CGX Energy

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Please indicate your interest in CGX Energy's Guyana assets by completing and submitting this electronic form or by contacting Bill Marko, Joe Gladbach or Andy Rogers (281.774.2000)

Representation of Capability:		Yes: I represent that my company is one of the following: (i) a bank, insurance company, registered investment company, business development company, or small business investment company; (ii) an employee benefit plan, if a bank, insurance company, or registered investment adviser makes the investment decisions, or if the plan has total assets in excess of $5 million; (iii) a charitable organization, corporation, or partnership with assets exceeding $5 million; (iv) a business in which all the equity owners are accredited investors; (v) a natural person who has individual net worth, or joint net worth with the person's spouse, that exceeds $1 million at the time of the purchase; (vi) a natural person with income exceeding $200,000 in each of the two most recent years or joint income with a spouse exceeding $300,000 for those years and a reasonable expectation of the same income level in the current year; or (vii) a trust with assets in excess of $5 million, not formed to acquire the securities offered, whose purchases a sophisticated person makes.
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ARIES/Windows Capability?		Yes No
If no, what economic evaluation program?