EFTA00178401

# CERTIFICATION OF BUSINESS RECORDS

I, the undersigned，___，declare that I am: employed by/associated with ___in the position of ___and by reason of my position am authorized and qualified to make this declaration.

In my employment with the above-named bank/company I am familiar with the business records it maintains. The above-named bank/company maintains records of its business which are:

1. made at or near the time of the occurrence of the matters set forth therein, by, or from information transmitted by, a person with knowledge of those matters;

2. kept in the course of regularly conducted business activity; and

3. made by the regularly conducted activity as a regular practice.

Among the records so maintained are the attached records itemized in Appendix A, Inventory of Documents.

I declare under penalty of perjury that the foregoing is true and correct.

Date of execution: ___

Place of execution: ___

Signature: ___

EFTA00178402

## APPENDIX A

DOCUMENT INVENTORY

The documents submitted are as follows:





Signature of Records Custodian: