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If delivering by express mail, courier,
or other expedited service: |
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By mail:
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Equiniti Trust Company, LLC
1110 Centre Pointe Curve Suite # 101 Mendota Heights, MN 55120 Attn: Onbase — Reorganization Department |
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Equiniti Trust Company, LLC
Operations Center Attn: Onbase — Reorganization Department 1110 Centre Pointe Curve Suite # 101 Mendota Heights, MN 55120 |
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| | ☐ US$2.80 | | | ☐ US$2.85 | | | ☐ US$2.90 | | | ☐ US$2.95 | |
| | ☐ US$3.00 | | | ☐ US$3.05 | | | ☐ US$3.10 | | | ☐ US$3.15 | |
| | ☐ US$3.20 | | | | | | | | | | |
| | Name(s) of Record Holder(s): | | |
(Please Print)
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| | Signature(s): | | |
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| | Address(es): | | |
(Include Zip Code)
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| | Area code and telephone number: | | |
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☐ If delivery will be by book-entry transfer, check this box.
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| | Name of tendering institution: | | |
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| | Account number: | | |
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| | Name of Eligible Institution Guaranteeing Delivery | | | Authorized Signature | |
| | Address | | | Name (Print Name) | |
| | Zip Code | | | Title | |
| | (Area Code) Telephone No. | | | Dated | |