Celsius Bankruptcy Survey Form

All answers will remain confidential. Thank you for taking the time to help us move forward towards the most desirable outcome for all creditors.

Name

Age (optional)

Are you an accredited investor?

Yes No

Which option best describes your Celsius account?

Which cryptocurrencies do you hold on Celsius? (Check all that apply)

Bitcoin Cardano CEL token Ethereum Matic PAX Gold Stablecoins Other

Which option do you prefer for Celsius moving forward?

Any comments or suggestions?