<p> Stoltmann Law Offices, P.C.</p><p>UBS Puerto Rico Bond Fund Questionnaire</p><p>DATE______</p><p>HE SHE</p><p>CLIENT’S NAME ______</p><p>CLIENT’S HOME ADDRESS ______</p><p>CLIENT’S HOME PHONE # ______</p><p>CLIENT’S WORK PHONE # ______</p><p>CLIENT’S CELL PHONE # ______</p><p>CLIENT’S WORK ______</p><p>FAX # ______</p><p>CLIENT’S EMAIL ADDRESS ______</p><p>CLIENT’S BIRTH DATE</p><p>______CLIENT’S BIRTH PLACE</p><p>______CLIENT’S CURRENT OCCUPATION ______CLIENT’S EMPLOYER</p><p>OR NAME OF CLIENT’S BUSINESS ______</p><p>YEARS IN CLIENT’S POSITION ______</p><p>1 CLIENT’S APPROX. INCOME LAST YEAR ______</p><p>CLIENT’S PRIOR OCCUPATION ______</p><p>YEARS IN CLIENT’S PRIOR POSITION ______</p><p>CLIENT’S HIGH SCHOOL</p><p>______</p><p>CLIENT’S COLLEGE, IF ANY, ______</p><p>AND MAJOR FIELD OF STUDY ______</p><p># OF CHILDREN OF CLIENT AND THEIR AGES ______</p><p>CONDITION OF CLIENT’S HEALTH AND HIS/HER HEALTH PROBLEMS ______</p><p>CITY AND STATE/US TERRITORY OF UBS BRANCH AT ISSUE ______NAME OF UBS BROKER or FINANCIAL ADVISOR WHO SOLD YOU FUNDS ______</p><p>1. What risks did you believe the UBS Puerto Rico funds had (if any)? From where did you learn this information? </p><p>2. What do you estimate your net worth to have been when you first bought the UBS Puerto Rico Bond funds? </p><p>2 3. Approximately how much money did you invest in the UBS funds? </p><p>4. What do you estimate your losses to have been in the UBS funds?</p><p>5. Approximately when did you purchase your first UBS Puerto Rico Bond fund? </p><p>6. Which specific UBS Puerto Rico Bond Fund(s) did you own? Have you sold your investment? If so, when? </p><p>7. Where did the money come from that initially funded the UBS Puerto Rico Bond fund purchases?</p><p>8. Do you have any friends or relatives who also had accounts with UBS and had similar losses in UBS Puerto Rico Bond funds? If so, who?</p><p>9. What representations or promises, if any, did UBS representatives make about the fund to you?</p><p>10. Did you log onto the UBS’s website to check the values of the funds?</p><p>11. What were you looking for with respect to the funds invested in the UBS funds? 12. Were you solicited by UBS to take out a line of credit or margin loan to purchase shares of the Funds?</p><p>Documents That You Should Produce to Us at this Time</p><p>3 1. Monthly, quarterly or yearly UBS account statements reflecting the purchases and sales of the funds. In the alternative, if you have a spreadsheet reflecting losses in the funds, please forward that to us. </p><p>2. Any and all promotional (i.e. marketing or sales) literature or prospectuses that you received from UBS regarding the Puerto Rico Bond funds (or from other sources).</p><p>Mailing Address to Which This Questionnaire and the Documents Should Be Sent:</p><p>Stoltmann Law Offices, P.C. 10 S. LaSalle Street, Suite 3500 Chicago, Illinois 60603 Phone: 312-332-4200 Fax: 312-332-4201 Email: [email protected] [email protected] [email protected] [email protected]</p><p>Websites: www.InvestmentFraud.PRO www.ubsbondfundfraud.com</p><p>4</p>