Common use of Certification instructions Clause in Contracts

Certification instructions. You must cross out Item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (“IRA”), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. If you are an exempt payee (if you are unsure, ask us for a complete set of IRS instructions), enter your exempt payee code (if any) here: If you are exempt from FATCA reporting (if you are unsure, ask us for a complete set of IRS instructions), enter your exemption from FATCA reporting code (if any) here: The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholding. BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS AGREEMENT. By signing this Agreement, you affirm that you are of full legal age in the state or jurisdiction in which you reside and have the capacity to enter into this Agreement. You further affirm that you have read, understood and agree to the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody Accounts

Certification instructions. You must cross out Item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For mortgage interest paid, acquisition or abandonment abandonm ent of secured property, cancellation of debt, contributions to an individual retirement arrangement (“IRA”), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. If you are a re an exempt payee (if you are unsure, ask us for a complete set of IRS instructions), enter your exempt payee code (if any) here: _______________________ If you are exempt from FATCA reporting (if you are unsure, ask us for a complete set of IRS instructions), enter your exemption exempti on from FATCA reporting code (if any) here: _____________________________________ The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup backu p withholding. BY SIGNING THIS AGREEMENT AGREEMENT, YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING COR CLEARING, LLC OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS ACCOUNT APPLICATION AND AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS ACCOUNT APPLICATION AND AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS ACCOUNT APPLICATION AND AGREEMENT. By signing this Agreement, you affirm that you are of full legal age in the state or jurisdiction in which you reside and have the capacity to enter into this Agreement. You further affirm that you have read, understood and agree to the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody Accounts.

Certification instructions. You must cross out Item 2 item (2) above if you have been notified by the IRS that you are currently subject to backup withholding because of under-reporting interest or dividends on your tax return. However, if after being notified by the IRS that you have failed are subject to backup withholding, you received another notification from the IRS that you are no longer subject to backup withholding, do not cross out item (2). _______________________________________________________________________________ SIGNATURE_______________________________ DATE ____________ , 1998 _______________________________________________________________________________ NOTE: FAILURE TO COMPLETE THIS FORM MAY RESULT IN BACKUP WITHHOLDING OF 31% OF ANY PAYMENTS MADE TO YOU. PLEASE REVIEW ENCLOSED GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 FOR ADDITIONAL DETAILS. GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 WHAT IS BACKUP WITHHOLDING? -- Persons making certain payments to you are required to withhold and pay to IRS 31% of such payments under certain conditions. This is called "backup withholding." Payments that could be subject to backup withholding include interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee compensation, and certain payments from fishing boat operators, but do not include real estate transactions. If you give the requester your correct TIN, make the appropriate certifications, and report all your taxable interest and dividends on your tax return, your payments will not be subject to backup withholding. Payments you receive will be subject to backup withholding if: (1) You do not furnish your TIN to the requester, or (2) IRS notifies the requester that you furnished an incorrect TIN, or (3) You are notified by IRS that you are subject to backup withholding because you failed to report all your interest and dividends on your tax return (for interest and dividend accounts only), or (4) You fail to certify to the requester that you are not subject to backup withholding under (3) above (for interest and dividend accounts opened after 1983 only), or (5) You fail to certify your TIN. This applies only to interest, dividend, broker or barter exchange accounts opened after 1983, or broker accounts considered inactive in 1983. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (“IRA”), and generally, payments other than interest and dividendspayments, you are not required subject to sign the certificationbackup withholding only if (1) or (2) above applies. Certain Payees and payments are exempt from backup withholding and information reporting. See payees and Payments Exempt From Backup Withholding, but you must provide your correct TIN. If below, and Exempt Payees and Payments under Specific Instructions below if you are an exempt payee (if you are unsure, ask us for a complete set of IRS instructions), enter your exempt payee code (if any) here: If you are exempt from FATCA reporting (if you are unsure, ask us for a complete set of IRS instructions), enter your exemption from FATCA reporting code (if any) here: The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholding. BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS AGREEMENT. By signing this Agreement, you affirm that you are of full legal age in the state or jurisdiction in which you reside and have the capacity to enter into this Agreement. You further affirm that you have read, understood and agree to the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody Accountspayee.

