INVESTMENT ADVISORY REGISTRANT'S CERTIFICATE (State Registered Advisers)
NOTE:
This report must be signed by a general partner if the applicant is a
partnership or the executive officer if a corporation or other form of
association.
The undersigned, being duly sworn, deposes and says that he/she is the
____________________________ of ___________________________________________
(title)
(Applicant)
a ________________________________; that, in such capacity, the undersigned is
(form of business organization)
authorized on behalf of the Applicant to execute this Registrant's Certificate; that the
undersigned has examined the attached statement of financial condition of the Applicant
as of the close of business on ________________; that, to the best of the undersigned's
(date of financial statement)
knowledge and belief, the facts set forth in such Statement of Financial Condition are
true and correct; and further, that neither the principal, nor any member, partner, officer or
director of the Applicant, as the case may be, has any proprietary interest in any account
classified solely as that of a customer, except as follows: .
In addition, the Applicant calculates its Net Tangible Assets as follows:
ALLOWABLE ASSETS:
________________
LESS LIABILITIES:
________________
NET TANGIBLE ASSETS:
________________
________________________________
Print Name of Signatory: ____________
Subscribed and sworn to before me this
_____ day of ________________ , 200___.
___________________________________
Notary Public
My Commission Expires:
Rev. 1/2001