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Form 260.241.2 - Verification Form Pursuant To Califonia Code Of Regulations Rule 260.241.2(B)

TO THE COMMISSIONER OF CORPORATIONS OF

THE STATE OF CALIFORNIA

VERIFICATION FORM PURSUANT TO

CALIFORNIA CODE OF REGULATIONS RULE 260.241.2(b)

(Executed WITHIN or WITHOUT of the State of California)

I,__________________________ , declare under penalty of perjury under the laws of the

State of California that I have read the annexed financial report and supporting schedules

and know the contents thereof to be true and correct to my best knowledge and belief;

and neither the licensee nor any partner, officer, or director thereof have any proprietary

interest in any account classified solely as that of a customer.

Executed this ________day of ___________________ at

______________________________ ________________________

City

State

________________________________________

(Signature of person signing report)

________________________________________

(Title of person signing report)

________________________________________

_______________________

(Name of Licensee)

(File Number)

INSTRUCTIONS:

If the broker-dealer or investment adviser is a sole proprietorship, the verification shall be

made by the proprietor; if a partnership, by a general partner; or if a corporation, by a

duly authorized officer.

260.241.2(b) (New 02/03)

Form 260.241.2 - Verification Form Pursuant To Califonia Code Of Regulations Rule 260.241.2(B)