STATE OF WASHINGTON 2007 FISCAL YEAR END INVESTMENT ADVISER REQUIREMENTS Firm Name___________________________________________________IARD No.______________ Form ADV Please check one of the following: ___ I have reviewed my firm’s Form ADV Part 1 and no changes are necessary. ___ I have reviewed the Part 1 and an amendment has been filed on IARD. Please check one of the following: ___ I have reviewed my firm’s Form ADV Part II and no changes are necessary. ___ I have reviewed the Part II and an amendment has been filed with the Division or is enclosed. Net Worth Requirement Please attach your balance sheet to this form (if you have already filed the balance sheet please check here ___). The balance sheet should be prepared in accordance with generally accepted accounting principles. The firm’s fiscal year ends on: ____________________ month _______ day Is the firm able to meet its obligations and pay its debts as they come due in the ordinary course of business? ___ Yes ___ No Note: If the firm has discretion the balance sheet must show net worth of at least $10,000, and if the firm has full custody of client funds or securities the net worth requirement is $35,000. Does the firm have discretion? ___ Yes ___ No Does the firm have custody? ___ Yes ___ No Is “Yes” checked only because the firm deducts fees from client accounts? ___Yes ___No If the balance sheet does not show sufficient net worth does the firm have one of the following it is relying on to meet net worth requirements: ___ Surety bond in the amount of $____________________ ___ Subordination agreement I certify that I am a principal of the adviser and have reviewed the balance sheet. ____________________________________________ Name ______________________________ Phone Number ____________________________________________ Title ______________________________ Date Please return this form and the balance sheet by March 31, 2008 to: Bruce Johnson, Securities Division, PO Box 9033, Olympia, WA 98507-9033 FAX 360-704-6981 Phone # 360-902-8781 American LegalNet, Inc. www.FormsWorkflow.com