Lost Certificates

LOST CERTIFICATES

DOCUMENTS TO BE FILED

FEES / REPLACEMENT COST

SURETY BOND

Fees:

X17 / Filing and Certificate Replacement, per certificate ………………… $ 50.00 US

Surety Bond ………(Generally) 2% of the Market Value of shares reported lost/stolen

Upon receipt of appropriately completed X17 and Certificate Replacement form, we will place a “lost certificate / stop transfer” order against the certificate. Please provide full details on the enclosed forms. Prompt receipt of this information will expedite the replacement procedure. The $50.00 fee for filing and replacement of each certificate is to be made payable to: First American Stock Transfer.

In order to assist shareholders in arranging for the required indemnity bond, we have adopted, for your convenience, a Blanket Lost Security Bond thru Seaboard Surety Company. The premium under this blanket bond is generally lower than the standard premium charged for separate or individual bonds. In addition, the Blanket Bond has several important features, which make it especially beneficial to the stockholders of our customers. Under this plan, please follow the instructions below:

AFFIDAVIT OF LOSS – EXHIBIT B: All of the pages need to be completed in detail, signed and notarized where indicated.

AGREEMENT OF INDEMNITY – EXHIBIT C: All of the pages need to be filled out in detail, signed and notarized where indicated.

BOND PREMIUM: Your check in the amount of 2% of the value of the shares being reported lost / stolen is to be made payable to: Seaboard Surety.

Losses in excess of $50,000.00 in total value, registered to one address, are subject to Seaboard Surety approval and additional documentation.

It is not necessary that you utilize the above indemnity arrangement. Should you prefer to furnish a separate bond from a surety company of your own selection, the surety company must be authorized to do business in the State of Arizona and be acceptable to us. Additionally, please be sure to check with your own insurers to inquire if you have coverage for losses such as this. We must be in receipt of the original bond to enable us to replace the certificate(s). Depending on the value of the certificate(s), a replacement certificate(s) may not be issued until all documents are filed with Seaboard Surety and we have obtained their approval to move forward with the replacement.

When completed, send all paperwork and both checks to First American Stock Transfer at 706 East Bell Road, Suite 202, Phoenix, AZ 85022.

EXHIBIT B

AFFIDAVIT OF LOSS

STATE OF}

} ss:

COUNTY OF}

The undersigned (hereinafter called “Deponent”), being duly sworn, deposes and says that:

(1) Deponent is an adult whose mailing address is:

and is the owner of or is acting in a representative or fiduciary capacity with respect to certain securities (describe type of security, identification number, and number of shares or face value):

issued by:

(hereinafter called the “Issuing Corporation”) and registered in the name of:

(2) Deponent further says that the aforesaid security or securities (hereinafter called the “Original”, whether one or more) have been lost, stolen, destroyed or misplaced under the following circumstances:

(was)

(3) That said Original (was not) endorsed. (If endorsed, describe form of endorsement and state whether signature was guaranteed.)

(4) Deponent has made or caused to be made diligent search for Original, and has been unable to find or recover same, and that Deponent was the unconditional owner of Original at the time of loss, and is entitled to the full and exclusive possession thereof; that neither the Original nor the rights of Deponent therein have, in whole or in part, been assigned, transferred, hypothecated, pledged or otherwise disposed of, in any manner whatsoever, and that no person, firm or corporation other than Deponent has any right, title, claim, equity or interest in, to, or respecting Original or the proceeds thereof, except as may be set forth in Statement (5) following.

(5) (If Deponent’s interest in the Original is in a representative or fiduciary capacity, indicate below the designation of such capacity, i.e., Adminstrator, Executor, etc., and the title of the estate, as follows):

Deponent isof the estate of

(Specify names of any other persons having an interest in the Original. List them below and indicate the nature of their interest, such as heir, legatee, etc.)

NAMEINTEREST

(Each heir, legatee, etc., having an interest in the Original must execute Agreement of Indemnity, Exhibit “C”.)

(6) Deponent makes this affidavit for the purpose of requesting and inducing the Issuing Corporation and its agents to issue new securities in substitution for the Original and Seaboard Surety Company to assume liability in respect thereof under its Indemnity Bond.

(7) Deponent agrees that if said Original should ever come into deponent’s hands, custody or power, Deponent will immediately and without consideration surrender Original to Issuing Corporation, its transfer agents, subscription agents, trustees or Seaboard Surety Company for cancellation.

(8) Signed, sealed and dated:______, 20______.

Sworn to and subscribed before me

this______day of______,20_____.

______

NOTARY PUBLICSignature of Deponent

(Affix Notarial Seal)

My Commission expires:

Sworn to and subscribed before me

this______day of ______, 20______.

______

NOTARY PUBLICSignature of Deponent

(Affix Notarial Seal)

My Commission expires:

EXHIBIT C

AGREEMENT OF INDEMNITY

KNOW ALL MEN BY THESE PRESENTS:

(1) WHEREAS, an Affidavit of Loss was made by

with respect to certain securities (describe type of security, identification number, and number of shares or face value):

issued by:

(hereinafter called the “Issuing Corporation”) and registered in the name of:

(2) WHEREAS, the aforesaid security or securities (hereinafter called “Original”, whether one or more) have been lost, stolen, destroyed or misplaced.

(3) NOW, THEREFORE, in consideration of Seaboard Surety Company assuming liability or liability attaching under its Indemnity Bond in favor of the Issuing Corporation and its agents, the undersigned (jointly and severally, if more than one) hereby agree at all times to indemnify and save harmless Seaboard Surety Company from and against any and all liabilities, losses, damages, judgments, costs, charges, counsel fees and expenses of every nature and character which they may sustain or incur by reason or on account of assuming liability or liability attaching under its Indemnity Bond.

(4)Signed, sealed and dated:______20______.

Sworn to and subscribed before me

this ______day of ______20______.

______

INDEMNITOR

______ADDRESS______

NOTARY PUBLIC

(Affix Notarial Seal)______

My Commission Expires:

Sworn to and subscribed before me

this ______day of ______20______.

______

INDEMNITOR

______ADDRESS______

NOTARY PUBLIC

(Affix Notarial Seal)______

My Commission Expires:

X-17F-1A FORM

MISSING / LOST / STOLEN / COUNTERFEIT

SECURITIES REPORT

Please type or print clearly

1. Reporting Institution: Name: First American Stock Transfer, Inc.

Address: 706 E Bell Rd, Suite 202

Phoenix, AZ85022

Attention: Phil Young

(602)485-1346 Fins/Access Code 4 0 9 3 1 8 / ______

Telephone Number

2. Type of Report: ___ Loss ___ Recovery ___ Update ___ Escheated

___ Stolen ___ Counterfeit ___ Other ______

3. Date of Loss/Recovery: ___/___/___

4. Type of Loss: ___ Mail ___ Delivery ___ On-sight ___ Other

______

5. Type of Security: ___ Common ___ Preferred ___ Corporate Bond

___ Municipal Bond ___ Government Agency ___ Other

______

6. Name of Issuer: ______

7. Interest rate: ______8. Maturity Date ___/___/______

9. CUSIP Number ______

10. Bearer/Name of Registered Holder:

______

11. Certificate/Serial Numbers 12. Denominations/Shares 13. Issue Date

______/___/______

______/___/______

______/___/______

______/___/______

______/___/______

______/___/______

______/___/______

14. Additional Pages Attached: ___ 15. Total Market/Face Value $ ______

16. Counterfeit ______

17. Criminality Indicated ___18. Reports filed with: a. FBI ___ b. Police ___

20. Transfer/Pay Agent: First American Stock Transfer, Inc.

21. Insurance Co. ______

22. ______23. ___/___/___

Authorized Signature Date

Stock Certificate Replacement Request

I, ______do state under oath that I have lost or am in non-receipt of these securities and

request First American Stock Transfer, Inc. to replace said shares. I understand there is a $50.00 fee for this service.

______

Signed and have it Notarized (Not medallion Guaranteed)

Notary Stamp here