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 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) Rule 3050 of the Rules of Fair PracticeNASD 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 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 _________ o No o If Yes, please describe: __________ 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 __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 Article 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 __________ 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 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 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: ____________________________Date:-----------------------------

NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ --------------------------------------------------------- --------------------------------------------------------- --------------------------------------------------------- *If Subscriber Holder 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 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 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 ____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 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 )? YES _________ No 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 Rules of Fair Practice. _________________________________ ---------------------------------- Name of NASD Member Firm By: ______________________________ ---------------------------------- Authorized Officer - Signature ---------------------------------- Authorized Officer - Printed Name Date: _____________________________ , 2004

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 )? 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 Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _____________________________________ Name of NASD Member Firm By: _________________________________ Authorized Officer - Signature _________________________________ Authorized Officer - Printed Name Date: _____________________________ , 2000

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 __________ 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 )? 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 Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: - Signature _________________________________ Authorized Officer - Printed Name Date: _____________________, 2002

NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No YES NO If Yes, please describe: __________ 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 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 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 Article 3, Sections Articles 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) Rule 3050 of the Rules of Fair PracticeNASD 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 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: ____________________________Authorized Officer

NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes YES _____ü____ No _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 Article 3, Sections 28(a) and (b) of the Rules of Fair PracticeNASD 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 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 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: ______________________________ By:---------------------------- Authorized Officer Date: ____________________________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: ____________________________

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) Rule 3050 of the Rules of Fair PracticeNASD 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: _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 27 *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 __________ YES NO ----------- ----------- If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ *If Subscriber the 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 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: ______________________________ ------------------------------------------ Authorized Officer - Signature -------------------------------------------- Authorized Officer - Printed Name Date: ____________________________, 2000 -----------------------------