ANNUAL REPORT OF ATTORNEY ENGAGED IN EXTRA-JUDICIAL MATTERS IN NEVADA (RPC 5.5A) This Annual Report is being filed pursuant to the requirements of RPC 5.5A relating to the representation of Nevada client(s) in transactional or extra-judicial matters pending in or substantially related to Nevada for each calendar year. This Annual Report must be filed by January 31 of the following year with the State Bar of Nevada, 600 East Charleston Boulevard, Las Vegas, Nevada 89104-1563, together with a reporting fee of $150. 1. Attorney name Attorney residence address Attorney firm name and office address 2. List all courts before which attorney has been admitted to practice and dates of admission. 3. Are you currently a member in good standing of and eligible to practice before the bar of the courts identified in item 2? ________YES _________NO (If no, please provide information on a separate page) 4. Are you currently on suspension or disbarred from the practice of law before the bar of any court? ________YES ________NO (If yes, please provide information on a separate page) 5. As Exhibit A hereto, provide the following information: the nature of the Nevada client (individual or business entity), the number of transactions performed for each client during the calendar year, and the general nature of those transactions. I certify that the information contained herein is true and correct. Date:_______________________ Printed Name: __________________________ Signature: ________________________________________________ American LegalNet, Inc. www.FormsWorkflow.com EXHIBIT A As provided by RPC 5.5A(f), the information provided herein shall not be disclosed to any third parties unless necessary for disciplinary investigation or criminal prosecution for the unauthorized practice of law. Nature of Nevada Client(s) Represented. Identify whether the client was an individual, a governmental entity, or a business entity (and if so, whether a corporation, partnership, etc.). Number of Transactions. State the number of separate transactions or matters worked on for the client. General Nature of Transactions. Set forth the general nature of each transaction or matter worked on for the Nevada clients (e.g., bond offering, estate planning). Nature of Nevada Clients Represented Number of Transactions General Nature of Transactions American LegalNet, Inc. www.FormsWorkflow.com