Exhibit 99.1
ENROLLMENT AUTHORIZATION FORM
PLEASE ENROLL MY ACCOUNT AS FOLLOWS:
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Place an "X" in ONE box only, using a dark ink pen
or a #2 pencil (/_/)
If you do not check any box, then FULL DIVIDEND
REINVESTMENT WILL BE assumed.
/_/ FULL DIVIDEND REINVESTMENT
Reinvest all dividends for this account.
/_/ PARTIAL DIVIDEND REINVESTMENT
Reinvest any dividends that may become payable to
me on __________________*shares of my stock and
invest any voluntary cash payments I may choose to
send.
/_/ VOLUNTARY CASH PAYMENTS ONLY (NO DIVIDEND
REINVESTMENT)
All dividends will be paid in cash.
* CANNOT BE GREATER THAN THE TOTAL NUMBER OF SHARES
CURRENTLY REGISTERED IN YOUR NAME AND HELD FOR YOU
UNDER THE PLAN.
Under each of the options above, participants may
make voluntary cash payments at any time.
Signature(s) of
Registered Owner(s)
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AUTOMATIC DEDUCTIONS
To authorize deductions, complete BOTH SIDES of the
next form below.
(Please detach, BUT DO NOT FOLD OR STAPLE)
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3. ACCOUNT TYPE
/_/ /_/
CHECKING SAVINGS
1. /_/_/_/_/_/_/_/_/_/ 2. /_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/ 4. $ /_/_/_/_/_/.0/0/
B /0/0/0/0/0/0/0/0/0/ B /0/0/0/0/0/0/0/0/0/0/0/0/0/0/0/ W /0/0/0/0/0/0/0/ 5.
A /1/1/1/1/1/1/1/1/1/ A /1/1/1/1/1/1/1/1/1/1/1/1/1/1/1/ I /1/1/1/1/1/1/1/ CYCLE
N /2/2/2/2/2/2/2/2/2/ N /2/2/2/2/2/2/2/2/2/2/2/2/2/2/2/ T /2/2/2/2/2/2/2/ 1ST
K /3/3/3/3/3/3/3/3/3/ K /3/3/3/3/3/3/3/3/3/3/3/3/3/3/3/ H /3/3/3/3/3/3/3/ /_/
/4/4/4/4/4/4/4/4/4/ /4/4/4/4/4/4/4/4/4/4/4/4/4/4/4/ D /4/4/4/4/4/4/4/
R /5/5/5/5/5/5/5/5/5/ A /5/5/5/5/5/5/5/5/5/5/5/5/5/5/5/ R /5/5/5/5/5/5/5/
O /6/6/6/6/6/6/6/6/6/ C /6/6/6/6/6/6/6/6/6/6/6/6/6/6/6/ A /6/6/6/6/6/6/6/
U /7/7/7/7/7/7/7/7/7/ C /7/7/7/7/7/7/7/7/7/7/7/7/7/7/7/ W /7/7/7/7/7/7/7/ 2ND
T /8/8/8/8/8/8/8/8/8/ O /8/8/8/8/8/8/8/8/8/8/8/8/8/8/8/ A /8/8/8/8/8/8/8/ /_/
I /9/9/9/9/9/9/9/9/9/ U /9/9/9/9/9/9/9/9/9/9/9/9/9/9/9/ L /9/9/9/9/9/9/9/
N N
G T A WITHDRAWAL
M AMOUNT
N N O MUST BE
U U U IN WHOLE
M M N DOLLARS
B B T ONLY,
E E DO NOT
R R INDICATE
CENTS
AUTHORIZATION FORM SEE REVERSE SIDE FOR IMPORTANT INFORMATION
FOR I (We) agree to the terms of the Automatic
AUTOMATIC DEDUCTIONS Deduction Authorization on the reverse
side
6. _______________________________________
SIGNATURE(S) DATE
(Please detach, but do not fold or staple)
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VOLUNTARY CASH PAYMENT FORM
To purchase additional shares,
please make your check or
money order payable in United
States dollars to "First
Chicago Trust".
(PLEASE NOTE YOUR ACCOUNT
NUMBER AND COMPANY CODE ON YOUR
PAYMENT.)
DO NOT SEND CASH.
Amount enclosed $____________
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MAIL YOUR PAYMENT TOGETHER
WITH THIS FORM IN THE POSTAGE
PRE-PAID ENVELOPE PROVIDED OR
TO THE ADDRESS SHOWN ON
THE REVERSE SIDE OF THIS FORM.
