Foreign Compliance Certification (For State Registered Investment Advisers Not Having CT Principal Place Of Business)

FOREIGN COMPLIANCE CERTIFICATION (FOR STATE-REGISTERED INVESTMENT ADVISERS NOT HAVING A CONNECTICUT PRINCIPAL PLACE OF BUSINESS) The undersigned, being duly sworn, deposes and says that the undersigned is the ________________________________ of _______________________________________ (title) (applicant) a ______________________________________ , an applicant for investment adviser (form of business organization) registration under the Connecticut Uniform Securities Act (hereafter, the Applicant); that, insuch capacity the undersigned authorized on behalf of the Applicant to execute this ForeignCompliance Certification; and that the Applicant, through its execution of this Foreign Compliance Certification, represents as follows: (1) The Applicant is licensed or registered asan investment adviser in the state where it maintains its principal place of business; (2) theApplicant is, and will remain in compliance with the net capital and/or bonding requirementsof the state where it maintains its principal place of business; (3) the Applicant is, and willremain in compliance with all applicable books and records requirements of the state where itmaintains its principal place of business; and (4) in the event the Applicant should no longerbe licensed or registered as an investment adviser in the state where it maintains its principalplace of business, the Applicant recognizes that it will become subject to Connecticut capitalization requirements for investment advisers and to any supplementary books and records requirements applicable to investment advisers having their principal place of business in this state. ___________________________________________ (Signature) ___________________________________________ Print Name of Signatory Subscribed and sworn to, before me this ______ , day of ___________ , ______ . ___________________________________ Notary Public My Commission Expires:. Rev. 1/2001