List any changes in the General scope of Applicant’s activities relative to serving in a capacity of an insurance manager and background/expertise of the Applicant’s executives and staff. Attach the resume of the primary individuals that will be serving the insurers and reinsurers of the Tribal jurisdiction.

I hereby apply to serve as an insurance manager in the Tribal jurisdiction. I certify that to the best of my knowledge and belief, all information contained in this application and in the documents attached or furnished in support of this application are true and accurate.