Common use of Firm Information Clause in Contracts

Firm Information. Citizenship: □ U.S. Citizen or □ Resident Alien or □ Nonresident Alien ______________________________________ Country of citizenship for nonresident alien ______________________________________________________ □ Applied for. Employer Identification Number, or Qualified Date of application: ______________________ Intermediary Employer Identification Number Street Address or APO/FPO (a P.O. box or rural route number is not acceptable) City State Zip Code Telephone Number FAS/[COMPANY] DEFINED CONTRIBUTION CLEARANCE & SETTLEMENT AGREEMENT (VVIF ONLY) 0458058

Firm Information. Citizenship: □ o U.S. Citizen or □ Resident oResident Alien or □ o Nonresident Alien ______________________________________ Country of citizenship for nonresident alien ______________________________________________________ □ o Applied for. Employer Identification Number, or Qualified Date of application: _______________ Intermediary Employer Identification Number __________________________________________________________________________________________ Intermediary Employer Identification Number Street Address or APO/FPO (a FPO(a P.O. box or rural route number is not acceptable) ___________________________________ ___________________________________ ___________________________________ City State Zip Code ___________________________________ ___________________________________ Daytime Telephone Number FAS/[COMPANY] DEFINED CONTRIBUTION CLEARANCE & SETTLEMENT AGREEMENT (VVIF ONLY) 0458058Evening Telephone Number