Form Adv-W - Notice Of Withdrawal From Registration As An Investment Adviser Page 7

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Form ADV-W
Page 4
Item 8
Books and Records
This item requires you to list (i) the name and address of each person who has or will have custody or possession of your
books and records; and (ii) each location at which any of your books and records are or will be kept. You must list this
information on Schedule W1, and you must complete a separate Schedule W1 for each person who has or will have custody
of your books and records at each location. The instructions to Form ADV-W contain additional information and examples
to assist you in responding to Item 8.
NOTE: Section 204 of the Advisers Act, or similar state law, requires you to preserve your books and records after
you have withdrawn from registration.
Execution
I, the undersigned, have signed this Form ADV-W on behalf of, and with the authority of, the adviser withdrawing its
registration. The adviser and I both certify, under penalty of perjury under the laws of the United States of America, that
the information and statements made in this Form ADV-W, including exhibits and any other information submitted, are
true. I further certify that the adviser’s books and records will be preserved and available for inspection as required by law,
and that all information previously submitted on Form ADV is accurate and complete as of this date. I understand that if
any information contained in items 1D or IE of this Form ADV-W is different from the information contained on Form
ADV, the information on this Form ADV-W will replace the corresponding entry on the adviser’s Form ADV composite
available through IARD. Finally, I authorize any person having custody or possession of these books and records to make
them available to authorized regulatory representatives.
Signature:
_________________________________
Date:
__________________________
Printed Name:
_________________________________
Title:
__________________________

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