Certification instructions. You must cross out Item 2 item (2) above if you have been notified by the IRS has notified you that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For mortgage interest paidHowever, acquisition if after being notified by the IRS that you were subject to backup withholding you received another notification from the IRS that you were no longer subject to backup withholding, do not cross out item (2). Signature: Date: YOU SHOULD COMPLETE THE FOLLOWING CERTIFICATE IF YOU WROTE “APPLIED FOR” IN PART I OF THIS SUBSTITUTE FORM W-9 CERTIFICATE OF AWAITING TAXPAYER IDENTIFICATION NUMBER I certify under penalties of perjury that a taxpayer identification number has not been issued to me, and either (a) I have mailed or abandonment delivered an application to receive a taxpayer identification number to the appropriate Internal Revenue Service Center or Social Security Administration Office or (b) I intend to mail or deliver an application in the near future. I understand that, notwithstanding the information I provided in Part III of secured propertythe Substitute Form W-9 (and the fact that I have completed this Certificate of Awaiting Taxpayer Identification Number), cancellation of debtall reportable payments made to me thereafter will be subject to a 30% backup withholding tax until I provide a properly certified taxpayer identification number. Signature: ______________________________ Date: _________________________ , contributions 200 NOTE: FAILURE TO COMPLETE AND RETURN THE SUBSTITUTE FORM W-9 MAY RESULT IN BACKUP WITHHOLDING TAX OF 30% OF ANY PAYMENTS MADE TO YOU PURSUANT TO YOUR SUBSCRIPTION FOR COMMON STOCK. PLEASE REVIEW THE ENCLOSED GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 FOR ADDITIONAL DETAILS. 7 GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 Guidelines for Determining the Proper Identification Number to Give the Payer. The taxpayer identification number for an individual retirement arrangement (“IRA”)is the individual’s Social Security number. Social Security numbers have nine digits separated by two hyphens: e.g., 000-00-0000. The taxpayer identification number for an entity is the entity’s Employer Identification number. Employer Identification numbers have nine digits separated by only one hyphen: e.g., 00-0000000. The table below will help determine the number to give the payer. Give the NAME and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. If you are an exempt payee (if you are unsure, ask us for a complete set SOCIAL SECURITY For this type of IRS instructions), enter your exempt payee code (if any) hereaccount: If you are exempt from FATCA reporting (if you are unsure, ask us for a complete set of IRS instructions), enter your exemption from FATCA reporting code (if any) here: The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholding. BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS AGREEMENT. By signing this Agreement, you affirm that you are of full legal age in the state or jurisdiction in which you reside and have the capacity to enter into this Agreement. You further affirm that you have read, understood and agree to the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody Accountsnumber of—

Certification instructions. You must cross out Item item 2 above if you You have been notified by the IRS that you You are currently subject to backup withholding because you have failed to report all of underreporting interest and or dividends on your Your tax return. For mortgage interest paidMembership Application Agreement Whenever used in this Membership Application and Agreement, acquisition or abandonment the words "You" and "Your" refer to the Primary Accountholder and any Joint Owners named in this Membership Application and Agreement. The words "We," "Us" and "Our" mean the Xxxxx Xxxxxxx Federal Credit Union. You understand with Your signature on this Agreement You can establish other Credit Union accounts and that Your signature constitutes a request for any identifying number and/or access device issued by the Xxxxx Xxxxxxx Federal Credit Union in connection with such accounts. If You are a joint owner, You understand that ownership of secured property, cancellation of debt, contributions to an individual retirement arrangement Account is subject to meeting membership eligibility requir ements. You understand and agree that only those named in this Agreement are authorized to initiate Wire Transfer Requests with the Xxxxx Xxxxxxx Federal Credit Union. Any such request will be made in accordance with Our underwriting guidelines for Wire Transfers. Signatures (“IRA”)Required) You hereby apply for membership in the Xxxxx Xxxxxxx Federal Credit Union. You, and generallyall joint owners, payments other than interest acknowledge receiving a copy of the Xxxxx Xxxxxxx Federal Credit Union Agreements and dividendsDisclosures and You agree to be bound by the terms and conditions found therein with respect to any products and/or services You are now requesting and with respect to those that You may request in the future. You further agree to be bound by the bylaws, you are not required rules and regulations of the Credit Union in effect from time to sign time. In addition to establishing a Share Savings Account with Us, You may also from time to time request additional Accounts and/or Account services be established on Your behalf and/or the certificationaddition of joint owner(s) of Your Account. Your signature below is Your continuing authorization for Us to follow Your written or verbal instructions to do so and You agree that Your continuing authorization will remain in effect unless We receive written instructions to the contrary. You hereby authorize Us to recognize any of the signatures subscribed below in the payment of funds or the transaction of any business for Your Account. You authorize Us to transfer funds from any Share Account You may have with Us in multiples necessary to clear any overdraft on any Share Draft Account You may have with Us, but you must provide your correct TINsubject to any fees related to such transfers. If you are an exempt payee (if you are unsureSubject to applicable laws and regulations, ask us You further authorize any person, association, firm, corporation, personnel office or credit reporting agency to furnish, upon Our request, information concerning Your employment, credit standing and financial responsibility. In addition to using this information to evaluate Your eligibility for a complete set membership, it may also be used to pre-determine Your possible eligibility for various Xxxxx Xxxxxxx Federal Credit Union credit products and services. You warrant the truth of IRS instructions), enter your exempt payee code (if any) here: If you are exempt from FATCA reporting (if you are unsure, ask us the information contained in Your application for a complete set of IRS instructions), enter your exemption from FATCA reporting code (if any) here: membership and/or subsequent representations to Us. You realize that such information will be relied upon by Us in determining Your membership eligibility and/or credit worthiness. The IRS Internal Revenue Service does not require your Your consent to any provision of this document other than the certifications required to avoid backup withholding. BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWOApplicant's (Primary Member) Signature Date Joint Owner #1 Signature Date Joint Owner #2 Signature Date For credit union use only: Qualifile (Primary Member) Qualifile (Joint Owner 1) Qualifile (Joint Owner 2) Agreements and Disclosures, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENTRate Supplement and Schedule of Fees and Charges given personally: Employee's Initials Date Agreements and Disclosures, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS AGREEMENT. By signing this Agreement, you affirm that you are Rate Supplement and Schedule of full legal age in the state Fees and Charges given by mail/ Electronically: Employee's Initials Date Employee ID or jurisdiction in which you reside and have the capacity to enter into this Agreement. You further affirm that you have read, understood and agree to the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name eligibility verified Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody AccountsVerified JHFCU Employee's Initials

Certification instructions. You must cross out Item 2 part 2) above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all of under-reporting or lack of reporting of interest and or dividends on your tax return. For mortgage interest paidHowever, acquisition or abandonment of secured property, cancellation of debt, contributions if after being notified by the IRS that you were subject to an individual retirement arrangement (“IRA”), and generally, payments other than interest and dividends, backup withholding you received another notification from the IRS that you are no longer subject to backup withholding, do not required to sign the certification, but you must provide your correct TINcross out such part 2). If you are an exempt payee (if you are unsure, ask us for a complete set of IRS instructions), enter your exempt payee code (if any) here: If you are exempt from FATCA reporting (if you are unsure, ask us for a complete set of IRS instructions), enter your exemption from FATCA reporting code (if any) here: The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholding. BY SIGNING THIS AGREEMENT Signature(s) Date - Day Month Year --------------------------------------- --------- --------- ---------------- --------------------------------------- --------- --------- ---------------- YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING OR LOANED OUT TO OTHERS. MUST COMPLETE THE FOLLOWING CERTIFICATE IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN "AWAITING TIN" BOX ABOVE. CERTIFICATE OF AWAITING TAXPAYER IDENIFICATION NUMBER I certify under penalties of perjury that (i) a TIN has not been issued to me, (ii) either a) I have mailed an application to receive a TIN to the appropriate Internal Revenue Service Center or Social Security Administration Office or b) I intend to mail or deliver an application in the near future, and (iii) I understand that if I do not provide a TIN by the time of payment, I will be subject to backup withholding at a rate of 28% of all reportable payments made to me. Signature(s) Date - Day Month Year --------------------------------------- --------- --------- ---------------- --------------------------------------- --------- --------- ---------------- NOTE: FAILURE TO COMPLETE AND RETURN THIS SUBSTITUTE FORM W-9, MAY RESULT IN BACKUP WITHHOLDING BEING WITHHELD AT A