Legal Issuer Profile Form

LEGAL ISSUER PROFILE FORM

This Legal Issuer Profile Form (the "Form") is made and entered into as of Date: by and between Issuer Name: (the "Issuer") and Recipient Name: (the "Recipient").

RECITALS

WHEREAS, the Issuer is duly organized and validly existing under the laws of Jurisdiction of Formation: and was formed on Formation Date: ; and

WHEREAS, the Issuer desires to provide to the Recipient certain organizational, ownership, compliance and operational information (collectively, the "Issuer Information") for the purpose of regulatory, compliance, investor or counterparty due diligence, and the Recipient requires such information in order to evaluate or maintain a business relationship with the Issuer; and

WHEREAS, the Issuer represents that the Issuer Information to be delivered under this Form will be true, complete and accurate in all material respects as of the dates specified herein, and acknowledges that the Recipient will rely upon the representations and certifications contained in this Form.

NOW THEREFORE, in consideration of the mutual covenants and agreements set forth in this Form, and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows:

1. ISSUER INFORMATION

Corporation Limited Liability Company (LLC) Partnership Trust Other:

2. AUTHORIZED REPRESENTATIVE

3. OWNERSHIP, CONTROL AND MARKET STATUS

Is the Issuer a reporting company under applicable securities laws? Yes No

Is the Issuer publicly traded? Yes No If yes, Exchange and Ticker:

4. REPRESENTATIONS AND WARRANTIES

The Issuer represents and warrants to the Recipient that: (a) the Issuer is duly organized, validly existing and in good standing in the jurisdiction of formation; (b) the person executing this Form on behalf of the Issuer is duly authorized to do so and to bind the Issuer; (c) the Issuer Information provided to the Recipient is true, complete and accurate in all material respects as of the date of this Form and that no material facts have been omitted that would render such information misleading; (d) the Issuer is not currently subject to any final sanctions, criminal indictment, or material regulatory enforcement action that would reasonably be expected to impair its ability to perform its obligations hereunder.

The Issuer covenants to promptly notify the Recipient in writing of any material change to the Issuer Information within ten (10) business days of the Issuer’s knowledge of such change. The Issuer acknowledges that the Recipient may rely on the Issuer Information in connection with compliance obligations, contractual relationships, and risk assessments.

5. CONFIDENTIALITY AND DATA USE

The Recipient shall treat all Issuer Information delivered under this Form as confidential and use such information solely for the purposes of compliance, due diligence, credit evaluation, investor relations and related lawful business purposes. The Recipient may disclose Issuer Information to its affiliates, advisors and service providers who have a need to know and who are bound by confidentiality obligations consistent with this paragraph. Notwithstanding the foregoing, the Recipient may disclose Issuer Information as required by law, regulation, or valid subpoena or governmental order, provided the Recipient, to the extent permitted, provides prior written notice to the Issuer and cooperates with the Issuer in any lawful effort to limit disclosure.

6. ATTACHMENTS AND DOCUMENTS

The Issuer shall provide, as applicable, current certified copies of its organizational documents, a certificate of good standing from the jurisdiction of formation, a list of officers and directors, and any other documentation reasonably requested by the Recipient to verify the Issuer Information. Indicate which of the following are attached:

Certificate of Formation / Incorporation Certificate of Good Standing Organizational Documents (e.g., bylaws, operating agreement) Officer/Director List

7. NOTICES

All notices, requests, consents and other communications required or permitted under this Form shall be in writing and shall be delivered to the addresses set forth below (or to such other address as a party may designate by notice to the other party).

8. MISCELLANEOUS

Governing Law: This Form and any dispute arising out of or in connection with it shall be governed by and construed in accordance with the laws of Governing Law Jurisdiction: , without regard to conflicts of law principles.

Entire Agreement: This Form constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior or contemporaneous oral or written agreements and understandings between the parties related to the Issuer Information.

Severability: If any provision of this Form is held to be illegal, invalid or unenforceable in any respect, such provision shall be severed and the remaining provisions shall remain in full force and effect.

Amendments; Waiver: Any amendment or modification of this Form must be in writing and signed by both parties. No failure or delay by either party in exercising any right or remedy shall operate as a waiver of that right or remedy.

Counterparts: This Form may be executed in counterparts, each of which when executed and delivered shall be an original, but all counterparts together shall constitute one and the same instrument. Signatures delivered by electronic means shall be deemed original signatures.

CERTIFICATION

By signing below, the authorized signatory of the Issuer certifies, to the best of their knowledge and belief, that the information provided in this Form and any attachments is true, complete and accurate in all material respects and that the signatory is authorized to make the representations, warranties and certifications contained herein on behalf of the Issuer.

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