ANNEX 3-E NON-DISCLOSURE CERTIFICATE

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I, the undersigned, am an Officer and/or Director

Name of Parent Organization

a corporation which, by official action of its Board of Directors, is excluded from access to PROTECTED/CLASSIFIED information. I am also an Officer and/or Director of

Name of Subsidiary

and I am required to be granted a government personnel security clearance as a condition of clearing

Government personnel security clearance as a condition of clearing Name of Subsidiary

for access to PROTECTED/CLASSIFIED information.

I understand that

PROTECTED/CLASSIFIED Name of Parent Organization

, is not cleared for access to PROTECTED/CLASSIFIED information and I certify that I shall not disclose PROTECTED/CLASSIFIED information to the

I shall not disclose Name of Parent Organization

or any of its agents regardless of my official business or personal association therewith.

I further understand that any breach of security with respect to the disclosure of PROTECTED/CLASSIFIED information or assets to

PROTECTED/CLASSIFIED2 Name of Parent Organization

may result in the denial of access to such information to

Denial of access to such information Name of Subsidiary

Signature of Officer and/or Director