RATE OF 28% ON PAGE TWOANY PAYMENTS MADE TO YOU. GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 OBTAINING A NUMBER Payments of interest not generally subject to backup withholding include the following: If you do not have a taxpayer identification number ("TIN") or you don't know your number, YOU ACCEPT o Payments of tax-exempt interest (including obtain Form SS-5, Application for a Social exempt-interest dividends under Section 852) of Security Number Card or Form SS-4, Application the Internal Revenue Code. for Employer Identification Number, at the local office of the Social Security Administration or o Payments described in Section 6049(b)(5) of the Internal Revenue Service and apply for a the Internal Revenue Code to non-resident number. aliens. PAYEES EXEMPT FROM BACKUP WITHHOLDING o Payments made by certain foreign organizations. Payees that may be exempted from backup withholding on all dividend and interest o Payments made to a nominee. payments and on broker transactions include the following: EXEMPT PAYEES DESCRIBED ABOVE SHOULD FILE THE TERMS SUBSTITUTE FORM W-9 TO AVOID POSSIBLE ERRONEOUS o A corporation. BACKUP WITHHOLDING. COMPLETE THE SUBSTITUTE FORM W-9 AS FOLLOWS: o A financial institution. ENTER YOUR TAXPAYER IDENTIFICATION NUMBER, WRITE o An organization exempt from tax under Section "EXEMPT" ACROSS THE FACE OF THE PERSHING LLC MARGIN AGREEMENTFORM, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD RETURN 501(a) of the Internal Revenue Code, or an THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS FORM TO THE RISKS ASSOCIATED WITH PAYER. individual retirement plan, or a custodial account under Section 403(b)(7) of the Internal Certain payments, other than payments of Revenue Code. interest, dividends, and patronage dividends, that are subject to information reporting are o The United States or any agency or also not subject to backup withholding. For instrumentality thereof. details, see Sections 6041, 6041A(a), 6042, 6044, 6045, 6049, 6050A and 6050N of the o A MARGIN ACCOUNTstate, the District of Columbia, a Internal Revenue Code and the regulations possession of the United States, or any thereunder. PLEASE NOTE THAT THIS AGREEMENT CONTAINS subdivision or instrumentality thereof. PRIVACY ACT NOTICE o An international organization or any agency or Section 6109 of the Internal Revenue Code instrumentality thereof. requires you to provide your correct taxpayer identification number to payers, who must report o A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IVforeign government, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS AGREEMENTa political subdivision the payments to the IRS. YOU ACKNOWLEDGE RECEIVING The IRS uses the number of a foreign government, or any agency or for identification purposes and may also provide instrumentality thereof. this information to various government agencies for tax enforcement or litigation purposes. o A COPY OF THIS AGREEMENTregistered dealer in securities or Payers must be given the numbers whether or not commodities registered in the United States or a recipients are required to file tax returns. By signing this Agreementpossession of the United States. Payers must generally withhold 30% of taxable interest, dividend, and certain other payments o A real estate investment trust. to a payee who does not furnish a taxpayer identification number to a payer. Certain o A common trust fund operated by a bank under penalties may also apply. Section 584(a) of the Internal Revenue Code. PENALTIES o An entity registered at all times during the (1) PENALTY FOR FAILURE TO FURNISH TAXPAYER tax year under the Investment Company Act of IDENTIFICATION NUMBER -- If you fail to furnish 1940. your correct taxpayer identification number to a payer, you affirm that are subject to a penalty of $50 for o A foreign central bank of issue. each such failure unless your failure is due to reasonable cause and not to willful neglect. o An exempt charitable remainder trust, or a (2) CIVIL PENALTY FOR FALSE INFORMATION WITH non-exempt trust described in Section 4947 of RESPECT TO WITHHOLDING -- If you make a false the Internal Revenue Code. statement with no reasonable basis which results in no imposition of backup withholding, you are Payments of full legal age dividends and patronage dividends subject to a penalty of $500. not generally subject to backup withholding (3) CRIMINAL PENALTY FOR FALSIFYING INFORMATION include the following: -- Willfully falsifying certifications or affirmations may subject you to criminal o Payments to nonresident aliens subject to penalties including fines and/or imprisonment. withholding under Section 1441 of the Internal (4) MISUSE OF TAXPAYER IDENTIFICATION NUMBERS -- Revenue Code. If the payer discloses or uses taxpayer identification numbers in violation of Federal o Payments to partnerships not engaged in a law, the payer may be subject to civil and trade or business in the state or jurisdiction United States and which criminal penalties. have at least one nonresident partner. FOR ADDITIONAL INFORMATION CONTACT YOUR TAX o Payments of patronage dividends where the CONSULTANT OR THE INTERNAL REVENUE SERVICE amounts received are not paid in which you reside and money. o Payments made by certain foreign organizations. o Payments made to a nominee. ------------------------------------------------------------------------------------------------------------------ GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 Guidelines for Determining the Proper Identification Number for the Payee (You) to Give the Payer -- Social Security numbers have nine digits separated by two hyphens: i.e. 000-00-0000, employer identification numbers have nine digits separated by only one hyphen: i.e. 00-0000000, the capacity table below will help determine the number to enter into this Agreementgive the payer. You further affirm that you have read, understood and agree to the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody Accounts-------------------------------------------------------

