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Exhibit A STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS Affidavit Control #: AFFIDAVIT BY BROKER I Karin I. Transcribe swear under penalty of perjury as follows. I am a Surplus Line Broker licensed
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How to fill out affidavit control:

01
Begin by obtaining a blank affidavit control form from the appropriate authority or jurisdiction. This may be available online or at a local government office.
02
Read the instructions carefully before proceeding to ensure that you understand the requirements and purpose of the affidavit control.
03
Gather all necessary information and documents that are required to complete the affidavit control. This may include personal identification, relevant supporting evidence, and any specific details requested.
04
Start filling out the form by providing your personal details, such as your full name, address, and contact information. Follow the specified format and provide accurate information.
05
Proceed to the main section of the affidavit control, which usually involves stating the facts or details of the matter at hand. Ensure that you provide clear and concise information, avoiding any unnecessary or irrelevant statements.
06
If required, provide any supporting evidence or documents that are necessary to validate the details mentioned in the affidavit control. Attach any photocopies or references to support your statements.
07
Review the completed affidavit control form to check for any errors, omissions, or inconsistencies. Make sure all information is accurate and presented in a logical manner.
08
Sign the affidavit control at the designated area, ensuring that you follow the specific instructions regarding signatures. In some cases, the affidavit control may need to be notarized or witnessed by a legal authority. Follow the prescribed procedures accordingly.
09
Make copies of the completed affidavit control for your own records before submitting it to the appropriate entity or organization that requires it.

Who needs affidavit control:

01
Individuals involved in legal proceedings may require an affidavit control. This could include parties in a lawsuit, those seeking a court order, or individuals providing evidence or testimony in a legal case.
02
Affidavit control may be necessary for government agencies and departments when conducting investigations or processing applications that require sworn statements.
03
Businesses and organizations may also need affidavit control when verifying information or making official declarations in various contexts, such as contracts, employment agreements, or licensing requirements.
It is important to note that the specific need for an affidavit control may vary depending on the jurisdiction, legal requirements, or the nature of the matter at hand. It is recommended to consult with legal professionals or relevant authorities to ensure compliance and accuracy when filling out an affidavit control.
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Affidavit control is a legal document used to verify the accuracy of certain information.
The individuals or entities required to file affidavit control depend on the specific requirements set forth by the governing body or organization.
To fill out affidavit control, one must follow the instructions provided on the form and provide accurate information as requested.
The purpose of affidavit control is to ensure the accuracy and compliance of certain information or actions.
The specific information required to be reported on affidavit control varies depending on the purpose and requirements set forth by the governing body or organization.
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