Disclosure Of Corporate Affiliations And Other Interests Page 2

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4.
Is there any other publicly held corporation or other publicly held entity that has a direct
financial interest in the outcome of the litigation (Local Rule 26.1(a)(2)(B))?
YES
NO
If yes, identify entity and nature of interest:
5.
Is party a trade association? (amici curiae do not complete this question)
YES
NO
If yes, identify any publicly held member whose stock or equity value could be affected
substantially by the outcome of the proceeding or whose claims the trade association is
pursuing in a representative capacity, or state that there is no such member:
6.
Does this case arise out of a bankruptcy proceeding?
YES
NO
If yes, identify any trustee and the members of any creditors’ committee:
Signature: ____________________________________
Date: ___________________
Counsel for: __________________________________
CERTIFICATE OF SERVICE
**************************
I certify that on _________________ the foregoing document was served on all parties or their
counsel of record through the CM/ECF system if they are registered users or, if they are not, by
serving a true and correct copy at the addresses listed below:
_______________________________
________________________
(signature)
(date)
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