Certification instructions. You must cross out Item 2 item (2) above if you have been notified by the IRS that you are currently subject to backup withholding because of under-reporting interest or dividends on your tax return. However, if after being notified by the IRS that you have failed are subject to backup withholding, you received another notification from the IRS that you are no longer subject to backup withholding, do not cross out item (2). ------------------------------------------------------------------------------------------------------------------------- SIGNATURE DATE , 1998 -------------------------------------------------------------------- ---------------------- ------------------------------------------------------------------------------------------------------------------------- NOTE: FAILURE TO COMPLETE THIS FORM MAY RESULT IN BACKUP WITHHOLDING OF 31% OF ANY PAYMENTS MADE TO YOU. PLEASE REVIEW ENCLOSED GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 FOR ADDITIONAL DETAILS. 8 GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 WHAT IS BACKUP WITHHOLDING? -- Persons making certain payments to you are required to withhold and pay to IRS 31% of such payments under certain conditions. This is called "backup withholding." Payments that could be subject to backup withholding include interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee compensation, and certain payments from fishing boat operators, but do not include real estate transactions. If you give the requester your correct TIN, make the appropriate certifications, and report all your taxable interest and dividends on your tax return, your payments will not be subject to backup withholding. Payments you receive will be subject to backup withholding if: (1) You do not furnish your TIN to the requester, or (2) IRS notifies the requester that you furnished an incorrect TIN, or (3) You are notified by IRS that you are subject to backup withholding because you failed to report all your interest and dividends on your tax return (for interest and dividend accounts only), or (4) You fail to certify to the requester that you are not subject to backup withholding under (3) above (for interest and dividend accounts opened after 1983 only), or (5) You fail to certify your TIN. This applies only to interest, dividend, broker or barter exchange accounts opened after 1983, or broker accounts considered inactive in 1983. For mortgage interest paidother payments, acquisition you are subject to backup withholding only if (1) or abandonment of secured property(2) above applies. Certain Payees and payments are exempt from backup withholding and information reporting. See payees and Payments Exempt From Backup Withholding, cancellation of debt, contributions to an individual retirement arrangement (“IRA”)below, and generally, payments other than Exempt Payees and Payments under Specific Instructions below if you are an exempt payee. PAYEES AND PAYMENTS EXEMPT FROM BACKUP WITHHOLDING. -- The following is a list of payees exempt from backup withholding and for which no information reporting is required. For interest and dividends, you all listed payees are not required to sign the certificationexempt except item (9). For broker transactions, but you must provide your correct TIN. If you are an exempt payee payees listed in (if you are unsure, ask us for a complete set of IRS instructions1) through (13), enter your and a person registered under the Investment Advisers Act of 1940 who regularly acts as a broker are exempt. Payments subject to reporting under sections 6041 and 6041A are generally exempt payee code from backup withholding only if made to payees described in items (if any1) here: If you through (7), except that a corporation that provides medical and health care services or bills and collects payments for such services is not exempt from backup withholding or information reporting. Only payees described in items (2) through (6) are exempt from FATCA reporting (if you are unsurebackup withholding for barter exchange transactions, ask us for a complete set of IRS instructions)patronage dividends, enter your exemption from FATCA reporting code (if any) here: The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholding. BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS AGREEMENT. By signing this Agreement, you affirm that you are of full legal age in the state or jurisdiction in which you reside and have the capacity to enter into this Agreement. You further affirm that you have read, understood and agree to the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody Accountspayments by certain fishing boat operators.

