Non-Foreign Status Certification

STATE OF ___________________ )
) SS
COUNTY OF __________________ )

The disposition of a U.S. real property interest by a foreign person, non-resident alien(s) and foreign entities (otherwise known as the
“Transferor(s)”) is subject to the Foreign Investment in Real Property Tax Act of 1980 (FIRPTA) (26 U.S.C. § 1445)

I/We, the undersigned, do hereby certify and swear:

1. The facts and matters contained and recited in this Certification are based upon my/our personal knowledge.

2. Pursuant to a Real Estate Purchase Agreement, I/We are the sellers (otherwise known as the Transferors) of the real property described in
Exhibit “A” attached hereto and made a part hereof (the “Property”) and will convey the Property to _______________________ (“Purchaser”
otherwise known as “Transferee”).

3. I/We am/are not foreign person(s) as defined in Section 1145 of the Internal Revenue Code of 1986, as amended.

4. My/Our United States current mailing address is: __________________________________________________________________

5. After the real property is conveyed to Transferee, my/our mailing address will be:
____________________________________________________________________________________________________________

6. My/Our Social Security number(s) or U.S. Employer Identification Number(s) (E.I.N.) is/are:

Print Legal Name: _______________________________________ Print Legal Name: _______________________________________

Social Security / E.I.N.Number: _____________________________ Social Security / E.I.N.Number: _____________________________

7. I/We understand this Certification will be relied upon by the Purchaser (Transferee) in assuring compliance with Section 1445 of the Internal
Revenue Code in connection with the transfer and conveyance of the Property. I/We further understand that Purchaser may disclose this
Certification to the United States Internal Revenue Service and that any false statement contained herein by the Transferor(s) could be punishable
by fine, imprisonment or both.

8. I/We declare that we are EXEMPT from IRS 1445 (26 U.S.C. § 1445) by one, or more of the following: a) Transferee(s) is/are purchasing the
property for use as a residence for a certain period of time and the total net amount received by Transferor(s) for the property is $300,000 (Three
Hundred Thousand U.S. Dollars) or less, b) Transferor(s) have applied for and obtained a withholding certificate from the IRS that specifies (1)
Transferor(s) is/are exempt from paying taxes on the gain; or (2) Transferor(s) has entered into an agreement with the IRS to pay the tax owed, c)
Gain on the sale is not recognized under certain provisions of the IRS code or the provisions of any United States treaty. Transferor(s) are advised
to seek the advice of a competent attorney or tax professional regarding whether any gain is recognized under the provisions of the IRS FIRPTA
code, d) Buyer(s) will be held harmless if Buyer(s) do/does not withhold taxable proceeds from the Transferor(s) based on the Transferor(s) false,
misleading and/or inaccurate reporting to the Transferee(s).

9. Under penalties of perjury, I/We declare that I/we have examined this Certification and it is true, correct and complete, and I/we further declare
that I/we have authority to execute this Certification.

Witnesses: Seller(s) / Transferor(s):

Sign: __________________________________________________ Date: ______________________________________

Sign: __________________________________________________ Date: ______________________________________

State of OREGON
County of ________________
Signed and sworn to (or affirmed) before me on __________, 20____ by __________________________________.
_________________________________________
Notary Public - State of Oregon

NON-FOREIGN STATUS CERTIFICATION © 2009 EBA PORTLAND, LLC PAGE 1