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Underlying Qualifying Designation (“UQD”):

I affirm, by placing a mark in one or more of the checkboxes below, and filling in the Designation ID and Date Earned fields, that I have earned the following designation(s) representative of the learned Methodology and discipline of Financial Planning. I shall then submit the Proving Docs on each of those designations using the thereunder provided “Upload Tool.”

Underlying Qualifying Financial Planning Designation Date Earned Certificate/License/Student ID # Active Inactive

Other Licenses:

License Type Date Earned License ID State Active Inactive

Securities Affiliations:

Securities Affiliations Identifiers:

Other Earned Designations (Optional)

Select Your IAQFP Affiliation as MEMBER or Associate

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ATTESTATION

I hereby attest, affirm, and acknowledge under penalty of perjury, to the following:

I acknowledge that I have earned one or more of the herein throughout indicated Financial Planning credentials (designations, degrees, diplomas) of: ChFC®; PFS™; CFP®; QFP—QUALIFIED FINANCIAL PLANNER; MS and/or MSFS (the latter two with a demonstrated concentrated study in the learned discipline and methodology of Financial Planning). And, that I have herein uploaded, or otherwise previously provided IAQFP, with a legal copy of the proving credentialing document of my actual earning of said credential, understanding that IAQFP entirely relies upon said proving document(s) to approve, or have approved, my IAQFP Registration/Re-Registration, Affiliation, and also my use of the QFP credential publicly.

I acknowledge that I have represented to IAQFP that said proving credential document(s) is/are legally valid and accurate, and that IAQFP may confidently rely upon same to approve or grant me a QFP Certificate, use of the QFP designation, and any inclusion of me and it in the QFP Verification Registry of Qualified Financial Planners.

I acknowledge, based upon the sole discretion and determination of IAQFP Board of Directors, that if it finds that I have made any material misrepresentations, that in addition to the herein noted monetary penalty, I will also forfeit the original, non-prorated amount, of all tendered or paid Affiliation fees/dues, and I will be removed from the public QFP Registry either permanently or for a period of time as determined by the IAQFP Ethics Committee and Chairperson/President of IAQFP.

I hereby, legally and financially, hold harmless IAQFP in all respects, acknowledging that I shall be subject to a minimum monetary penalty of $10,000 for any misrepresentations made by me herein throughout.

I affirm that I have not made, here or elsewhere, any false or misleading statements, or representations, and that if I am found to have done so IAQFP is fully authorized, without any liability, to suspend or permanently remove my listing (me) from its’ public QFP Registry.

I affirm that I am now, and will remain, compliant with all laws and professional licenses of the United States of America, and/or of the State, Province, or Country in which I reside and/or practice (publicly “hold out” or otherwise advertise or represent myself) as a QFP.

I affirm that I will, at all times, actively both observe and fully adhere to the IAQFP Standards (as amended from time to time, and as currently posted on the IAQFP.org website), throughout my Registration and Affiliation as an IAQFP Certified—Financial Planner. I acknowledge that if I am approved or otherwise accepted by IAQFP, issued a QFP Certificate, and Affiliate as either a MEMBER or Associate, that such is/are conditioned upon my abiding, at all times, by and to each of the IAQFP Standards, Ethics, and Professional Code of Conduct, etc.

I hereby affirm the truthfulness of each statement or entry made herein throughout, upon which IAQFP is to, and shall legally and solely rely, and so hereby acknowledge by my clicking onto the Submit button below.