AFFIDAVIT OF INVESTMENT ADVISORY ACTIVITY Securities Department 600 E Boulevard Ave Dept 414 Bismarck ND 58505 (701) 328-2910 www.ndsecurities.com NORTH DAKOTA SECURITIES DEPARTMENT SFN 53494 (7-2011) Name of Applicant: Applicant does hereby certify: 1. That the above-named Applicant and its investment adviser representatives have not given investment advice for compensation to any North Dakota resident, or been involved in wrap-fee programs; 2. That the above-named Applicant and its investment adviser representatives have engaged in giving of investment advice for compensation to North Dakota residents, or been involved in wrap-fee programs, and all pertinent information relating to said advice is attached to this affidavit, including names and addresses of clients receiving investment advice, the dates such advisory services were provided as to each client, the nature of such investment advice as to each client, and the amount of fees generated from each client. I, on behalf of (Name of Applicant), acknowledge the foregoing to be truthful with full knowledge that misrepresentation of such facts to the Securities Department of the State of North Dakota may result in administrative action by the Department. Signature of Officer, Partner or Sole Proprietor: Subscribed and sworn to before me this day of , 20 Notary Public County of (NOTARIAL SEAL) State of My commission expires on .