I, {field:manager_name_1727713279912}, as Manager of {field:llc_name_1727711933020} (hereinafter referred to as "The LLC"), hereby authorize CBIRA Plan Services, LLC to submit the required Beneficial Ownership Information on behalf of The LLC to the Financial Crimes Enforcement Network (FinCEN) as mandated under applicable federal regulations.

I further warrant that the information provided to CBIRA Plan Services, LLC for submission to FinCEN is accurate and complete to the best of my knowledge. I understand that this information will be submitted solely for compliance with FinCEN's Beneficial Ownership Reporting Requirements, and I authorize CBIRA Plan Services, LLC to make this submission on behalf of The LLC.

I also acknowledge and confirm that CBIRA Plan Services, LLC will not share, sell, or otherwise disclose the Beneficial Ownership Information to any third-party vendors, contractors, or outside entities, except as required by law or regulation.

By signing this statement, I affirm my understanding of these terms and authorize CBIRA Plan Services, LLC to act on behalf of The LLC in compliance with the regulatory requirements.

I also agree to pay CBIRA Plan Services, LLC $75.00 (Seventy-five and No/100ths dollars) for the completion of the above service.

Beneficial Ownership Information Application to Fin Cen