tact Phone Numbers Ng, ev COI /Inv Oita. 'Ph* It Permanent Address: If P O. Box is listed under Mailing Address zit residence is different from Maiing Address. Street/RFD* or URB (No P.O. Box) Apartinentillra Stale Zip Code IS. Emergency Contact • Provide the informs Pion ofa person not traveling mlh y

Additianal InstnxSions: OTCC#: Name of Receiving Firm: Account Name; Chedc Q Issue a check in the amount of S Recipient's Name: Recipient's Maiing Address; paieWeto; Account Number at Receiving Firm Qty/Symbol/Securttv; Oty/Svm bol/Security; EFTA01403048 SmdhgAuthcriaalion Q The undersigned her

deliver the securities indicated below to; DTCC#; Name of Receiving Firm; Check Q Issue a check In the amount of $ Redpient's Name; Recipient's Maiing Address; Account Name; payable to; Account Number; at Receiving Hrm Qty/Symbol/Security; Qty/Symbol/Security; EFTA01403679 Slanr&ig Auttiorealion Q

to; AdEftional Instnictbns; DTCC# Name of Receiving Firm: Account Name: Check Q Issue a check in the amount of S Redpient's Name: Reapient's Maiing Address; foyable to: Account Number: at Receh/rng Firm EFTA01404658 OiV/Symbol/Securiiy: Qty/Symbrtl/Socurity: Slandino Autiuivatioti Q The undersig

icated below to: Additional InstrucHons: DTCC#: Name of Receiving Firm: Check Q Issue a check in the amount of $ Recipient's Name: Recipient's Maiing Address; Account Name: payable to; Account Number: EFTA01404714 at Receiving Firm Qty/Symbol/Sacurity; Qty/Symbol/Security; Standing Authorfzatjon