Investment Advisory Registrants Certificate (State Registered Advisers)

INVESTMENT ADVISORY REGISTRANTS CERTIFICATE (State Registered Advisers) NOTE: This report must be signed by a general partner if the applicant is a partnership or the executive officer if a corporation or other form of association. The undersigned, being duly sworn, deposes and says that he/she is the ____________________________ of ___________________________________________ (title) (Applicant) a ________________________________; that, in such capacity, the undersigned is (form of business organization) authorized on behalf of the Applicant to execute this Registrants Certificate; that the undersigned has examined the attached statement of financial condition of the Applicant as of the close of business on ________________; that, to the best of the undersigneds (date of financial statement) knowledge and belief, the facts set forth in such Statement of Financial Condition are true and correct; and further, that neither the principal, nor any member, partner, officer ordirector of the Applicant, as the case may be, has any proprietary interest in any accountclassified solely as that of a customer, except as follows: . In addition, the Applicant calculates its Net Tangible Assets as follows: ALLOWABLE ASSETS: ________________ LESS LIABILITIES: ________________ NET TANGIBLE ASSETS: ________________ ________________________________ Print Name of Signatory: ____________Subscribed and sworn to before me this _____ day of ________________ , 200___. ___________________________________ Notary Public My Commission Expires: Rev. 1/2001