STATE OF SOUTH DAKOTA :SS COUNTY OF MINNEHAHA ) )IN CIRCUIT COURT SECOND JUDICIAL CIRCUIT CIV. Plaintiff, vs. AFFIDAVIT AS TO PREJUDGMENT INTEREST AND APPROVAL Defendant. STATE OF SOUTH DAKOTA :SS COUNTY OF MINNEHAHA ) ) _________________, being first duly sworn, upon (his or her) oath deposes and says that (he or she) is the attorney for __________________, the Plaintiff in the above-entitled matter. The interest rate for the debt in this action was, by agreement with the Defendant to be _____% as appears from the document attached as Exhibit A; therefore, the Plaintiff should be awarded prejudgment interest at the agreed rate. The prejudgment interest totals $__________. Dated this _____ day of ______________, 20__. Subscribed and sworn to before me this _______ day of ______________, 20__. Notary Public, South Dakota My commission expires: APPROVAL OF PREJUDGMENT INTEREST Based upon the above affidavit, prejudgment interest at the rate of ______% in the sum of $_________ is approved. Dated this _____ day of _________, 20__. BY THE COURT: ____________________________ __ Circuit Court Judge ATTEST: Charles M. Fechner, Clerk of Courts By___________________________ Deputy (2nd Circuit Default Judgment form #5, August, 2004)