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100% DIVIDEND INVESTMENT – to have cash dividends on all registered shares of common stock automatically invested and to have the option of investing additional amounts by making cash payments.
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PARTIAL DIVIDEND INVESTMENT – to have cash dividends on _________ shares of common stock automatically invested and continue to receive cash dividends on the remaining share balance and to have the option of investing additional amounts by making cash payments. You must reinvest dividends on at least 10% of your share balance.
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Date ____________________________________
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________________________________________
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______________________________
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Enter Social Security or Taxpayer I.D. Number
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Signature of Shareholder
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______________________________
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Signature of Shareholder
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