State of Alaska Department of Commerce, Community, and Economic Development Division of Banking and Securities 550 West Seventh Avenue, Suite 1850, Anchorage, AK 99501 Telephone: 907-269-8140 E-mail: ancsa@alaska.gov Website: commerce.alaska.gov/dnn/dbs/Home.aspx REQUEST FOR INVESTIGATION OF ALASKA NATIVE CORPORATION PROXY SOLICITATION Initial Questions: Yes No Is this request for investigation related to an Alaska Native Regional, Village, or Urban Corporation? Is this request for investigation related to a corporation having 500 or more shareholders? Is this request for investigation related to a corporation that has assets exceeding $1,000,000.00? Is this request for investigation related to a violation of the regulations that govern proxy solicitations (3 AAC 08.305 - 3 AAC 08.365)? Are you a shareholder, director, or officer of the corporation in question? Yes No Yes No Yes No Yes No If you were unable to answer yes to all of the questions above or are unsure about the answers to the questions above, please contact the Division of Banking and Securities by phone or e-mail listed above before completing this form. Requester Information: Full name: Mailing address: Telephone number: E-mail address: Information about the alleged violator (if known): Full name of corporation or individual: Mailing address: Telephone number: E-mail address: Division of Banking and Securities Request for Investigation of Alaska Native Corporation Proxy Solicitation (4/14) American LegalNet, Inc. www.FormsWorkFlow.com Page 1 of 3 Information about the alleged violation: Date of the shareholder meeting for which proxies are/were solicited (if known): If this request for investigation is filed more than 90 days after the date of the shareholder vote for which the proxies in question were solicited, please provide the reason that the requester did not discover (and could not have reasonably discovered) the violation within 90 days: Please describe the solicitation involving an alleged violation of the regulations and provide a copy of any materials relevant to the alleged violation(s): Please list each regulation allegedly violated (if known): Yes No Do you know of any other persons who may have information regarding the alleged violation? If yes, please provide their contact information (if known): Full name: Mailing address: Telephone number: E-mail address : Division of Banking and Securities Request for Investigation of Alaska Native Corporation Proxy Solicitation (4/14) Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com Please provide a written summary of any meetings, communications, or other contacts you have had with the alleged violator of 3 AAC 08.305 - 3 AAC 08.365 regarding the alleged violation: Please describe any court action related to the alleged violation of 3 AAC 08.305 - 3 AAC 08. 365 that has been filed: Yes No I hereby acknowledge that I have read the information contained in and attached to this request for investigation and that all information I have given is accurate and complete to the best of my knowledge and belief. Yes No I further acknowledge that the information provided must be updated immediately if other information is discovered, a ruling or decision is issued in a court action, or if a court action is filed. I understand that the information provided constitutes a request for investigation and may be disclosed by the administrator as necessary or appropriate to investigate an allegation, in a public order of the administrator, or at an administrative hearing that could result from an investigation. Yes No Please print, sign, and deliver the completed Request for Investigation Form to: Division of Banking and Securities 550 West Seventh Avenue, Suite 1850 Anchorage, AK 99501 Alternatively, you may scan the signed form and deliver it by e-mail to: ancsa@alaska.gov. If you need to fax the signed form, please contact the Division of Banking and Securities by phone or email for further instructions. Signature: Date: Division of Banking and Securities Request for Investigation of Alaska Native Corporation Proxy Solicitation (4/14) Page 3 of 3 American LegalNet, Inc. www.FormsWorkFlow.com