2026 AZCGP Arizona Corporation Commission Survey Certificate of Disclosure Question Title * 1. Have you as a current officer, director, trustee, incorporator, or who, in a For Profit corporation control or hold more than 10% of the issued and outstanding common shares or 10% of any other proprietary, beneficial or membership interest in the corporation been:Convicted of a felony involving a transaction in securities, consumer fraud or antitrust in any state or federal jurisdiction within the five year period immediately preceding the execution of this certificate? Yes No OK Question Title * 2. Have you as a current officer officer, director, trustee, incorporator, or who, in a For Profit corporation controls or holds more than 10% of the issued and outstanding common shares or 10% of any other proprietary, beneficial or membership interest in the corporation been:Convicted of a felony, the essential elements of which consisted of fraud, misrepresentation, theft by false pretenses or restraint of trade or monopoly in any state or federal jurisdiction within the five year period immediately preceding the execution of this certificate? Yes No OK Question Title * 3. Have you as a current officer, director, trustee, incorporator, or who, in a For Profit corporation controls or holds more than 10% of the issued and outstanding common shares or 10% of any other proprietary, beneficial or membership interest in the corporation been:Subject to an injunction, judgement, decree or permanent order of any state or federal court entered within the five year period immediately preceding execution of this certificate where such injunction, judgement, decree or permanent order involved the violation of : Fraud of registration provisions of the securities laws of that jurisdiction, orthe Consumer Fraud laws of that jurisdiction, orthe Antitrust restraint of trade laws of that jurisdiction? Yes No OK Question Title * 4. Have you as a current officer, director, trustee, incorporator, or who, in a For Profit corporation controls or holds more than 20% of the issued and outstanding common shares or 20% of any other proprietary, beneficial or membership interest in the corporation served in any such capacity or held a 20% interest in any other corporation on the bankruptcy or receivership of that other corporation? Yes No OK Question Title * 5. Please provide your name OK DONE