Non-Solicitation Form

Dear Sir or Madam:

I, the undersigned, hereby confirm with full personal and legal responsibility, that I have requested this information of my own free will and accord, and that I am not seeking investment opportunities, products, services, or benefits of any nature.

I hereby affirm that the information that I am requesting is about a private consultation activity.

I hereby confirm that neither you nor anyone on your behalf or anyone else associated with your activity has solicited me in any way. All parties state as truth that they are not employees or officials in or of any agency, and are not a member of the media whose purpose is to collect information for defamation or prosecution. All parties agree that falsification of this criteria entitles the party defrauded thereby is entitled to $100,000.00 (U.S.) for violation of rights against forced association.

Any documents, information, or property received by me will not be construed as solicitation in any way whatsoever. I further affirm that I have been told that the nature of these activities is that of charity and I affirm that my involvement with said activities are solely a voluntary act of my own accord. I also understand that should I get involved with said activities that my gift will be just that, a gift, and it is nothing to which I may lay claim in the future; it is a gift.

It is agreed that a fax or email copy will be considered legal and enforceable as an original.

Sincerely yours,