Rivei Holdings, LLC - Investor Questionnaire

Step 1

Investor Information

Let's start with your basic information.

Full Legal Name *

Investor Type *

Individual

Entity

Entity Type *

State/Country of Organization *

Date of Formation/Organization *

Authorized Signatory Name *

Signatory Title *

Is this entity owned or controlled by another entity? *

Yes

Name of controlling/parent entity *

Mailing Address - Street *

City *

Country *

State/Province *

ZIP/Postal Code *

Email *

Phone *

U.S. Person? *

Yes

Includes U.S. citizens, permanent residents (green card holders), and U.S.-organized entities — even if located abroad.

Citizenship *

Additional Citizenship (Optional)

Country of Tax Residence *

Pre-filled based on citizenship; update if different.

State/Country where you are physically located *

This may differ from your mailing address. Required for securities law jurisdiction purposes.

Tipo de Inversionista *

Persona Física (Individual)

Persona Moral (Entidad / Empresa)

Nombre Completo *

Nacionalidad *

RFC *

13 caracteres para personas físicas / 12 para personas morales

CURP *

18 caracteres

Fecha de Nacimiento *

Seleccione día, mes y año

Lugar de Nacimiento *

Información de la Entidad

Denominación o Razón Social *

RFC de la Entidad *

12 caracteres: 3 letras + 6 dígitos + 3 alfanuméricos

Tipo de Entidad *

Fecha de Constitución *

Número de Escritura Constitutiva *

Notaría y Número *

Domicilio Fiscal de la Entidad

Calle y Número *

Colonia *

Código Postal *

Ciudad *

Estado *

Actividad Económica Principal *

Objeto Social *

Representante Legal

Nombre del Representante Legal *

RFC del Representante Legal *

CURP del Representante Legal *

Número de Poder Notarial *

Notaría que otorgó el Poder *

Alcance del Poder *

Domicilio *

Ciudad *

Estado *

Código Postal *

Correo Electrónico *

Teléfono *

Tipo de Identificación *

Número de Identificación *

Vigencia *

Step 3

Investment Details

Please provide the details of your intended investment.

Investment Amount (USD) *

Unit Class *

C-Class

Common · $100.00/unit · 1 vote per unit

Your unit class has been pre-assigned. Contact the Company if you need to change it.

Number of Units

Select investment amount to calculate

Source of Funds *

Please specify source of funds *

Are you investing through a retirement account? *

Yes

Investments through retirement accounts may be subject to additional requirements. The Company will follow up with specific instructions.

Is the investor a tax-exempt organization under Section 501(c)(3) or similar provision? *

Yes

Please provide documentation of tax-exempt status with your submission.

Are the funds being used for this investment "plan assets" subject to ERISA? *

Yes

If you're unsure, the answer is most likely 'No.' ERISA typically applies to employer-sponsored benefit plans such as pension funds and some 401(k) plans — not to individual investors or self-directed IRAs.

What is your anticipated investment horizon? *

This investment is illiquid and has no guaranteed timeline for return of capital.

Step 4

Acknowledgments & Representations

Section A: How You Learned About This Offering

How did you first learn about this investment opportunity? *

Please describe *

Section B: Investment Acknowledgments

These are standard representations required under federal securities law for private placements. Please review and confirm all statements below.

I am acquiring these membership interestscommon stock shares for my own account, for investment purposes only — not for distribution or resale.
I understand that these membership interestscommon stock shares have not been registered under the Securities Act of 1933 and cannot be resold unless subsequently registered or an exemption from registration is available. I acknowledge the restricted and illiquid nature of this investment.
I acknowledge that this investment involves substantial risk, including the possible loss of my entire investment. I have the financial ability to bear a total loss and have no need for liquidity from this investment.

I have read and agree to all acknowledgments above.

Step 5

Compliance & Regulatory Screening

Subsection A: AML / KYC Verification

Are you (or any beneficial owner) a Politically Exposed Person (PEP)? *

Yes

A PEP is a current or former senior government official, or an immediate family member or close associate of such a person.

Please specify role/relationship *

Beneficial Ownership *

List each person who directly or indirectly owns 20% or more of the entity.

Name	Title	% Ownership	Citizenship

Please attach a copy of a valid government-issued photo ID (passport, driver's license, or national ID) when returning this questionnaire. For entities, provide ID for each beneficial owner and the authorized signatory.

