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 the NASD Conduct Rules. _________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________

NASD AFFILIATION. Are you Is the Subscriber 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 Subscriber NASD member firm acknowledges receipt of the notice required by Article 3, Articles 28(a) and (b) of the NASD Conduct RulesRules of Fair Practice. _________________________________ ------------------------------------- Name of NASD Member Firm By: ______________________________ ---------------------------------- Authorized Officer Date: ____________________________--------------------------------

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 Conduct RulesRule 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: _________________________________________________________ _________________________________________________________ _________________________________________________________ 30 *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 Conduct RulesRule 3050. _________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________

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 Conduct RulesRule 3050. _________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________:

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 Conduct RulesRule 3050. _________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________

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 Rule 3050 of the NASD Conduct Rules. _________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________:

NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): [] 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 Conduct Rules. _________________________________ Name of NASD Member Firm By: ________________________________ Authorized Officer Date: ______________________________

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 Rule 3050 of the NASD Conduct Rules. _________________________________ ------------------------------------ Name of NASD Member Firm By: ______________________________ --------------------------------- Authorized Officer Date: ____________________________--------------------------------

NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): YES NO If Yes, please describe: 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 Article 3, Sections 28(a) and (b) of the NASD Conduct RulesRules of Fair Practice. _________________________________ --------------------------------- Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________