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By Hand, Overnight Delivery or Mail
(Registered or Certified Mail Recommended): UMB Bank, N.A. 5555 San Felipe St., Suite 870 Houston, TX 77056 Attn: Corporate Trust Officer/Mauri J. Cowen |
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By Facsimile Transmission
(for eligible institutions only): (214) 389-5949 Attn: Corporate Trust Officer/Mauri J. Cowen |
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Name(s) and Address(es) of Registered
Holder(s) |
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Certificate
Number(s)* |
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Aggregate
Principal Amount Represented by Certificate(s)* |
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Aggregate Principal
Amount Tendered** |
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| | | | | | | | | | | | | | |
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| | | | | | Total: | | | | | | | | |
| | | | | | | |
, 2022
|
|
| | | | | | | |
, 2022
|
|
| | | | | | | |
, 2022
|
|
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Signatures by Tendering Beneficial Owners
|
| | Date | | | | |
| | | | | | | | | |
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Telephone Number(s)
|
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Name(s)
(Please Type or Print)
|
| | | |
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Capacity(ies)
|
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Address(es)
(Including Zip Code)
|
| | | |
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Telephone Number(s)
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