Fixed Rate

U.S. Nationwide

Yes

Board Observer

No Change

Non-Leveraged

Limited Liability Corporation

Covenant Violation

United States of America (USA)

Principal

Venture

Growth Equity

Multi-Sector (Less than/Equal to 3 Sectors)

Quantum Science

Direct Equity Investment

Partially Realized

Platform Acquisition

AL

Seed

Common Equity

Senior Unsecured Debt

Floating Rate

East Coast

No

Board Member

Change Implemented

Standard Debenture SBIC

C-Corp

Restructuring

Afghanistan

Employee

Growth Equity

Buyout

Business Products & Services

FutureG

Co-investment

Unrealized

Initial Public Offering

AR

Post-Seed

Convertible Note

Unitrache Debt

Midwest

N/A

N/A

Intend to Change

Accrual SBIC

Both

Accounting & Tax

Albania

Member of the GP (non-Principal)

Secondaries

Special Situations

Education

Advanced Materials

Structured Credit

Merger

AZ

A

SAFE Note

Subordinated Debt with Warrants

West Coast

Reinvestor SBIC

Depository Bank and Lender

Algeria

Management Company Owner (non-Principal)

Private Credit

Distressed

Personal Care

Trusted AI and Autonomy

Long-term Loan

Secondary Sale

CA

B

Subordinated Debt without Warrants

South

Bank-Owned SBIC

IT Services

Andorra

Charitable Donation

Private Equity

Mezzanine

Food, Beverage & Tobacco

Integrated Network Systems-of-Systems

Royalty or Revenue-Based Investment

Sale to Strategic Buyer

CO

C

Subordinated Debt with PIK Notes

Southeast

Business Development Company (BDC) Standard Debenture

Fund Administration and Reporting

Angola

Other Non-Profit

Hybrid

Direct Lending

Household Products

Microelectronics

Leveraged Buyout

Sale to Financial Buyer

CT

D

Royalty

Southwest

To-Be-Determined

Legal Counsel

Anguilla

Carry Reserve for Future Hires or Promotion

Fund Secondary

Retailing and Distribution

Space Technology

Liquidation/Sale of Assets

DC

E

Revenue-Based Loan

Northwest

Placement Agent

Antigua & Barbuda

Carry Reserve for Performance Incentive

Direct Secondary

Consumer Services

Renewable Energy Generation and Storage

Growth Financing

DE

Loan

Northeast

Outsourced HR Services

Argentina

Other

Co-Investment

Consumer Durables and Apparel

Advanced Computing and Software

Restructuring

FL

South Central

Retirement Benefits

Armenia

Multiple

Media & Entertainment

Human-Machine Interfaces

Bridge Loan

GA

Mid-Atlantic

Business Insurance Provider

Australia

Seed

Industrials

Directed Energy

Seed Financing

HI

Office Leasor / Workspace Provider

Austria

Early Venture

Materials

Hypersonics

IA

Regulatory Compliance

Azerbaijan

Late Venture

Manufacturing

Integrated Sensing and Cyber

ID

Outsourced CFO Services

Bahamas

Expansion

Transportation

IL

Heath Insurance Provider

Bahrain

Balanced Venture

Energy

IN

GP Stake Provider

Bangladesh

Co-Investments

Software

KS

Other

Barbados

Hybrid Debt/Equity

IT Services

KY

Belarus

Venture Debt

Semiconductors and Semiconductor Equipment

LA

Belgium

Angel

Telecommunication Services

MA

Belize

Technology Hardware and Equipment

MD

Benin

Healthcare

ME

Bermuda

Pharma, Biotech & Life Sciences

MI

Bhutan

Medical Devices & Equipment

MN

Bolivia

Healthcare Services

MO

Bosnia & Herzegovina

Banks

MS

Botswana

Diversified Financials

MT

Brazil

Defense

Multiple

Brunei Darussalam

Insurance

NC

Bulgaria

Other

ND

Burkina Faso

NE

Burundi

NH

Cambodia

NJ

Cameroon

NM

Canada

Non-US

Cape Verde

NV

Cayman Islands

NY

Central African Republic

OH

Chad

OK

Chile

OR

China

PA

China - Hong Kong / Macau

PR

Colombia

RI

Comoros

SC

Congo

SD

Congo, Democratic Republic of (DRC)

TN

Costa Rica

TX

Croatia

UT

Cuba

VA

Cyprus

VT

Czech Republic

WA

Denmark

WI

Djibouti

WV

Dominica

WY

Dominican Republic

GUAM

Ecuador

Egypt

El Salvador

Equatorial Guinea

Eritrea

Estonia

Eswatini

Ethiopia

Fiji

Finland

France

French Guiana

Gabon

Gambia, Republic of The

Georgia

Germany

Ghana

Great Britain

Greece

Grenada

Guadeloupe

Guatemala

Guinea

Guinea-Bissau

Guyana

Haiti

Honduras

Hungary

Iceland

India

Indonesia

Iran

Iraq

Israel and the Occupied Territories

Italy

Ivory Coast (Cote d'Ivoire)

Jamaica

Japan

Jordan

Kazakhstan

Kenya

Korea, Democratic Republic of (North Korea)

Korea, Republic of (South Korea)

Kosovo

Kuwait

Kyrgyz Republic (Kyrgyzstan)

Laos

Latvia

Lebanon

Lesotho

Liberia

Libya

Liechtenstein

Lithuania

Luxembourg

Madagascar

Malawi

Malaysia

Maldives

Mali

Malta

Martinique

Mauritania

Mauritius

Mayotte

Mexico

Moldova, Republic of

Monaco

Mongolia

Montenegro

Montserrat

Morocco

Mozambique

Myanmar/Burma

Namibia

Nepal

Netherlands

New Zealand

Nicaragua

Niger

Nigeria

North Macedonia, Republic of

Norway

Oman

Pacific Islands

Pakistan

Panama

Papua New Guinea

Paraguay

Peru

Philippines

Poland

Portugal

Puerto Rico

Qatar

Reunion

Romania

Russian Federation

Rwanda

Saint Kitts and Nevis

Saint Lucia

Saint Vincent and the Grenadines

Samoa

Sao Tome and Principe

Saudi Arabia

Senegal

Serbia

Seychelles

Sierra Leone

Singapore

Slovak Republic (Slovakia)

Slovenia

Solomon Islands

Somalia

South Africa

South Sudan

Spain

Sri Lanka

Sudan

Suriname

Sweden

Switzerland

Syria

Tajikistan

Tanzania

Thailand

Timor Leste

Togo

Trinidad & Tobago

Tunisia

Türkiye (Turkey)

Turkmenistan

Turks & Caicos Islands

Uganda

Ukraine

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