SECURITIES AND BUSINESS REGULATION 2 Martin Luther King, Jr. Drive, S.E. Ste 802, West Tower Atlanta, Georgia 30334 (404) 656-3079 http://www.sos.state.ga.us/securities/ KAREN HANDEL Commissioner of Securities ROBERT D. TERRY ISSUER’S BOND Assistant Commissioner of Securities Georgia Securities Act of 1973, as amended OCGA 10-5-6(b)(1) KNOW ALL MEN BY THESE PRESENTS: That we, (Name) a (corporation, partnership, limited liability company, individual or other) organized under the laws of the State of: AS PRINCIPAL, and a corporation organized and existing under the laws of the State of ____________, and authorized to do business in the State of Georgia, AS SURETY, are hereby held and firmly bound unto the State of Georgia, for the use and benefit of all interested persons injured by any breach of the conditions of this obligation, in the sum of Twenty-Five Thousand ($25,000) Dollars lawful money of the United States of America, for the payment of which sum, well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. SEALED with our seals and dated this day of 200 THE CONDITIONS OF THE ABOVE OBLIGATION ARE SUCH THAT: WHEREAS, the above-mentioned principal has made application for the registration of certain securities under the provisions of the Georgia Securities Act of 1973, as amended, representing by said application and by these presents, that all the statements set forth in said application to the Commissioner of Securities of Georgia, and that all of the written evidence or other probative matter filed with said Commissioner in connection with such application, are true; and obligating itself and its agents to faithful compliance with all provisions of the Georgia Securities Act of 1973, as now or hereafter amended, and any and all regulations and orders issued or hereafter to be issued by the Commissioner of Securities. NOW, THEREFORE, if said principal shall in all things, well and truly perform, fulfill, comply with and observe all and singular the above named conditions, representations and obligations, then this obligation shall be null and void; otherwise to be and remain in full force and effect; provided, however, that the aggregate liabilities recoverable against such bonds shall not exceed the sum of Twenty-Five Thousand ($25,000.00) Dollars regardless of the number of claimants and shall not be construed as individual liability. IN WITNESS WHEREOF, said principal, acting by and through its duly authorized officers, has hereunto set its hand and seal, and the said surety has caused these presents to be signed by its duly authorized officers and its corporate seal to be hereto affixed This day of 200 ATTEST: (SEAL) Principal Secretary BY: Name and Official Position COUNTERSIGNED: (SEAL) BY: Resident Agent of Georgia BY: Surety Name and Official Position Address of Resident Agent: Approved this day of 200 Commissioner of Securities of Georgia NOTE: Resolutions authorizing the execution of this bond should be attached. If this bond has been subscribed to/by an “Attorney in Fact,” there must be attached a “Power of Attorney”. Form 9 Rev. 1/2007 American LegalNet, Inc. www.FormsWorkflow.com