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X in the appropriate O directly, as a Registered Holder O through a Broker. If you marked this box, plea
ne box may be applicable): (please print full name) K Corporation (or Limited Liability Company) K Individual K Trust O Partnership O Other K Bank O Broker O Financial Institution 3. For individuals only: 4. For all other Shareholders Date of birth: / / Country of incorporation or organi
X in the appropriate O directly, as a Registered Holder O through a Broker. If you marked this box, plea
ne box may be applicable): (please print full name) K Corporation (or Limited Liability Company) K Individual K Trust O Partnership O Other K Bank O Broker O Financial Institution 3. For individuals only: 4. For all other Shareholders Date of birth: / / Country of incorporation or organi
X in the appropriate O directly, as a Registered Holder O through a Broker. If you marked this box, plea
ne box may be applicable): (please print full name) K Corporation (or Limited Liability Company) K Individual K Trust O Partnership O Other K Bank O Broker O Financial Institution 3. For individuals only: 4. For all other Shareholders Date of birth: / / Country of incorporation or organi
Entities connected to both Eric Holder and K Bank