AFFIDAVIT This affidavit is made and filed with the Office of the Secretary of the Commonwealth, Massachusetts Securities Division for the purpose of excepting from the definition of Investment Adviser Representative the individual named herein who, otherwise, automatically would be registered pursuant M.G.L. c.110A 202(a). _________________________________ hereby swears of affirms: N ame of Affian t 1. I am ____________________ of ________________________________ Title Name of Investment Adviser an investment adviser registered or seeking registration in the Commonwealth of Massachusetts. 2. In that capacity, I do not engage in any of the following activities: a) making recommendations or otherwise rendering advice regarding securities; b) managing accounts or portfolios of clients; c) determining which recommendations or advice regarding securities should be given; d) soliciting, offering or negotiating the sale, or selling investment advisory services; e) supervising employees who perform any of the foregoing functions. Signed under the penalties of perjury this _____ day of __________________, 20 ____ _____________________________________ S ignature of Affiant American LegalNet, Inc. www.USCourtForms.com