Qic

Includes form instructions and options. Options shown in this text do not identify which boxes were selected.

GENERAL INSTRUCTIONS
This Disclosure Reporting Page (DRP ADV) is an 
INITIAL OR
AMENDED response used to report details for affirmative responses to Items 11.C., 11.D.,
11.E., 11.F. or 11.G. of Form ADV.
Regulatory Action
Check item(s) being responded to:
11.C(1)
11.C(2)
11.C(3)
11.C(4)
11.C(5)
11.D(1)
11.D(2)
11.D(3)
11.D(4)
11.D(5)
11.E(1)
11.E(2)
11.E(3)
11.E(4)
G
Use a separate DRP for each event or proceeding . The same event or proceeding may be reported for more than one person or entity using one DRP. File
with a completed Execution Page. 
One event may result in more than one affirmative answer to Items 11.C., 11.D., 11.E., 11.F. or 11.G. Use only one DRP to report details related to the
same event. If an event gives rise to actions by more than one regulator, provide details for each action on a separate DRP.
PART I
A.  The person(s) or entity(ies) for whom this DRP is being filed is (are):
You (the advisory firm)
You and one or more of your advisory affiliates
One or more of your advisory affiliates
If this DRP is being filed for an advisory affiliate, give the full name of the advisory affiliate below (for individuals, Last name, First name, Middle name). 
If the advisory affiliate has a CRD number, provide that number. If not, indicate "non-registered" by checking the appropriate box.
ADV DRP - ADVISORY AFFILIATE
CRD
Number:
7816450
This advisory affiliate is 
a Firm
an Individual
Registered:
Yes
No
Name:
Jepsen, Rune, Mou
(For individuals, Last, First,
Middle)
This DRP should be removed from the ADV record because the advisory affiliate(s) is no longer associated with the adviser.
This DRP should be removed from the ADV record because: (1) the event or proceeding occurred more than ten years ago or (2) the adviser is
registered or applying for registration with the SEC or reporting as an exempt reporting adviser with the SEC and the event was resolved in the
adviser's or advisory affiliate's favor.
If you are registered or registering with a state securities authority , you may remove a DRP for an event you reported only in response to Item
11.D(4), and only if that event occurred more than ten years ago. If you are registered or registering with the SEC, you may remove a DRP for any
event listed in Item 11 that occurred more than ten years ago.
This DRP should be removed from the ADV record because it was filed in error, such as due to a clerical or data-entry mistake. Explain the
circumstances: 