Subsection B: Bad Actor Screening — Rule 506(d)

Federal securities law (Rule 506(d)) requires the Company to verify that no investor or their significant owners have certain regulatory or legal disqualifications. Please review and confirm the following:

I certify that neither I (nor any beneficial owner of 20% or more of the investor entity):

Have been convicted of any felony or misdemeanor in connection with the purchase or sale of any security, involving any false filing with the SEC, or arising out of the conduct of certain financial intermediaries.
Am subject to any order, judgment, or decree of any court restraining or enjoining me from engaging in any conduct or practice in connection with the purchase or sale of any security.
Am subject to a final order of a state securities commission, banking regulator, federal banking agency, the NCUA, or the CFTC that bars me from associating with a regulated entity or engaging in securities, insurance, or banking activities.
Am subject to any SEC disciplinary order, cease-and-desist order, or suspension/revocation of registration as a broker, dealer, or investment adviser.
Have been found by the SEC to have made an untrue statement of a material fact, or to have been the cause of another person's violation of anti-fraud provisions of the federal securities laws.
Am subject to a U.S. Postal Service false representation order.

I certify that none of the above disqualifications apply to me or any beneficial owner.

Subsection C: Non-U.S. Person Compliance

Country for tax treaty purposes *

I acknowledge that as a non-U.S. investor in a partnership holding U.S. real property interests, I may be subject to FIRPTA withholding upon disposition of such interests, and that the Company may be required to withhold taxes on my behalf.

Please attach completed IRS Form W-8BEN (individuals) or W-8BEN-E (entities) when returning this questionnaire.

Cumplimiento Normativo Mexicano Sección A: Origen de Fondos

Actividad Económica Principal *

Fuente de Ingresos *

Ingreso Mensual Aproximado (MXN) *

Origen Específico de los Fondos *

Sección B: Beneficiario Controlador

¿Por cuenta de quién realiza la inversión? *

Por cuenta propia

Por cuenta de un tercero

Nombre del Tercero *

RFC del Tercero *

Relación con el Tercero *

Sección C: Personas Expuestas Políticamente (PEP)

¿Es usted o algún familiar cercano una Persona Expuesta Políticamente? *

Sí

Nombre de la Persona Expuesta *

Cargo o Posición *

Institución *

Período en Cargo *

Relación con Usted *

Sección D: Documentos Requeridos

Adjunto copia de identificación oficial vigente

Adjunto comprobante de domicilio (recibo de servicios, no anterior a 3 meses)

Adjunto constancia de situación fiscal ante el SAT

Step 6

Certification & Signature

The information collected in this questionnaire will be used solely for securities law compliance, tax reporting, and anti-money laundering verification. Your data will be stored securely and shared only with the Company's legal counsel and tax advisors as necessary. Government-issued identification documents will be stored in encrypted form. You may request access to or deletion of your personal information by contacting [email protected].

SSN *

Printed Name *

Title *

Date *

I certify that all information provided in this questionnaire is true, complete, and correct to the best of my knowledge. I understand that Rivei Holdings, LLC is relying on the accuracy of this information in connection with the offering and sale of Membership Interests. I agree to promptly notify Rivei Holdings, LLC of any material change in the information provided herein. I certify that all information provided in this questionnaire is true, complete, and correct to the best of my knowledge. I understand that Rivei Holdings Inc. is relying on the accuracy of this information in connection with the offering and sale of Common Stock Shares. I agree to promptly notify Rivei Holdings Inc. of any material change in the information provided herein.

RFC *

Nombre Completo *

Fecha *

Declaro bajo protesta de decir verdad que:

Toda la información proporcionada en este cuestionario es verdadera, completa y correcta según mi leal saber y entender.
Los fondos destinados a esta inversión provienen de fuentes lícitas y no están relacionados con recursos de procedencia ilícita, de conformidad con la LFPIORPI.
Autorizo a Rivei MX Capital, S.A. de C.V. para verificar la información proporcionada con terceros y autoridades gubernamentales.
Me comprometo a notificar de inmediato a la Sociedad de cualquier cambio material en la información proporcionada, dentro de un plazo de 30 días.
Reconozco mis obligaciones bajo la Ley Federal para la Prevención e Identificación de Operaciones con Recursos de Procedencia Ilícita (LFPIORPI) y autorizo la verificación de beneficiarios controladores.
No estoy actuando en nombre de personas o terceros sin declarar, o si lo hago, ya he identificado al beneficiario controlador real.

Confirmo todas las declaraciones anteriores.

Comments or Questions (Optional)

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