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—Signature Authorized Officer—Printed Name Date: , 2001

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—Signature Authorized Officer—Printed Name 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—Officer — Signature Authorized Officer—Officer — Printed Name Date: , 2001

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—Signature Authorized Officer—Printed Name Officer Date: , 2001:

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—Signature Authorized Officer—Printed Name Officer Date: , 2001:_________________________

NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one)? YES NO ): 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—Signature Authorized Officer—Printed Name Officer Date: , 2001:

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—Signature Authorized Officer—Printed Name Officer Date: , 2001-------------------------------------

NASD AFFILIATION. Initials_____ Are you affiliated or associated with an NASD member firm (please check one)? YES NO ): 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—Signature Authorized Officer—Printed Name Officer Date: , 2001:

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—Signature Authorized Officer—Printed Name Officer Date: , 2001:

NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one)? YES NO ): 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—Signature Authorized Officer—Printed Name Officer Date: , 2001:

NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one)? ): ¨ YES ¨ NO If yesYes, 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) Rule 3050 of the Rules of Fair PracticeNASD Conduct Rules. Name of NASD Member Firm By: Authorized Officer—Signature Authorized Officer—Printed Name Officer Date: , 2001:

NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one)? YES NO firm: Yes No If yesYes, 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 Rule 3050. Name of NASD Member Firm By: Authorized Officer—Signature Authorized Officer—Printed Name Officer Date: , 2001:

NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one)? YES NO ): Yes _________ No __________ If yesYes, please describe:** *: *If March 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—Signature Authorized Officer—Printed Name Officer Date: , 2001:

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—Signature Authorized Officer—Printed Name Officer Date: , 2001_____________________________________