Question 9 Clause Samples

Question 9. If you are affiliated with a broker-dealer, did you have any agreements or understandings, directly or indirectly, with any person to distribute the securities at the time that you purchased the securities? Yes No Please note that the Commission takes the position that if you are a broker-dealer, you are to be identified in the Registration Statement as an underwriter. In the “Plan of Distribution,” the Registration Statement will provide substantially as follows: “The selling stockholders and any broker-dealers, agents or underwriters that participate with the selling stockholders in the distribution of the issued and outstanding shares of common stock or the shares of stock issuable upon exercise of warrants may be deemed to be “underwriters” within the meaning of the Securities Act, in which event any commissions received by these broker-dealers, agents or underwriters and any profits realized by the selling stockholders on the resales of the securities may be deemed to be underwriting commissions or discounts under the Securities Act. If the selling stockholders are deemed to be underwriters, the selling stockholders may be subject to certain statutory and regulatory liabilities, including liabilities imposed pursuant to Sections 11, 12 and 17 of the Securities Act and Rule 10b-5 under the Exchange Act.” Are their specific individuals who have voting or investment control over the securities? Yes No If you answered “yes”, please list the names of such individuals: The answers to the foregoing questions are true and correct to the best of the undersigned’s knowledge, information and belief. The undersigned agrees to promptly notify the Company in writing in care of Chief Financial Officer, InSite Vision Incorporated, ▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, ▇▇▇▇▇▇▇, ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇ of (a) any transfer by you of your Units, (b) sales of common stock of the Company (giving the number of shares sold and the name of the broker-dealer used) and (c) any other changes in the answers to this questionnaire that should be made as a result of any material development occurring subsequent to the date hereof. Dated: , 2004.

Question 9. Who do you believe to be the Critics/Sceptics in relation to H2 Powered Transport and Why are they Critics/Sceptics? % of Responses Nominating Category as Sceptics/Critics of H2 (N=58) Government/Officials Current Energy Producers (Elect./Oil) Environmental Groups Other Alternative Energy Lobby Some OEM's/Lobby Scientists 0 25 30 In an effort to broaden the base of individuals interviewed, interviewees were asked to nominate others whom they saw as critics and sceptics of the use of H2 in transport. It was noteworthy that some of the individuals/organisations that were nominated, when interviewed, did not see themselves as either critics or sceptics and were surprised to hear they had been identified as such.

Question 9. What additional costs may be incurred by you or those you represent as a result of implementing the AIHTS requirements for manufacturers? (For example, include costs incurred in relation to the alteration of designs and instructions and provision of suitable identification). Question 10: What additional training costs may be incurred by you or those you represent as a result of implementing the AIHTS? Please give the total number of permitted target species caught per make and model (not the number caught per individual trap). Please do not include traps that YOU or those you represent have but no longer use. Make and model Working Life of Trap The purpose of the following questions is to estimate the average numbers of animals (other than stoat – see Q12) listed on AIHTS that are trapped each year and identify the traps used. Those species not ordinarily resident in the UK may be held in captivity and occasionally require trapping.