B.
If the advisory affiliate is registered through the IARD system or CRD system, has the advisory affiliate submitted a DRP (with Form ADV, BD or U-4) to
the IARD or CRD for the event? If the answer is "Yes," no other information on this DRP must be provided.
 Yes
 No
NOTE: The completion of this form does not relieve the advisory affiliate of its obligation to update its IARD or CRD records.
PART II
1.  Regulatory Action initiated by:
SEC   
Other Federal   
State   
SRO
Foreign
(Full name of regulator, foreign financial regulatory authority, federal, state, or SRO) 
KOMISJA NADZORU FINANSOWEGO (KNF)
2.
Principal Sanction:
Civil and Administrative Penalt(ies) /Fine(s)
Other Sanctions: 
3.
Date Initiated (MM/DD/YYYY): 
01/14/2020
 Exact
 Explanation
If not exact, provide explanation:
4.
Docket/Case Number:
KNF: DPS-DPSZA.1.456.3.2020.IF
5.
Advisory Affiliate Employing Firm when activity occurred which led to the regulatory action (if applicable):
QIC PRIVATE CAPITAL PTY LTD
6.
Principal Product Type:
No Product
Other Product Types: 
7.
Describe the allegations related to this regulatory action (your response must fit within the space provided):
THE KNF COMMENCED ADMINISTRATIVE PROCEEDINGS IN CONNECTION WITH MR. JEPSEN'S ROLE AS A MEMBER OF THE SUPERVISORY BOARD OF THE
POLISH PUBLICLY LISTED COMPANY GETBACK S.A. (GB), A FORMER PORTFOLIO COMPANY INVESTMENT MADE BY QIC'S PRIVATE EQUITY TEAM. THE KNF
ALLEGED IMPROPER PERFORMANCE OF OBLIGATIONS IN CONNECTION WITH PREPARATION OF PERIODIC FINANCIAL STATEMENTS AND CONSOLIDATED
FINANCIAL STATEMENTS IN FY 2017 AND FAILURE TO TIMELY PREPARE THE ANNUAL FINANCIAL STATEMENTS FOR 2017 AND CONSOLIDATED FINANCIAL
STATEMENTS FOR 2018, AND PERIODIC CONSOLIDATED FINANCIAL STATEMENTS FOR THE FY 2018Q1.
8.
Current Status?      
 Pending
 On Appeal
 Final
9.
If on appeal, regulatory action appealed to (SEC, SRO, Federal or State Court) and Date Appeal Filed:
THE APPEAL TO THE VOIVODESHIP ADMINISTRATIVE COURT (WSA) WAS FILED AT 23 SEPTEMBER 2021. THE CASSATION APPEAL TO THE SUPREME
ADMINISTRATIVE COURT (NSA) WAS FILED AT 19 APRIL 2022.
If Final or On Appeal, complete all items below. For Pending Actions, complete Item 13 only.
10. How was matter resolved:
Order
11. Resolution Date (MM/DD/YYYY):
08/20/2021
 Exact
 Explanation
If not exact, provide explanation:
12. Resolution Detail:
A.  Were any of the following Sanctions Ordered (check all appropriate items)?
 Monetary/Fine Amount: $ 22,000.00
 Revocation/Expulsion/Denial
 Disgorgement/Restitution
 Censure
 Cease and Desist/Injunction
 Bar
 Suspension
B.
Other Sanctions Ordered:
Sanction detail: if suspended, enjoined or barred, provide duration including start date and capacities affected (General Securities Principal,
Financial Operations Principal, etc.). If requalification by exam/retraining was a condition of the sanction, provide length of time given to

requalify/retrain, type of exam required and whether condition has been satisfied. If disposition resulted in a fine, penalty, restitution,
disgorgement or monetary compensation, provide total amount, portion levied against you or an advisory affiliate, date paid and if any portion
of penalty was waived: 
MR. JEPSEN WAS ORDERED TO PAY A FINE OF PLN 80,000 (APPROXIMATELY $22,000) ON AUGUST 20, 2021. MR. JEPSEN PAID THE FINE
PROMPTLY AFTER THE DECISION WAS ENTERED, SUBJECT TO HIS APPEAL DISCLOSED BELOW.
13. Provide a brief summary of details related to the action status and (or) disposition and include relevant terms, conditions and dates (your response
must fit within the space provided).
A CASSATION APPEAL CHALLENGING THE JUDGMENT ISSUED BY THE VOIVODESHIP ADMINISTRATIVE COURT (WSA) AND VALIDITY OF THE PENALTY
IMPOSED BY KNF WAS FILED IN THE SUPREME ADMINISTRATIVE COURT IN WARSAW (NSA) ON APRIL 19, 2022. THE MONETARY FINE IMPOSED BY KNF
WAS PAID BY MR. JEPSEN PROMPTLY AFTER THE DECISION WAS ENTERED, AS REQUIRED BY LAW. THE ADMINISTRATIVE PROCEEDINGS WERE INITIATED
BY THE KNF DUE TO PRIOR FINDINGS OF VIOLATIONS COMMITTED BY GETBACK S.A. AS THE ISSUER (THE PUBLIC COMPANY). THE MONETARY FINE
AGAINST MR. JEPSEN WAS AUTOMATICALLY IMPOSED IN CONNECTION WITH THE VIOLATIONS COMMITTED BY THE ISSUER, WITHOUT EXAMINATION OF
HIS ACTUAL INVOLVEMENT IN THE VIOLATION BY THE COMPANY. THE APPEALS PROCESS IS ONGOING AS OF SEPTEMBER 2026.

Includes form instructions and options. Options shown in this text do not identify which boxes were selected.