Certification instructions. You must cross out Item item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For mortgage interest paidSignature: ________________________________ Date: ______________________ PLACE AN X IN ONE ELECTION BOX ONLY Ž ¨ All Cash Election Only  ¨ All Stock Election Only (SHARES ELECTED FOR CASH)  ¨ Cash and Stock Election ¨¨¨¨¨¨¨¨ l ¨¨¨¨ WHOLE SHARES FRACTIONS Note: Remaining shares are elected for stock. ‘ ¨ No Election If you cannot produce some or all of your First Mutual Bancshares, acquisition Inc. 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 abandonment request special mailing. ’ 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 Please Fill In Certificate No(s). if Known Number of secured propertyShares Attach separate schedule if needed By signing this Election and Transmittal Form, I/we or myself/ourselves swear, depose and state that: I/we or myself/ourselves am/are the lawful owner(s) of the certificate(s) representing shares of First Mutual common stock owned by the undersigned (the “Securities”). The Securities have not been endorsed, pledged, cashed, negotiated, transferred, assigned, or otherwise disposed of. I/We or myself/ourselves have made a diligent search for the securities and have been unable to find it or them and make this Affidavit for the purpose of inducing the sale, exchange, redemption, or cancellation of debtthe securities, contributions to an individual retirement arrangement (“IRA”as outlined in this Election and Transmittal Form, without the surrender of the original(s), and generallyalso to request and induce Federal Insurance Company to provide suretyship for me/us to cover the missing securities under its Blanket Bond # 8302-00-67. I/We or myself/ourselves hereby agree to surrender the Securities for cancellation should I/we or myself/ourselves, payments at any time, find the Securities. I/We or myself/ ourselves hereby agree for myself/ourselves, my/our heirs, successors, assigns and personal representatives, in consideration of the proceeds of the sale, exchange, redemption or cancellation of the Securities, and the aforementioned suretyship, to indemnify, protect and hold harmless Federal Insurance Company (the Surety), Mellon Investor Services LLC, Washington Federal, First Mutual, and each of their subsidiaries, successors and assigns from and against any and all loss, costs, and damages including court costs and attorney’s fees, which they may be subject to or liable for in respect to the sale, exchange, redemption, or cancellation of the Securities without requiring surrender of the original Securities. The rights accruing to the parties under the preceding sentence shall not be limited or abridged by their negligence, inadvertence, accident, oversight, breach or failure to inquire into, contest, or litigate any claim, whenever such negligence, inadvertence, accident, oversight, breach or failure may occur or may have occurred. I/We or myself/ourselves agree that this Affidavit and Indemnity Agreement is to become part of Blanket Bond # 8302-00-67 underwritten by Federal Insurance Company. Any person who, knowingly and with intent to defraud any insurance company or other than interest person, files an application or statement of claim, containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime, and dividendsshall also be subject to civil penalties as prescribed by law. X Signed by Affiant (stockholder) ______________________________________on this (date)_______________________________________________ (Deponent) (Indemnitor) (Heirs Individually) Month Day Year Social Security #___________________________ Date____________________ Notary Public_____________________________________ Lost Securities Surety Premium/Service Fee Calculation The following formula should be used to calculate the surety premium, you are not required to sign the certificationif any, but and service fee that you must provide your correct TIN. If you are an exempt payee (if you are unsure, ask us for a complete set of IRS instructions), enter your exempt payee code (if any) here: If you are exempt from FATCA reporting (if you are unsure, ask us for a complete set of IRS instructions), enter your exemption from FATCA reporting code (if any) here: The IRS does not require your consent to any provision of submit with this document other than the certifications required to avoid backup withholding. BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS AGREEMENT. By signing this Agreement, you affirm that you are of full legal age in the state or jurisdiction in which you reside and have the capacity to enter into this Agreement. You further affirm that you have read, understood and agree to the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody Accountsform.

