Investor ID Number

 

 

 

 

u	Signature: This form must be signed by the registered holder(s) exactly as their name(s) appears on the certificate(s) or by person(s) authorized to sign on behalf of the registered holder(s) by documents transmitted herewith.
X
Signature of Stockholder		Date	Daytime Telephone #
X
Signature of Stockholder		Date	Daytime Telephone #

PLEASE CERTIFY YOUR TAXPAYER IDENTIFICATION NUMBER (TIN) BY COMPLETING THE INFORMATION IN BOX NUMBER y ON THE REVERSE SIDE.

PLACE AN x IN ONE TENDER BOX ONLY

v

c

Tender All

w

c

Partial Tender

•

WHOLE SHARES

FRACTIONS

 

 

 

 

 

Certified  Certificate(s)  Number

If you cannot produce some or all of your Delaware Investments National Municipal Income Fund stock certificates, you must obtain a lost instrument open penalty surety bond. Please see the reverse side of this form for instructions.

Please complete the back if you would like to transfer ownership or request special mailing.

x AFFIDAVIT OF LOST, MISSING OR DESTROYED CERTIFICATE(S) AND AGREEMENT OF INDEMNITY					Investor ID Number
THIS AFFIDAVIT IS INVALID IF A CHECK IS NOT INCLUDED AND IF THE AFFIDAVIT IS NOT SIGNED AND NOTARIZED BELOW. NOTE: FOREIGN OWNERS MUST also include Apostille seal or legal equivalent.
	TOTAL SHARES LOST  F
	Please Fill In Certificate No(s). if Known	Number of Shares
	Attach separate schedule if needed

	X Signed by Affiant (stockholder)		on this (date)
		(Deponent) (Indemnitor) (Heirs Individually)		Month	Day	Year

Social Security #

Date

Notary Public

• Enter number of share(s) lost _____________________________ X (Cash Rate) $13.28 =  $______________________ share value
• If the share value exceeds $500,000, or if the shareholder is foreign and the share value exceeds $100,000, do not complete this affidavit. Complete only the Transmittal Form and contact BNY Mellon Shareowner Services regarding the lost certificate(s).

• The surety premium equals 1% (.01) of the share value noted in line 1 above: $______________ X (1%) or (.01) = ….....$__________________Surety Premium

• If the share value is less than or equal to $250.00, the Service Fee = $50.00
• If the share value is greater than $250.00 but less than or equal to $3,000.00, the Service Fee = $100.00
• If the share value is greater than $3,000.00, the Service Fee = $200.00

 

 

 

u	Sign, date and include your daytime telephone number in this Transmittal Form in Box 1 and after completing all other applicable sections return this form and your stock certificates in the enclosed envelope. The method of delivery of any documents, including share certificates, is at the election and risk of the tendering shareholder. If documents are sent by mail, it is recommended that they be sent by registered mail, properly insured, with return receipt requested.
v	If you are tendering all your shares for cash, please check this box only.
w	If you are tendering some of your shares for cash, please check the box, indicate the number of shares you wish to tender and receive in cash.
x	If you cannot produce some or all of your Delaware Investments National Municipal Income Fund stock certificates, you must obtain a lost instrument open penalty surety bond and file it with BNY Mellon. To do so through BNY Mellon’s program with Federal Insurance Company, complete Box 4 on the front side of this form, including the lost securities premium and service fees calculations, and return the form together with your payment as instructed. Please print clearly. Alternatively, you may obtain a lost instrument open penalty surety bond from an insurance company of your choice that is rated A+XV or better by A. M. Best & Company. In that instance, you would pay a surety premium directly to the surety bond provider you select and you would pay BNY Mellon its service fee only. Please contact us at the number provided below for further instructions on obtaining your own bond.
y	PLEASE SIGN IN BOX 5 TO CERTIFY YOUR TAXPAYER ID OR SOCIAL SECURITY NUMBER if you are a U.S. Taxpayer. If the Taxpayer ID or Social Security Number is incorrect or blank, write the corrected number in Box 5 and sign to certify. Please note that BNY Mellon Shareowner Services may withhold 28% of your proceeds as required by the IRS if the Taxpayer ID or Social Security Number is not certified on our records. To avoid back up withholding, you are required to fully and accurately complete the Substitute Form W-9. For additional instructions, please see the "Information for Substitute Form W-9" document. Note: You are required to check the appropriate box for your status (Individual/Sole proprietor, Corporation, etc.) to avoid withholding. If you are a non - U.S. Taxpayer, please complete and return form W-8BEN.
z	If you want your check to be issued in another name, fill in Box 6 above. Signature(s) in Box 6 above must be medallion guaranteed. To complete your transfer request you must also indicate below a Transfer Reason by executing the Transfer Reason box below. Transfer Reason1 - Check only one: All transfers will be assumed to be Gifts if no reason is provided. If we receive documentation (e.g., death certificate) indicating that the registered shareowner is deceased, the transfer reason will default to Death.

 

c		Gift		Date of Gift2:		____/____/____		(Gift applies to certificates only)
c		Private Sale		Date of Sale3:		____/____/____		Value per Share:		USD__________. ___ ___
c		Death		Date of Death3:		____/____/____		Value per Share4:		USD__________. ___ ___
c		None of the above5:								(Please specify)

 

	1 You may wish to consult with your tax advisor on the definition and tax implications for each type of transfer.
	2 If not provided, gift date for certificates will default to the date that the transfer is processed. For book entry shares, the gift date will always be the date that the transfer is processed.
	3 Date of Sale/Death will default to the date that the transfer is processed unless provided. For transfers due to death, date of death will default to the date indicated in the documents (e.g., death certificate) received with the transfer instructions, if any.
	4 Required to determine cost basis to be applied per beneficiary.
	5 Existing cost basis of shares will be carried over to the new account.
{	Complete Box 7 only if your certificate(s) for Delaware Investments National Municipal Income Fund and/or check for cash is to be delivered to a person other than the registered holder or to a different address.

 

 

 

From within the U.S., Canada or Puerto Rico:		1-866-416-6001 (Toll Free)
From outside the U.S.:		1-201-680-6579 (Collect)

 

By Mail:   BNY Mellon Shareowner Services        Attn: Corporate Action Dept. P.O. Box 3301 South Hackensack, NJ 07606

By Overnight Courier or By Hand BNY Mellon Shareowner Services Attn: Corporate Action Dept., 27th Floor 480 Washington Boulevard Jersey City, NJ 07310