GENERAL INSTRUCTIONS
This Disclosure Reporting Page (DRP ADV) is an 
INITIAL OR
AMENDED response used to report details for affirmative responses to Items 11.C., 11.D.,
11.E., 11.F. or 11.G. of Form ADV.
Regulatory Action
Check item(s) being responded to:
11.C(1)
11.C(2)
11.C(3)
11.C(4)
11.C(5)
11.D(1)
11.D(2)
11.D(3)
11.D(4)
11.D(5)
11.E(1)
11.E(2)
11.E(3)
11.E(4)
11.F.
11.G.
Use a separate DRP for each event or proceeding . The same event or proceeding may be reported for more than one person or entity using one DRP. File
with a completed Execution Page. 
One event may result in more than one affirmative answer to Items 11.C., 11.D., 11.E., 11.F. or 11.G. Use only one DRP to report details related to the
same event. If an event gives rise to actions by more than one regulator, provide details for each action on a separate DRP.
PART I
A.  The person(s) or entity(ies) for whom this DRP is being filed is (are):
You (the advisory firm)
You and one or more of your advisory affiliates
One or more of your advisory affiliates
If this DRP is being filed for an advisory affiliate, give the full name of the advisory affiliate below (for individuals, Last name, First name, Middle name). 
If the advisory affiliate has a CRD number, provide that number. If not, indicate "non-registered" by checking the appropriate box.
ADV DRP - ADVISORY AFFILIATE
CRD
Number:
7816450
This advisory affiliate is 
a Firm
an Individual
Registered:
Yes
No
Name:
Jepsen, Rune, Mou
(For individuals, Last, First,
Middle)
This DRP should be removed from the ADV record because the advisory affiliate(s) is no longer associated with the adviser.
This DRP should be removed from the ADV record because: (1) the event or proceeding occurred more than ten years ago or (2) the adviser is
registered or applying for registration with the SEC or reporting as an exempt reporting adviser with the SEC and the event was resolved in the
adviser's or advisory affiliate's favor.
If you are registered or registering with a state securities authority , you may remove a DRP for an event you reported only in response to Item
11.D(4), and only if that event occurred more than ten years ago. If you are registered or registering with the SEC, you may remove a DRP for any
event listed in Item 11 that occurred more than ten years ago.
This DRP should be removed from the ADV record because it was filed in error, such as due to a clerical or data-entry mistake. Explain the
circumstances: 
B.
If the advisory affiliate is registered through the IARD system or CRD system, has the advisory affiliate submitted a DRP (with Form ADV, BD or U-4) to
the IARD or CRD for the event? If the answer is "Yes," no other information on this DRP must be provided.

