STATE OF CALIFORNIA DEPARTMENT OF BUSINESS OVERSIGHT VERIFICATION FORM DBO-260.241.2(b) (Rev. 10-17) TO THE COMMISSIONER OF BUSINESS OVERSIGHT OF THE STATE OF CALIFORNIA VERIFICATION FORM PURSUANT TO CALIFORNIA CODE OF REGULATIONS RULE 260.241.2(b) (Executed WITHIN or WITHOUT of the State of California) I, , declare under penalty of perjury under the laws of the State of California that I have read the annexed financial report and supporting schedules and know the contents thereof to be true and correct to my best knowledge and belief; and neither the licensee nor any partner, officer, or director thereof have any proprietary interest in any account classified solely as that of a customer. Executed this day of at City State (Signature of person signing report) (Title of person signing report) (Name of Licensee) (File Number) INSTRUCTIONS: If the broker-dealer or investment adviser is a sole proprietorship, the verification shall be Made by the proprietor; if a partnership, by a general partner; or if a corporation, by a duly authorized officer. American LegalNet, Inc. www.FormsWorkFlow.com