Common use of NASD AFFILIATION Clause in Contracts

NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by NASD Rule 3050. Name of NASD Member Firm By: Date: Authorized Officer

NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by NASD Rule 3050. Name of NASD Member Firm By: Authorized Officer Date: Authorized Officer____________________________

NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ --------------------------------------------------------- *If Subscriber Purchaser is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by NASD Rule 3050Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. --------------------------------- Name of NASD Member Firm By: ______________________________ Authorized Officer Date: Authorized Officer____________________________

NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Rule 3050 of the NASD Rule 3050Conduct Rules. Name of NASD Member Firm By: Date: Authorized Officer:

NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ YES NO If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ *If Subscriber subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by the NASD Rule 3050Conduct Rules. _________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: Authorized Officer____________________________

NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes ____YES _____ No _____NO _____ If Yes, please describe: _________________________________________________________ _________________________________________________________ ----------------------------------------------------------------------- ----------------------------------------------------------------------- ----------------------------------------------------------------------- *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Rule 3050 of the NASD Rule 3050Conduct Rules. ------------------------------------ Name of NASD Member Firm By: --------------------------------- Authorized Officer Date: Authorized Officer--------------------------------

NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by NASD Rule 3050. Name of NASD Member Firm By: Authorized Officer Date: Authorized Officer:

NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ [] YES [] NO If Yes, please describe: ______________________________________________________________ ______________________________________________________________ *If Subscriber Investor is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Rule 3050 of the NASD Rule 3050Conduct Rules. ________________________ Name of NASD Member Firm By: ________________________________ Authorized Officer Date: Authorized Officer______________________________

NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by NASD Rule 3050. _________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: Authorized Officer____________________________

NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Rule 3050 of the NASD Rule 3050Conduct Rules. --------------------------------- Name of NASD Member Firm By: :______________________________ Authorized Officer Date: Authorized Officer:____________________________

NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ *If Subscriber subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by the NASD Rule 3050Conduct Rules. _________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: Authorized Officer____________________________

NASD AFFILIATION. Are you Is the Subscriber affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ YES | | NO |_| If Yes, please describe: _________________________________________________________ _________________________________________________________ --------------------------------------------------------- --------------------------------------------------------- --------------------------------------------------------- *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned Subscriber NASD member firm acknowledges receipt of the notice required by NASD Rule 3050Article 3, Articles 28(a) and (b) of the Rules of Fair Practice. ------------------------------------- Name of NASD Member Firm By: ---------------------------------- Authorized Officer Date: Authorized Officer--------------------------------