(Rev. 1/10) AFFIDAVIT OF NO SALES STATE OF NEW MEXICO I, the undersigned, __________________________________________, being first duly sworn, upon oath state: I am an official of the broker-dealer firm of __________________________________ (hereinafter “Broker-dealer”) and, as such, authorized to make this affidavit on behalf of Broker-dealer. Broker-dealer has not transacted business as a broker-dealer in New Mexico. Broker-dealer agrees to comply with the New Mexico Uniform Securities Act and to refrain from transacting any nonexempt business as a broker-dealer in New Mexico until such time as both Broker-dealer and agent thereof are duly licensed by the New Mexico Securities Division. I have executed this Affidavit in behalf of Broker-dealer after having read and understanding the contents hereof, and with the knowledge that the representations contained herein will be verified with Broker-dealer’s clearing broker(s). I hereby represent that all information contained herein is true, current and complete, to the best of my knowledge and belief. Dated this _______ day of _______________________, __________ __________________________________ Print Broker-dealer Name By: _______________________________ (Signature of Authorized Official) Title: ______________________________ ACKNOWLEDGMENT STATE OF ______________________ ) ) ss. COUNTY OF _____________________ ) On this ______ day of _________________________, _________, before me personally appeared ____________________________, to me know to be the person described in and who executed the foregoing instrument and acknowledged to me that he/she executed the same as his/her free act and deed. (Notarial seal) ___________________________________ Notary Public My Commission expires: _________________________ American LegalNet, Inc. www.FormsWorkFlow.com