WISCONSIN INVESTMENT ADVISORY ACTIVITY OF APPLICANT Pursuant to 247551.403(1), Wis. Stats., it is unlawful for any person to transact business in Wisconsin as an investment adviser unless so licensed or licensed as a broker-dealer whose activities in Wisconsin include investment advisory services under 247551, Wis. Stats., except that licensing is not required under any the following circumstances: 1.The person effects transactions or provides investment advice in this state exclusively for the accountof persons specified in s. 551.403(2), Wis. Stats. or 247 DFI-Sec 5.13(1), Wis. Adm. Code.2.The person has no place of business in Wisconsin and in the last twelve months has had fewer than 6clients in Wisconsin.3.The person is now, or was at the time of the transactions in question, a federal covered adviser and notsubject to state registration requirements. The fact that a person may have transacted business as an investment adviser in Wisconsin in violation of 247551.403(1), Wis. Stats., does not mean that a person222s Wisconsin application for registration will automatically bedenied. As part of the Wisconsin Investment Adviser Registration Application, the applicant must respond as to whether or not the applicant has engaged in investment advisory business in Wisconsin without being properly registered. To facilitate your response, please complete the questionnaire below and return the completed form to this Division. NO, this applicant is not now transacting and has never transacted investment advisory business in Wisconsin. YES, this applicant has transacted investment advisory business in Wisconsin prior to this application. (Do not include services performed during any period when the applicant was registered as a federal covered adviser and not subject to state regulation.) If yes, list all transactions effected in Wisconsin: Name & Address Date of Description of Date of Client Name of Total Advisory of Customer Transaction Transaction Agreement IA Rep Fees Charged (Attach additional pages if space provided is insufficient.) Name of Applicant Firm222s Authorized Signatory Date Firm IARD Number Typed Name and Title of Signatory This document can be made available in alternate formats upon request to qualifying individuals with disabilities. American LegalNet, Inc. www.FormsWorkFlow.com