PROFIT CERTIFICATE OF DISCLOSURE Pursuant to A.R.S. §10-202. (D). ____________________________________________________ EXACT CORPORATE NAME A. Has any person serving either by election or appointment as officer, director, trustee, incorporator and persons controlling or holding over 10% of the issued and outstanding common shares or 10% of any other proprietary, beneficial or membership interest in the corporation: 1. Been convicted of a felony involving a transaction in securities, consumer fraud or antitrust in any state or federal jurisdiction within the sevenyear period immediately preceding the execution of this Certificate? 2. Been convicted of a felony, the essential elements of which consisted of fraud, misrepresentation, theft by false pretenses, or restraint of trade or monopoly in any state or federal jurisdiction within the seven-year period immediately preceding the execution of this Certificate? 3. Been or are subject to an injunction, judgment, decree or permanent order of any state or federal court entered within the seven-year period immediately preceding the execution of this Certificate wherein such injunction, judgment, decree or permanent order: (a) Involved the violation of fraud or registration provisions of the securities laws of that jurisdiction; or (b) Involved the violation of the consumer fraud laws of that jurisdiction; or (c) Involved the violation of the antitrust or restraint of trade laws of that jurisdiction? Yes No________ B. IF YES, the following information MUST be attached: 1. 2. 3. 4. 5. Full name, prior name(s) and aliases, if used. Full birth name. Present home address. Prior addresses (for immediate preceding 7-year period). Date and location of birth. 6. The nature and description of each conviction or judicial action, date and location, the court and public agency involved and file or cause number of case. C. Has any person serving as an officer, director, trustee, incorporator or holder of over twenty per cent of the issued and outstanding common shares or twenty per cent of any other proprietary, beneficial or membership interest in the corporation served in any such capacity or held a twenty per cent interest in any other corporation in any jurisdiction on the bankruptcy or receivership of the other corporation? Yes No________ IF YOUR ANSWER TO THE ABOVE QUESTION IS "YES", YOU MUST ATTACH THE FOLLOWING INFORMATION FOR EACH CORPORATION: 1. Name and address of the corporation. 2. Full name (including aliases) and address of each person involved. 3. State(s) in which the corporation: (a) Was incorporated. (b) Has transacted business. 4. Dates of corporate operation. 5. Date and case number of bankruptcy or receivership. Under penalties of law, the undersigned incorporator(s)/officer(s) declare(s) that I(we) have examined this Certificate, including any attachments, and to the best of my(our) knowledge and belief it is true, correct and complete, and hereby declare as indicated above. THE SIGNATURE(S) MUST BE DATED WITHIN THIRTY (30) DAYS OF THE DELIVERY DATE. BY BY_________________________________________________________ PRINT NAME PRINT NAME ____________________________________________ TITLE DATE TITLE DATE ______________ DOMESTIC CORPORATIONS: ALL INCORPORATORS MUST SIGN THE INITIAL CERTIFICATE OF DISCLOSURE. If within sixty days, any person becomes an officer, director, trustee or person controlling or holding over 10% of the issued and outstanding shares or 10% of any other proprietary, beneficial, or membership interest in the corporation and the person was not included in this disclosure, the corporation must file an AMENDED certificate signed by at least one duly authorized officer of the corporation. FOREIGN CORPORATIONS: MUST BE SIGNED BY AT LEAST ONE DULY AUTHORIZED OFFICER OF THE CORPORATION. CF: 0022 – Business Corporations Rev: 09/2008 Arizona Corporation Commission Corporations Division American LegalNet, Inc. www.FormsWorkflow.com