 Yes
 No
NOTE: The completion of this form does not relieve the advisory affiliate of its obligation to update its IARD or CRD records.
PART II
1.  Regulatory Action initiated by:
SEC   
Other Federal   
State   
SRO
Foreign
(Full name of regulator, foreign financial regulatory authority, federal, state, or SRO) 
KOMISJA NADZORU FINANSOWEGO (KNF)
2.
Principal Sanction:
Civil and Administrative Penalt(ies) /Fine(s)
Other Sanctions: 
3.
Date Initiated (MM/DD/YYYY): 
01/05/2022
 Exact
 Explanation
If not exact, provide explanation:
4.
Docket/Case Number:
CASE NUMBER OF PROCEEDINGS CONDUCTED BY KNF IN FIRST INSTANCE: DPS-DPSZA3.456.2.2022.MS (FORMERLY: DPS-DPSZA3.456.2.2022.EK)
5.
Advisory Affiliate Employing Firm when activity occurred which led to the regulatory action (if applicable):
QIC PRIVATE CAPITAL PTY LTD
6.
Principal Product Type:
No Product
Other Product Types: 
7.
Describe the allegations related to this regulatory action (your response must fit within the space provided):
THE KNF COMMENCED ADMINISTRATIVE PROCEEDINGS IN CONNECTION WITH MR. JEPSEN'S ROLE AS A MEMBER OF THE SUPERVISORY BOARD OF THE
POLISH PUBLICLY LISTED COMPANY GETBACK S.A. (GB). THE KNF ALLEGED GROSS BREACH BY GB OF ITS DISCLOSURE OBLIGATIONS DURING THE
PERIOD WHEN MR. JEPSEN WAS A MEMBER OF GB'S SUPERVISORY BOARD, REFERRED IN THE MARKET ABUSE REGULATIONS (MAR) BY IMPROPER
PERFORMANCE AND FAILURE TO PERFORM THE DISCLOSURE OBLIGATIONS BY GB.
8.
Current Status?      
 Pending
 On Appeal
 Final
9.
If on appeal, regulatory action appealed to (SEC, SRO, Federal or State Court) and Date Appeal Filed:
THE APPEAL TO THE VOIVODESHIP ADMINISTRATIVE COURT WAS FILED AT 6 NOVEMBER 2023.
If Final or On Appeal, complete all items below. For Pending Actions, complete Item 13 only.
10. How was matter resolved:
Order
11. Resolution Date (MM/DD/YYYY):
09/15/2023
 Exact
 Explanation
If not exact, provide explanation:
12. Resolution Detail:
A.  Were any of the following Sanctions Ordered (check all appropriate items)?
 Monetary/Fine Amount: $ 33,000.00
 Revocation/Expulsion/Denial
 Disgorgement/Restitution
 Censure
 Cease and Desist/Injunction
 Bar
 Suspension
B.
Other Sanctions Ordered:
Sanction detail: if suspended, enjoined or barred, provide duration including start date and capacities affected (General Securities Principal,
Financial Operations Principal, etc.). If requalification by exam/retraining was a condition of the sanction, provide length of time given to
requalify/retrain, type of exam required and whether condition has been satisfied. If disposition resulted in a fine, penalty, restitution,
disgorgement or monetary compensation, provide total amount, portion levied against you or an advisory affiliate, date paid and if any portion
of penalty was waived: 
MR. JEPSEN WAS ORDERED TO PAY FINES AMOUNTING TO PLN 120,000 (APPROXIMATELY $33,000) (THE INDIVIDUAL FINES AMOUNTED TO,
RESPECTIVELY, PLN 70,000 (APPROXIMATELY $19,300), PLN 20,000 (APPROXIMATELY $5,500) AND PLN 30,000 (APPROXIMATELY $8,300)) ON

SEPTEMBER 15, 2023. FINES WERE PROMPTLY PAID AFTER THE DECISION WAS ENTERED.
13. Provide a brief summary of details related to the action status and (or) disposition and include relevant terms, conditions and dates (your response
must fit within the space provided).
MR. JEPSEN WAS ORDERED TO PAY FINES AMOUNTING TO PLN 120,000 (APPROXIMATELY $33,000) (THE INDIVIDUAL FINES AMOUNTED TO,
RESPECTIVELY, PLN 70,000 (APPROXIMATELY $19,300), PLN 20,000 (APPROXIMATELY $5,500) AND PLN 30,000 (APPROXIMATELY $8,300)) ON
SEPTEMBER 15, 2023. FINES WERE PROMPTLY PAID AFTER THE DECISION WAS ENTERED. AN APPEAL CHALLENGING THE VALIDITY OF THE PENALTIES
WAS FILED WITH THE VOIVODESHIP ADMINISTRATIVE COURT ON 6 NOVEMBER 2023. THE PROCEEDINGS BEFORE THE VOIVODESHIP ADMINISTRATIVE
COURT ARE SUSPENDED UNTIL THE END OF RELATED PROCEEDINGS BEFORE THE SUPREME ADMINISTRATIVE COURT WHICH GETBACK S.A., BEING AN
ISSUER, IS A PARTY TO. THE ADMINISTRATIVE PROCEEDINGS WERE INITIATED BY THE KNF DUE TO PRIOR FINDINGS OF VIOLATIONS COMMITTED BY
GETBACK S.A. AS THE ISSUER (THE PUBLIC COMPANY). THE MONETARY FINE AGAINST MR. JEPSEN WAS AUTOMATICALLY IMPOSED IN CONNECTION
WITH THE VIOLATIONS COMMITTED BY THE ISSUER WITHOUT EXAMINATION OF HIS ACTUAL INVOLVEMENT IN THE VIOLATION OF THE COMPANY. THE
APPEALS PROCESS IS ONGOING AS OF SEPTEMBER 2026.