Certification instructions. You must cross out Item item 2 above if you You have been notified by the IRS that you You are currently subject to backup withholding because you have failed to report all of underreporting interest and or dividends on your Your tax return. For mortgage interest paidMembership Application Agreement Whenever used in this Membership Application and Agreement, acquisition or abandonment the words "You" and "Your" refer to the Primary Accountholder and any Joint Owners named in this Membership Application and Agreement. The words "We," "Us" and "Our" mean the Xxxxx Xxxxxxx Federal Credit Union. You understand with Your signature on this Agreement You can establish other Credit Union ac counts and that Your signature constitutes a request for any identifying number and/or access device issued by the Xxxxx Xxxxxxx Federal Credit Union in connection with such accounts. If You are a joint owner, You understand that ownership of secured property, cancellation of debt, contributions to an individual retirement arrangement Account is subject to meeting membership eligibility requirements. You understand and agree that only those named in this Agreement are authorized t o initiate Wire Transfer Requests with the Xxxxx Xxxxxxx Federal Credit Union. Any such request will be made in accordance with Our underwrit ing guidelines for Wire Transfers. Signatures (“IRA”)Required) You hereby apply for membership in the Xxxxx Xxxxxxx Federal Credit Union. You, and generallyall joint owners, payments other than interest acknowledge receiving a copy of the Xxxxx Xxxxxxx Federal Credit Union Agreements and dividendsDisclosures and You agree to be bound by the terms and conditions found therein with respect to any products and/or services You are now requesting and with respect to those that You may request in the future. You further agree to be bound by the bylaws, you are not required rules and regulations of the Credit Union in effect from time to sign time. In addition to establishing a Share Savings Account with Us, You may also from time to time request additional Accounts and/or Account services be established on Your behalf and/or the certificationaddition of joint owner(s) of Your Account. Your signature below is Your continuing authorization for Us to follow Your written or verbal instructions to do so and You agree that Your continuing authorization will remain in effect unless We receive written instructions to the contrary. You hereby authorize Us to recognize any of the signatures subscribed below in the payment of funds or the transaction of any business for Your Account. You authorize Us to transfer funds from any Share Account You may have with Us in multiples necessary to clear any overdraft on any Share Draft Account You may have with Us, but you must provide your correct TINsubject to any fees related to such transfers. If you are an exempt payee (if you are unsureSubject to applicable laws and regulations, ask us You further authorize any person, association, firm, corporation, personnel office or credit reporting agency to furnish, upon Our request, information concerning Your employment, credit standing and financial responsibility. In addition to using this information to evaluate Your eligibility for a complete set membership, it may also be used to pre-determine Your possible eligibility for various Xxxxx Xxxxxxx Federal Credit Union credit products and services. You warrant the truth of IRS instructions), enter your exempt payee code (if any) here: If you are exempt from FATCA reporting (if you are unsure, ask us the information contained in Your application for a complete set of IRS instructions), enter your exemption from FATCA reporting code (if any) here: membership and/or subsequent representations to Us. You realize that such information will be relied upon by Us in determining Your membership eligibility and/or credit worthiness. The IRS Internal Revenue Service does not require your Your consent to any provision of this document other than the certifications required to avoid backup withholding. BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWOApplicant's (Primary Member) Signature Date Joint Owner #1 Signature Date Joint Owner #2 Signature Date For credit union use only: Qualifile (Primary Member) Qualifile (Joint Owner 1) Qualifile (Joint Owner 2) Agreements and Disclosures, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENTRate Supplement and Schedule of Fees and Charges given personally: Employee's Initials Date Agreements and Disclosures, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS AGREEMENT. By signing this Agreement, you affirm that you are Rate Supplement and Schedule of full legal age in the state Fees and Charges given by mail/ Electronically: Employee's Initials Date Employee ID or jurisdiction in which you reside and have the capacity to enter into this Agreement. You further affirm that you have read, understood and agree to the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name eligibility verified Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody AccountsVerified JHFCU Employee's Initials

