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COMPLIANCE ATTESTATIONS
The following questions are for legal compliance purposes only in order to meet the requirements of
SEC Rule 506(d) of the Securities Act of 1933. Responses are generally not shared with the hiring
manager, except as appropriate and necessary for legal and compliance purposes.
Definitions. Certain terms used in this questionnaire are italicized, and the definitions of those terms
are set forth in Exhibit A, which is attached. Please review those definitions before answering any
of the following questions.
Basis for Response; Amending Responses. Please answer every question. Please immediately advise
Human Resources if there is any change in the information set forth herein after you have
completed this questionnaire.
Attachments. Please feel free to attach extra pages as necessary. Please reference the question to
which any attachment relates.
1. Have you, within the last ten (10) years, been convicted of a felony or misdemeanor (i) in
connection with the purchase or sale of any security, (ii) involving the making of any false
filing with the Commission or (iii) arising out of the conduct of the business of an underwriter,
broker, dealer, municipal securities dealer, investment adviser or paid solicitor of purchasers
of securities? Yes □ No □
If your response to question 1 is ―yes,‖ please explain. In your explanation, please include
(i) the jurisdiction in which the conviction occurred, (ii) the nature of the offense, (iii) the
nature of the conviction (i.e. felony or misdemeanor), (iv) the date of the conviction and (v)
the sentence received.
2. Are you currently subject to any order, judgment or decree of any court of competent
jurisdiction, entered in the last five (5) years, that restrains or enjoins you from engaging in
any conduct or practice (i) in connection with the purchase or sale of any security, (ii)
involving the making of a false filing with the Commission or (iii) arising out of the conduct of
the business of an underwriter, broker, dealer, municipal securities dealer, investment adviser
or paid solicitor of purchasers of securities? Yes □ No □
If your response to question 2 is ―yes,‖ please explain. In your explanation, please include
(i) the jurisdiction in which the court injunction or restraining order was issued, (ii) the
nature of the offense, (iii) the date the injunction or restraining order was issued and (iv) the
dates during which the injunction or restraining order is in effect.
3. Are you currently subject to a final order of a State securities commission (or an agency or
officer of a State performing like functions), a State authority that supervises or examines
banks, savings associations, or credit unions, a State insurance commission (or an agency or
officer of a State performing like functions), an appropriate Federal banking agency, the
National Credit Union Administration, or the U.S. Commodity Futures Trading
Commission, that—
(i) bars you from—