1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 CENTRAL DISTRICT OF CALIFORNIA 10 11 SHLOMI MOSHE, Case No. 2:18-cv-09238-RGK-GJS 12 Plaintiff, STIPULATED PROTECTIVE ORDER 13 v.

14 TAPIN2, INC., a Delaware corporation; ANTHONY 15 CHRISTOPOULOS, an individual; JORDAN SYMS, an individual; 16 DAVID RONE, an individual; BRAD COSTELLO, an individual; MICHAEL 17 WARGOTZ, an individual; and DOES 1 through 10, inclusive, 18 Defendants. 19 20 21 1. A. PURPOSES AND LIMITATIONS 22 Discovery in this action is likely to involve production of confidential, 23 proprietary or private information for which special protection from public 24 disclosure and from use for any purpose other than prosecuting this litigation may 25 be warranted. Accordingly, the parties hereby stipulate to and petition the Court to 26 enter the following Stipulated Protective Order. The parties acknowledge that this 27 Order does not confer blanket protections on all disclosures or responses to 28 discovery and that the protection it affords from public disclosure and use extends 1 only to the limited information or items that are entitled to confidential treatment 2 under the applicable legal principles. 3 B. GOOD CAUSE STATEMENT 4 This action is likely to involve confidential information including trade 5 secrets, business strategies, customer and pricing lists and other valuable research, 6 development, commercial, financial, technical and/or proprietary information for 7 which special protection from public disclosure and from use for any purpose other 8 than the litigation of this action is warranted. Such confidential and proprietary 9 materials and information consist of, among other things, confidential business or 10 financial information, information regarding confidential business practices, or 11 other confidential research, development, or commercial information (including 12 information implicating privacy rights of third parties), information otherwise 13 generally unavailable to the public, or which may be privileged or otherwise 14 protected from disclosure under state or federal statutes, court rules, case decisions, 15 or common law. In addition, the action may involve confidential customer 16 information that may be subject to non-disclosure by prior agreement. 17 Further, the action is also likely to involve the personal financial and identifying 18 information of individuals, including but not limited to TapIn2’s current and former 19 employees, members of the Company’s Board of Directors, shareholders, and other 20 third parties. Unrestricted disclosure of such may violate these individuals’ privacy 21 interests. 22 Accordingly, to expedite the flow of information, to facilitate the prompt 23 resolution of disputes over confidentiality of discovery materials, to adequately 24 protect information the parties are entitled to keep confidential, to ensure that the 25 parties are permitted reasonable necessary uses of such material in preparation for 26 and in the conduct of trial, to address their handling at the end of the litigation, and 27 serve the ends of justice, a protective order for such information is justified in this 28 matter. It is the intent of the parties that information will not be designated as 1 confidential for tactical reasons and that nothing be so designated without a good 2 faith belief that it has been maintained in a confidential, n on-public manner, and 3 there is good cause why it should not be part of the public record of this case. 4 C. ACKNOWLEDGMENT OF PROCEDURE FOR FILING UNDER SEAL 5 The parties further acknowledge, as set forth in Section 12.3, below, that this 6 Stipulated Protective Order does not entitle them to file confidential information 7 under seal; Local Civil Rule 79-5 sets forth the procedures that must be followed 8 and the standards that will be applied when a party seeks permission from the court 9 to file material under seal. 10 There is a strong presumption that the public has a right of access to judicial 11 proceedings and records in civil cases. In connection with non-dispositive motions, 12 good cause must be shown to support a filing under seal. See Kamakana v. City 13 and County of Honolulu,

(9th Cir. 2006), Phillips v. Gen. 14 Motors Corp.,

, 1210-11 (9th Cir. 2002), Makar-Welbon v. Sony 15 Electrics, Inc.,

(E.D. Wis. 1999) (even stipulated protective 16 orders require good cause showing), and a specific showing of good cause or 17 compelling reasons with proper evidentiary support and legal justification, must be 18 made with respect to Protected Material that a party seeks to file under seal. The 19 parties’ mere designation of Disclosure or Discovery Material as CONFIDENTIAL 20 does not—without the submission of competent evidence by declaration, 21 establishing that the material sought to be filed under seal qualifies as confidential, 22 privileged, or otherwise protectable—constitute good cause. 23 Further, if a party requests sealing related to a dispositive motion or trial, 24 then compelling reasons, not only good cause, for the sealing must be shown, and 25 the relief sought shall be narrowly tailored to serve the specific interest to be 26 protected. See Pintos v. Pacific Creditors Ass’n,

(9th Cir. 27 2010). For each item or type of information, document, or thing sought to be filed 28 or introduced under seal in connection with a dispositive motion or trial, the party 1 seeking protection must articulate compelling reasons, supported by specific facts 2 and legal justification, for the requested sealing order. Again, competent evidence 3 supporting the application to file documents under seal must be provided by 4 declaration. 5 Any document that is not confidential, privileged, or otherwise protectable in 6 its entirety will not be filed under seal if the confidential portions can be redacted. 7 If documents can be redacted, then a redacted version for public viewing, omitting 8 only the confidential, privileged, or otherwise protectable portions of the document, 9 shall be filed. Any application that seeks to file documents under seal in their 10 entirety should include an explanation of why redaction is not feasible. 11 2. DEFINITIONS 12 2.1 Action: Shlomi Moshe v. TapIn2, Inc. et al., Case No. 18-cv-09238- 13 RGK-GJS (C.D. Cal.). 14 2.2 Challenging Party: a Party or Non-Party that challenges the 15 designation of information or items under this Order. 16 2.3 “CONFIDENTIAL” Information or Items: information (regardless of 17 how it is generated, stored or maintained) or tangible things that qualify for 18 protection under Federal Rule of Civil Procedure 26(c), and as specified above in 19 the Good Cause Statement. 20 2.4 Counsel: Outside Counsel of Record and House Counsel (as well as 21 their support staff). 22 2.5 Designating Party: a Party or Non-Party that designates information or 23 items that it produces in disclosures or in responses to discovery as 24 “CONFIDENTIAL.” 25 2.6 Disclosure or Discovery Material: all items or information, regardless 26 of the medium or manner in which it is generated, stored, or maintained (including, 27 among other things, testimony, transcripts, and tangible things), that are produced 28 or generated in disclosures or responses to discovery in this matter. 1 2.7 Expert: a person with specialized knowledge or experience in a matter 2 pertinent to the litigation who has been retained by a Party or its counsel to serve as 3 an expert witness or as a consultant in this Action. 4 2.8 House Counsel: attorneys who are employees of a party to this Action. 5 House Counsel does not include Outside Counsel of Record or any other outside 6 counsel. 7 2.9 Non-Party: any natural person, partnership, corporation, association or 8 other legal entity not named as a Party to this action. 9 2.10 Outside Counsel of Record: attorneys who are not employees of a 10 party to this Action but are retained to represent or advise a party to this Action and 11 have appeared in this Action on behalf of that party or are affiliated with a law firm 12 that has appeared on behalf of that party, and includes support staff. 13 2.11 Party: any party to this Action, including all of its officers, directors, 14 employees, consultants, retained experts, and Outside Counsel of Record (and their 15 support staffs). 16 2.12 Producing Party: a Party or Non-Party that produces Disclosure or 17 Discovery Material in this Action. 18 2.13 Professional Vendors: persons or entities that provide litigation 19 support services (e.g., photocopying, videotaping, translating, preparing exhibits or 20 demonstrations, and organizing, storing, or retrieving data in any form or medium) 21 and their employees and subcontractors. 22 2.14 Protected Material: any Disclosure or Discovery Material that is 23 designated as “CONFIDENTIAL.” 24 2.15 Receiving Party: a Party that receives Disclosure or Discovery 25 Material from a Producing Party. 26 3. SCOPE 27 The protections conferred by this Stipulation and Order cover not only 28 Protected Material (as defined above), but also (1) any information copied or 1 extracted from Protected Material; (2) all copies, excerpts, summaries, or 2 compilations of Protected Material; and (3) any testimony, conversations, or 3 presentations by Parties or their Counsel that might reveal Protected Material. 4 Any use of Protected Material at trial shall be governed by the orders of the 5 trial judge. This Order does not govern the use of Protected Material at trial. 