Financial Request Application

NOTE: ALL FIELDS MUST BE COMPLETED

First Name:
Last Name:
Title:
Email:
Phone Number:
Organization (if request is on behalf of the individual named above and not on behalf of an institution or company, please write "None"):
Reason for Information Request (please check the appropriate box):
Current Bondholder: The institution/company or individual (if request is on behalf of the individual named above): (1) confirms that it is a beneficial owner of the 9% Senior Notes due 2014 and/or the 10.25% Senior Subordinated Notes due 2015 issued by Hub International Holdings, Inc.; and (2) agrees (i) to keep all information obtained from the secure Website and conference call confidential, (ii) to not distribute such information to any third party, and (iii) to not use such information for any purpose other than evaluating its investment in the Notes. Prospective Bondholder: The institution/company or individual (if request is on behalf of the individual named above): (1) confirms that it is a prospective beneficial owner of the 9% Senior Notes due 2014 and/or the 10.25% Senior Subordinated Notes due 2015 issued by Hub International Holdings, Inc.; and (2) agrees (i) to keep all information obtained from the secure Website and conference call confidential, (ii) to not distribute such information to any third party, and (iii) to not use such information for any purpose other than evaluating its prospective investment in the Notes. Financial Analyst: The institution/company or individual (if request is on behalf of the individual named above): (1) confirms that it is a securities analyst; and (2) agrees (i) to keep all information obtained from the secure Website and conference call confidential, (ii) to not distribute such information or any information or advice extrapolated therefrom to any third party unless, to the best of its knowledge, such third party is, or has indicated that it is considering becoming, a holder of Hub International Limited’s Senior and/or Senior Subordinated Notes, and (iii) to not use such information for any purpose other than as described in clause (ii).