Common use of PLEASE COMPLETE THE FOLLOWING Clause in Contracts

PLEASE COMPLETE THE FOLLOWING. 1. If the exercise of this Warrant was solicited by Network 1 Financial Securities, Inc., please check the following box. |_| 2. The exercise of this Warrant was solicited by -------------------------------------------------------------------------------- 3. If the exercise of this Warrant was not solicited, please check the following box. |_|

PLEASE COMPLETE THE FOLLOWING. 1. If the exercise of this Warrant was solicited by Network 1 Financial Securities, Inc., please check the following box. |_|[ ] 2. The exercise of this Warrant warrant was solicited by --------------------------------------------------------------------------------by 3. If the exercise of this Warrant was not solicited, please check the following box. |_|[ ] Dated: _____________________________ X__________________________________ ______________________________________ Address ______________________________________ Social Security or Taxpayer Identification Number

PLEASE COMPLETE THE FOLLOWING. 1. If the exercise of this Warrant was solicited by Network 1 Financial Securities, Inc., please check the following box. |_| 2. The exercise of this Warrant warrant was solicited by ----------------------------------------------------------------------------------------------------------------------------------------------- 3. If the exercise of this Warrant was not solicited, please check the following box. |_|