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INVESTORS RELATION

FOREIGN INVESTOR QUESTIONNAIRE

THIS QUESTIONNAIRE MUST BE COMPLETED AND DELIVERED TO LION ENERGY S.A. IN ORDER FOR YOU TO REGISTER AS A FOREIGN INVESTOR AND BE CONSIDERED AS A PROSPECTIVE PURCHASER OF SECURITIES IN PRIVATE OFFERING.

INSTRUCTIONS: The purpose of this Questionnaire is to determine whether you meet the standards for participation in a non-public offering under Section 4(2) of the Securities Act of 1933, as amended ("Act"). The securities have not been and will not be registered with the Securities and Exchange Commission under the Act .The shares are being sold in reliance upon an exemption from the registration and qualification requirements of the Act .

Please complete and deliver this Questionnaire to Lion Energy S.A. electronically. Your answers will, at all times, be kept strictly confidential; however, each individual who completes this Questionnaire hereby agrees that to Lion Energy S.A. may present this Questionnaire to such parties as it deems appropriate for verification in order to assure itself and future issuers that the subsequent offer and sale of securities will not result in violation of the registration provisions of the Act.


*First Name:	Middle Initial:	*Last Name:

Age:	*Date of Birth:	*Daytime Phone No.:

*Occupation:

*Residential Address:

*City:	*Country:	*Postal Code:

*Employer:

*City:	*Country:	*Postal Code:

*Your E-mail Address:


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Please enter your fax number, if you have one as well as entering the date and place you are completing this form, in the space provided. The foregoing statements are true and accurate to the best of my information and belief and I will promptly notify Lion Energy S.A. of any changes in the foregoing answers.
	Please forward information about private placements by e-mail. I understand the minimum investment in Private Placements is €300 (euro)
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E-mail Address:		*Private Fax Number :
*Date:		*Place: [What is your present location ]
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