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Declaration of Non-Solicitation

To:

Dear Sir(s),

I, the undersigned person, do hereby declare that I am requesting information pertaining to Private Placement Opportunities.

I am not requesting this information as a result of any public solicitation, offering or promotion and am requesting this data for my own personal use.  I was referred to you by a private party.

I realize that the requested information is for private use and is not available to the public and that the purpose of this information is not to solicit me to invest in anything.

If I choose to participate in any private placement opportunities referred to in the requested information provided to me, it will be of my own free will and accord and not through solicitation or coercion by any agents, affiliates or non-affiliated entities related to you directly or indirectly.

Date:  

Signature:

Name Printed:

Full Address:

Telephone:

E-Mail Address: