Cal. Code Regs. tit. 10, § 10.4355
(a) Provide a table showing, with respect to each executive officer of the applicant:
(b) With respect to each executive officer of the applicant listed in the table called for in Subdivision (a) of this Section, provide:
(3) Statement dated as of a date within 90 days before the filing of the application and signed by the executive officer, stating: