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 Article 3, Sections 28(a) and (b) of the Rules 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 )? If Yesyes, 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 Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. Name of NASD Member Firm By:_______________________________________ Authorized Officer : Date:_____________________________________: , 2001

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 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 Rules 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 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 Rules of Fair Practice. Name of NASD Member Firm By:_______________________________________ 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 Yesyes, 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 Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. Name of NASD Member Firm By:_______________________________________ Authorized Officer : Date:_____________________________________: , 2001

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 Article 3, Sections 28(a) and (b) of the Rules 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 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 Article 3, Sections 28(a) and (b) of the Rules 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 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 Article 3, Sections 28(a) and (b) of the Rules 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 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 Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. Name of NASD Member Firm By:_______________________________________ Authorized Officer Date:Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________