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( )
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Daytime telephone number
Participation in the plan is subject to the terms as outlined in the plan
description.
For information, participants may write to First Chicago Trust Company of New
York, Investment Plans, P.O. Box 2598, Jersey City, NJ 07303-2598. If you
prefer, you may call First Chicago Trust Company of New York at the telephone
number listed in the enclosed plan description.
Voluntary cash payments should be mailed to First Chicago Trust Company of New
York, Investment Plans, P.O. Box 13531, Newark, NJ 07188-0001.
USE THIS ILLUSTRATION AS A GUIDE TO HELP YOU COMPLETE THE AUTHORIZATION FORM FOR
AUTOMATIC DEDUCTIONS BELOW
John Doe
123 Your Street ______ 19__ Withdrawal Amount
Anywhere,U.S.A.12345
/3/3/2/1/1/2/1/4/3/ $/_/_/_/2/5/.0/0/
Pay To The Order Of: FIRST CHICAGO TRUST $25.00 B W
/0/2/1/0/0/1/0/1/3/ --------------------------- A I
B Your Bank Name TWENTY FIVE AND 00/100-----Dollars N T
A 123 Main Street ----------------------------- K H
N Anywhere, U 5 A 12345 D
K A R
For___________________ C A
R C W
O ..................... 1:021006 0131: ii'332112143 O A
U EXAMPLE U L
T N
I Bank Routing Number Bank Account Number T
N EXAMPLE
G
AUTHORIZATION FORM FOR AUTOMATIC DEDUCTIONS
INSTRUCTIONS - PLEASE COMPLETE ALL 7 STEPS
Complete and return this form ONLY if you wish to authorize automatic deductions
to purchase additional shares. There are 7 steps to complete on BOTH sides of
this authorization form. Each one is important in setting this up for you.
Please be sure to complete all 7 steps, using a dark ink pen or a #2 pencil.
Let's start with the 6 items on the reverse side.
1. -- BANK ROUTING NUMBER: LOCATE your bank's 9 digit routing number in the
lower left portion of your check or deposit slip as illustrated above.
Write that number in the 9 boxes across the top of the grid and then shade
in the corresponding box beneath each number.
2. -- BANK ACCOUNT NUMBER: Locate your bank account number and shade in the grid
as you did in Step 1. Note that there may be more spaces than you need so
be sure to start from the left side as the machine that reads this form
will start reading the grid from the left side. Please do not put dashes
or leave blank spaces between your numbers.
3. -- ACCOUNT TYPE: Are we debiting your checking or savings account? Check one.
4. -- WITHDRAWAL AMOUNT: Enter the amount to debit from your bank account in the
boxes across the top of the grid. Now, shade in the grid as you did
before. Express the withdrawal amount in whole DOLLARS ONLY, NO CENTS.
5. -- CYCLE: Refer to the enclosed plan description for the frequency of
automatic deductions. If the plan permits deductions ONLY ONCE A MONTH,
YOU NEED NOT COMPLETE THIS PORTION. If the plan permits deductions TWICE
PER MONTH, YOU MUST INDICATE YOUR CHOICE OF DEDUCTION DATES, either the
earlier date (1st cycle) or the later date (2nd cycle), or both.
6. -- SIGNATURE(S): Also, be sure to read the Automatic Deduction Authorization
(below, at left) that authorizes us to perform this service for you.
7. -- BANK/FINANCIAL INSTITUTION INFORMATION: Now, fill in the bank name and
address (below, at right) and you're all done.
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AUTOMATIC DEDUCTION AUTHORIZATION
I (We) hereby authorize First Chicago Trust Company of New York to make
deductions of funds from the checking or savings account in the amount
stated on the reverse of this form. These funds will be used to purchase shares
to be held for my (our) account.
7. BANK/FINANCIAL INSTITUTION INFORMATION
NAME
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ADDRESS
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CITY STATE ZIP CODE
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VOLUNTARY CASH PAYMENT INFORMATION
Voluntary cash payments should be mailed to First Chicago Trust Company of New
York, Investment Plans, P.O. Box 13531, Newark, NJ 07188-0001. For information,
participants may write to First Chicago Trust Company of New York, Investment
Plans, P.O. Box 2598, Jersey City, NJ 07303-2598. If you prefer, you may call
First Chicago Trust Company of New York at the telephone number listed in the
enclosed plan description.