Notice Of Engagement Or Termination Of Services Of An Agent {R9}

FORM R-9 Rev. 03/13 COMMONWEALTH OF PUERTO RICO COMMISSIONER OF FINANCIAL INSTITUTIONS Centro Europa Building, Suite 600 1492 Ponce de León Avenue San Juan, PR 00907-4127 Tel. (787) 723-8403 Fax. (787) 724-2604 NOTICE OF ENGAGEMENT OR TERMINATION OF SERVICES OF AN AGENT Notice is hereby given to the Office of the Commissioner of Financial Institutions, pursuant to Section 201 (b) of the Puerto Rico Uniform Securities Act. I, have been engaged or terminated (strike inapplicable word) as agent of ______________________________________________________________ Name of Issuer Signature of Agent By Name and Title ____________________________ Address of Agent Dated and signed this day of , ____________ Year INSTRUCTION: In the event of a termination of services the agent may attach a separate letter to the Commissioner explaining the reason for the termination of services, if he so desires. Such letters will be kept confidential by the Commissioner. American LegalNet, Inc. www.FormsWorkFlow.com