6 4. DURATION 7 FINAL DISPOSITION of the action is defined as the conclusion of any 8 appellate proceedings, or, if no appeal is taken, when the time for filing of an 9 appeal has run. Except as set forth below, the terms of this protective order apply 10 through FINAL DISPOSITION of the action. The parties may stipulate that they 11 will be contractually bound by the terms of this agreement beyond FINAL 12 DISPOSITION, but will have to file a separate action for enforcement of the 13 agreement once all proceedings in this case are complete. 14 Once a case proceeds to trial, information that was designated as 15 CONFIDENTIAL or maintained pursuant to this protective order used or 16 introduced as an exhibit at trial becomes public and will be presumptively available 17 to all members of the public, including the press, unless compelling reasons 18 supported by specific factual findings to proceed otherwise are made to the trial 19 judge in advance of the trial. See Kamakana,

(distinguishing 20 “good cause” showing for sealing documents produced in discovery from 21 “compelling reasons” standard when merits-related documents are part of court 22 record). Accordingly, for such materials, the terms of this protective order do not 23 extend beyond the commencement of the trial. 24 5. DESIGNATING PROTECTED MATERIAL 25 5.1 Exercise of Restraint and Care in Designating Material for Protection. 26 Each Party or Non-Party that designates information or items for protection under 27 this Order must take care to limit any such designation to specific material that 28 qualifies under the appropriate standards. The Designating Party must designate for 1 protection only those parts of material, documents, items or oral or written 2 communications that qualify so that other portions of the material, documents, 3 items or communications for which protection is not warranted are not swept 4 unjustifiably within the ambit of this Order. 5 Mass, indiscriminate or routinized designations are prohibited. Designations 6 that are shown to be clearly unjustified or that have been made for an improper 7 purpose (e.g., to unnecessarily encumber the case development process or to 8 impose unnecessary expenses and burdens on other parties) may expose the 9 Designating Party to sanctions. 10 If it comes to a Designating Party’s attention that information or items that it 11 designated for protection do not qualify for protection, that Designating Party must 12 promptly notify all other Parties that it is withdrawing the inapplicable designation. 13 5.2 Manner and Timing of Designations. Except as otherwise provided in 14 this Order (see, e.g., second paragraph of section 5.2(a) below), or as otherwise 15 stipulated or ordered, Disclosure or Discovery Material that qualifies for protection 16 under this Order must be clearly so designated before the material is disclosed or 17 produced. 18 Designation in conformity with this Order requires: 19 (a) for information in documentary form (e.g., paper or electronic 20 documents, but excluding transcripts of depositions or other pretrial or trial 21 proceedings), that the Producing Party affix at a minimum, the legend 22 “CONFIDENTIAL” (hereinafter “CONFIDENTIAL legend”), to each page that 23 contains protected material. If only a portion of the material on a page qualifies for 24 protection, the Producing Party also must clearly identify the protected portion(s) 25 (e.g., by making appropriate markings in the margins). 26 A Party or Non-Party that makes original documents available for inspection 27 need not designate them for protection until after the inspecting Party has indicated 28 which documents it would like copied and produced. During the inspection and 1 before the designation, all of the material made available for inspection shall be 2 deemed “CONFIDENTIAL.” After the inspecting Party has identified the 3 documents it wants copied and produced, the Producing Party must determine 4 which documents, or portions thereof, qualify for protection under this Order. 5 Then, before producing the specified documents, the Producing Party must affix the 6 “CONFIDENTIAL legend” to each page that contains Protected Material. If only a 7 portion of the material on a page qualifies for protection, the Producing Party also 8 must clearly identify the protected portion(s) (e.g., by making appropriate markings 9 in the margins). 10 (b) for testimony given in depositions, that the Designating Party 11 identifies the Disclosure or Discovery Material on the record, before the close of 12 the deposition all protected testimony. 13 (c) for information produced in some form other than documentary and 14 for any other tangible items, that the Producing Party affix in a prominent place on 15 the exterior of the container or containers in which the information is stored the 16 legend “CONFIDENTIAL.” If only a portion or portions of the information 17 warrants protection, the Producing Party, to the extent practicable, shall identify the 18 protected portion(s). 19 5.3 Inadvertent Failures to Designate. If timely corrected, an inadvertent 20 failure to designate qualified information or items does not, standing alone, waive 21 the Designating Party’s right to secure protection under this Order for such 22 material. Upon timely correction of a designation, the Receiving Party must make 23 reasonable efforts to assure that the material is treated in accordance with the 24 provisions of this Order. 25 6. CHALLENGING CONFIDENTIALITY DESIGNATIONS 26 6.1 Timing of Challenges. Any Party or Non-Party may challenge a 27 designation of confidentiality at any time that is consistent with the Court’s 28 Scheduling Order. 1 6.2 Meet and Confer. The Challenging Party shall initiate the dispute 2 resolution process under Local Rule 37.1 et seq. 3 6.3 The burden of persuasion in any such challenge proceeding shall be on 4 the Designating Party. Frivolous challenges, and those made for an improper 5 purpose (e.g., to harass or impose unnecessary expenses and burdens on other 6 parties) may expose the Challenging Party to sanctions. Unless the Designating 7 Party has waived or withdrawn the confidentiality designation, all parties shall 8 continue to afford the material in question the level of protection to which it is 9 entitled under the Producing Party’s designation until the Court rules on the 10 challenge.7. ACCESS TO AND USE OF PROTECTED MATERIAL 11 7.1 Basic Principles. A Receiving Party may use Protected Material that is 12 disclosed or produced by another Party or by a Non-Party in connection with this 13 Action only for prosecuting, defending or attempting to settle this Action. Such 14 Protected Material may be disclosed only to the categories of persons and under the 15 conditions described in this Order. When the Action has been terminated, a 16 Receiving Party must comply with the provisions of section 13 below (FINAL 17 DISPOSITION). 18 Protected Material must be stored and maintained by a Receiving Party at a 19 location and in a secure manner that ensures that access is limited to the persons 20 authorized under this Order. 21 7.2 Disclosure of “CONFIDENTIAL” Information or Items. Unless 22 otherwise ordered by the court or permitted in writing by the Designating Party, a 23 Receiving Party may disclose any information or item designated 24 “CONFIDENTIAL” only to: 25 (a) the Receiving Party’s Outside Counsel of Record in this Action, as 26 well as employees of said Outside Counsel of Record to whom it is reasonably 27 necessary to disclose the information for this Action; 28 (b) the officers, directors, and employees (including House Counsel) of 1 the Receiving Party to whom disclosure is reasonably necessary for this Action; 2 (c) Experts (as defined in this Order) of the Receiving Party to whom 3 disclosure is reasonably necessary for this Action and who have signed the 4 “Acknowledgment and Agreement to Be Bound” (Exhibit A); 5 (d) the court and its personnel; 6 (e) court reporters and their staff; 7 (f) professional jury or trial consultants, mock jurors, and Professional 8 Vendors to whom disclosure is reasonably necessary for this Action and who have 9 signed the “Acknowledgment and Agreement to Be Bound” (Exhibit A); 10 (g) the author or recipient of a document containing the information or a 11 custodian or other person who otherwise possessed or knew the information; 12 (h) during their depositions, witnesses, and attorneys for witnesses, in the 13 Action to whom disclosure is reasonably necessary provided: (1) the deposing party 14 requests that the witness sign the form attached as Exhibit A hereto; and (2) they 15 will not be permitted to keep any confidential information unless they sign the 16 “Acknowledgment and Agreement to Be Bound” (Exhibit A), unless otherwise 17 agreed by the Designating Party or ordered by the court. Pages of transcribed 18 deposition testimony or exhibits to depositions that reveal Protected Material may 19 be separately bound by the court reporter and may not be disclosed to anyone 20 except as permitted under this Stipulated Protective Order; and 21 (i) any mediator or settlement officer, and their supporting personnel, 22 mutually agreed upon by any of the parties engaged in settlement discussions. 23 8. PROTECTED MATERIAL SUBPOENAED OR ORDERED PRODUCED 24 IN OTHER LITIGATION 25 If a Party is served with a subpoena or a court order issued in other litigation 26 that compels disclosure of any information or items designated in this Action as 27 “CONFIDENTIAL,” that Party must: 28 (a) promptly notify in writing the Designating Party. Such notification 1 shall include a copy of the subpoena or court order; 2 (b) promptly notify in writing the party who caused the subpoena or order 3 to issue in the other litigation that some or all of the material covered by the 4 subpoena or order is subject to this Protective Order. Such notification shall 5 include a copy of this Stipulated Protective Order; and 6 (c) cooperate with respect to all reasonable procedures sought to be 7 pursued by the Designating Party whose Protected Material may be affected. 8 If the Designating Party timely seeks a protective order, the Party served with 9 the subpoena or court order shall not produce any information designated in this 10 action as “CONFIDENTIAL” before a determination by the court from which the 11 subpoena or order issued, unless the Party has obtained the Designating Party’s 12 permission. The Designating Party shall bear the burden and expense of seeking 13 protection in that court of its confidential material and nothing in these provisions 14 should be construed as authorizing or encouraging a Receiving Party in this Action 15 to disobey a lawful directive from another court. 16 9. A NON-PARTY’S PROTECTED MATERIAL SOUGHT TO BE 17 PRODUCED IN THIS LITIGATION 18 (a) The terms of this Order are applicable to information produced by a 19 Non-Party in this Action and designated as “CONFIDENTIAL.” Such information 20 produced by Non-Parties in connection with this litigation is protected by the 21 remedies and relief provided by this Order. Nothing in these provisions should be 22 construed as prohibiting a Non-Party from seeking additional protections. 23 (b) In the event that a Party is required, by a valid discovery request, to 24 produce a Non-Party’s confidential information in its possession, and the Party is 25 subject to an agreement with the Non-Party not to produce the Non-Party’s 26 confidential information, then the Party shall: 27 (1) promptly notify in writing the Requesting Party and the Non-Party 28 that some or all of the information requested is subject to a confidentiality 1 agreement with a Non-Party; 2 (2) promptly provide the Non-Party with a copy of the Stipulated 3 Protective Order in this Action, the relevant discovery request(s), and a reasonably 4 specific description of the information requested; and 5 (3) make the information requested available for inspection by the 6 Non-Party, if requested. 7 (c) If the Non-Party fails to seek a protective order from this court within 8 14 days of receiving the notice and accompanying information, the Receiving Party 9 may produce the Non-Party’s confidential information responsive to the discovery 10 request. If the Non-Party timely seeks a protective order, the Receiving Party shall 11 not produce any information in its possession or control that is subject to the 12 confidentiality agreement with the Non-Party before a determination by the court. 13 Absent a court order to the contrary, the Non-Party shall bear the burden and 14 expense of seeking protection in this court of its Protected Material. 15 10. UNAUTHORIZED DISCLOSURE OF PROTECTED MATERIAL 16 If a Receiving Party learns that, by inadvertence or otherwise, it has disclosed 17 Protected Material to any person or in any circumstance not authorized under this 18 Stipulated Protective Order, the Receiving Party must immediately (a) notify in 19 writing the Designating Party of the unauthorized disclosures, (b) use its best 20 efforts to retrieve all unauthorized copies of the Protected Material, (c) inform the 21 person or persons to whom unauthorized disclosures were made of all the terms of 22 this Order, and (d) request such person or persons to execute the “Acknowledgment 23 and Agreement to Be Bound” that is attached hereto as Exhibit A. 24 11. INADVERTENT PRODUCTION OF PRIVILEGED OR OTHERWISE 25 PROTECTED MATERIAL 26 When a Producing Party gives notice to Receiving Parties that certain 27 inadvertently produced material is subject to a claim of privilege or other 28 protection, the obligations of the Receiving Parties are those set forth in Federal 1 Rule of Civil Procedure 26(b)(5)(B). This provision is not intended to modify 2 whatever procedure may be established in an e-discovery order that provides for 3 production without prior privilege review. Pursuant to Federal Rule of Evidence 4 502(d) and (e), insofar as the parties reach an agreement on the effect of disclosure 5 of a communication or information covered by the attorney-client privilege or work 6 product protection, the parties may incorporate their agreement in the stipulated 7 protective order submitted to the court. 8 12. MISCELLANEOUS 9 12.1 Right to Further Relief. Nothing in this Order abridges the right of any 10 person to seek its modification by the Court in the future. 11 12.2 Right to Assert Other Objections. By stipulating to the entry of this 12 Protective Order, no Party waives any right it otherwise would have to object to 13 disclosing or producing any information or item on any ground not addressed in 14 this Stipulated Protective Order. Similarly, no Party waives any right to object on 15 any ground to use in evidence of any of the material covered by this Protective 16 Order. 17 12.3 Filing Protected Material. A Party that seeks to file under seal any 18 Protected Material must comply with Local Civil Rule 79-5. Protected Material 19 may only be filed under seal pursuant to a court order authorizing the sealing of the 20 specific Protected Material at issue. If a Party’s request to file Protected Material 21 under seal is denied by the court, then the Receiving Party may file the information 22 in the public record unless otherwise instructed by the court. 23 13. FINAL DISPOSITION 24 After the final disposition of this Action, as defined in paragraph 4, within 60 25 days of a written request by the Designating Party, each Receiving Party must 26 return all Protected Material to the Producing Party or destroy such material. As 27 used in this subdivision, “all Protected Material” includes all copies, abstracts, 28 compilations, summaries, and any other format reproducing or capturing any of the 1 Protected Material. Whether the Protected Material is returned or destroyed, the 2 Receiving Party must submit a written certification to the Producing Party (and, if 3 not the same person or entity, to the Designating Party) by the 60 day deadline that 4 (1) identifies (by category, where appropriate) all the Protected Material that was 5 returned or destroyed and (2) affirms that the Receiving Party has not retained any 6 copies, abstracts, compilations, summaries or any other format reproducing or 7 capturing any of the Protected Material. Notwithstanding this provision, Counsel 8 are entitled to retain an archival copy of all pleadings, motion papers, trial, 9 deposition, and hearing transcripts, legal memoranda, correspondence, deposition 10 and trial exhibits, expert reports, attorney work product, and consultant and expert 11 work product, even if such materials contain Protected Material. Any such archival 12 copies that contain or constitute Protected Material remain subject to this Protective 13 Order as set forth in Section 4 (DURATION). 14 14. VIOLATION 15 Any violation of this Order may be punished by appropriate measures 16 including, without limitation, contempt proceedings and/or monetary sanctions. 17 IT IS SO STIPULATED, THROUGH COUNSEL OF RECORD.

18 DATED: August 7, 2019 NOVIAN & NOVIAN, LLP 19 20 By: __/s/ Farhad Novian________________ FARHAD NOVIAN 21 J. NICOLAS ANWANDTER Attorneys for Plaintiff 22 DATED: August 7, 2019 23 ROPERS MAJESKI KOHN & BENTLEY 24 By: ___/s/ Nicole S. Healy_______________ TODD A. ROBERTS 25 NICOLE S. HEALY EDWIN E. BARNES 26 Attorneys for Defendants TAPIN2, INC., ANTHONY 27 CHRISTOPOULOS, JORDAN SYMS, DAVID RONE, BRAD COSTELLO, 28 and MICHAEL WARGOTZ 1 || FOR GOOD CAUSE SHOWN, IT IS SO ORDERED. 2 3 DATED: August 22, 2019

4 Up 5 6| GAILJ.STANDISH 7 UNITED STATES MAGISTRATE JUDGE 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 15 ee eR

1 EXHIBIT A 2 ACKNOWLEDGMENT AND AGREEMENT TO BE BOUND 3 I, _____________________________ [print or type full name], of 4 _________________ [print or type full address], declare under penalty of perjury 5 that I have read in its entirety and understand the Stipulated Protective Order that 6 was issued by the United States District Court for the Central District of California 7 on [date] in the case of Shlomi Moshe v. TapIn2, Inc. et al., Case No. 18-cv-09238- 8 RGK-GJS (C.D. Cal.). I agree to comply with and to be bound by all the terms of 9 this Stipulated Protective Order and I understand and acknowledge that failure to so 10 comply could expose me to sanctions and punishment in the nature of contempt. I 11 solemnly promise that I will not disclose in any manner any information or item 12 that is subject to this Stipulated Protective Order to any person or entity except in 13 strict compliance with the provisions of this Order. 14 I further agree to submit to the jurisdiction of the United States District Court for 15 the Central District of California for enforcing the terms of this Stipulated 16 Protective Order, even if such enforcement proceedings occur after termination of 17 this action. I hereby appoint __________________________ [print or type full 18 name] of _______________________________________ [print or type full 19 address and telephone number] as my California agent for service of process in 20 connection with this action or any proceedings related to enforcement of this 21 Stipulated Protective Order. 22 Date: ______________________________________ 23 City and State where sworn and signed: _________________________________ 24 Printed name: _______________________________ 25 Signature: __________________________________ 26 27 28