Certification instructions. You must cross out Item 2 item (2) above if you have been notified by the IRS has notified you that you are currently subject to backup withholding because you have failed to wit report all interest and dividends on your tax returnr by the IRS that you were subject to backup with notification from the IRS that you were no long not cross out item (2). For mortgage interest paidhholding because you have failed to eturn. However, acquisition if after being notified holding you received another er subject to backup withholding, do Signature: Date: YOU SHOULD COMPLETE THE FOLLOWING CERTIFICATE IF YOU WROTE “APPLIED FOR” IN PART I OF THIS SUBSTITUTE FORM W-9 CERTIFICATE OF AWAITING TAXPAYER IDENTIFICATION NUMBER I certify under penalties of perjury that a taxpayer identification number has not been issued to me, and either (a) I have mailed or abandonment delivered an application to receive a taxpayer identification number to the appropriate Internal Revenue Service Center or Social Security Administration Office or (b) I intend to mail or deliver an application in the near future. I understand that, notwithstanding the information I provided in Part III of secured propertythe Substitute Form W-9 (and the fact that I have completed this Certificate of Awaiting Taxpayer Identification Number), cancellation of debtall reportable payments made to me thereafter will be subject to a 30% backup withholding tax until I provide a properly certified taxpayer identification number. Signature: ______________________________ Date: _________________________ , contributions 200 NOTE: FAILURE TO COMPLETE AND RETURN THE SUBSTITUTE FORM W-9 MAY RESULT IN BACKUP WITHHOLDING TAX OF 30% OF ANY PAYMENTS MADE TO YOU PURSUANT TO YOUR SUBSCRIPTION FOR COMMON STOCK. PLEASE REVIEW THE ENCLOSED GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 FOR ADDITIONAL DETAILS. 7 GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 Guidelines for Determining the Proper Identification Number to Give the Payer. The taxpayer identification number for an individual retirement arrangement (“IRA”)is the individual’s Social Security number. Social Security numbers have nine digits separated by two hyphens: e.g., 000-00-0000. The taxpayer identification number for an entity is the entity’s Employer Identification number. Employer Identification numbers have nine digits separated by only one hyphen: e.g., 00-0000000. The table below will help determine the number to give the payer. Give the NAME and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. If you are an exempt payee (if you are unsure, ask us for a complete set SOCIAL SECURITY For this type of IRS instructions), enter your exempt payee code (if any) hereaccount: If you are exempt from FATCA reporting (if you are unsure, ask us for a complete set of IRS instructions), enter your exemption from FATCA reporting code (if any) here: The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholding. BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS AGREEMENT. By signing this Agreement, you affirm that you are of full legal age in the state or jurisdiction in which you reside and have the capacity to enter into this Agreement. You further affirm that you have read, understood and agree to the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody Accountsnumber of—

Certification instructions. You must cross out Item 2 item (2) above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all of underreporting interest and or dividends on your tax return. For mortgage interest paidYou hereby make application for membership in the Truliant Federal Credit Union (herein “Credit Union”) and agree to conform to its laws, acquisition or abandonment of secured propertycharter, cancellation of debt, contributions to an individual retirement arrangement (“IRA”)bylaws, and generallyamendments and subscribe for at least one share. All account terms published by the Credit Union are incorporated herein by reference. You authorize the Credit Union to establish the account(s) and loan(s) (subject to approval) you have indicated on this application, payments other than interest and dividendsagree to the terms of those agreements. You certify that all information herein is true and complete. You authorize the Credit Union to verify or obtain further information concerning your credit standing. All joint owners agree that each is joint on all accounts requested herein unless indicated otherwise in the “Joint Owner(s) Initials” section below, you and all joint accounts are not required to sign the certification, but you must provide your correct TINjoint with rights of survivorship (see Account Terms for details). If you are an exempt payee this is a new account, please sign below and attach a copy of your driver’s license and $5.00 to activate your membership. COMPLETE THE SIGNATURE(S) BELOW TO ACTIVATE THE ACCOUNT. X Member Signature Date JOINT OWNER(S) INITIALS X Joint Owner Signature Date SV CK MM MP SM CC VC X Second Joint Owner Signature Date SV CK MM MP SM CC Record Your Personal Identification Number (if you are unsure, ask us PIN) for a complete set of IRS instructions), enter 24 hour phone access and your exempt payee code (if any) here: If you are exempt from FATCA reporting (if you are unsure, ask us for a complete set of IRS instructions), enter your exemption from FATCA reporting code (if any) here: Check/ATM Card MUST COMPLETE PAYROLL DEDUCTION AUTHORIZATION INFORMATION FOR CREDIT UNION USE ONLY Member # BEACON ID USED Membership Officer Signature BR # Initials New Card Update Card Company ID # Source Code Forms Mailed The IRS Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding. NAME MEMBER NO. (COMPLETED BY SIGNING CREDIT UNION) ADDRESS EMPLOYER CITY, STATE, ZIP ADDRESS I HEREBY AUTHORIZE MY EMPLOYER TO DEDUCT THE FOLLOWING AMOUNT FROM MY PAY EACH PAY PERIOD UNTIL FURTHER NOTICE FROM ME AND TRANSMIT SAME TO THE ABOVE NAMED CREDIT UNION. ROUTING TRANSIT # 000000000 TOTAL DEDUCTION $ THIS AGREEMENT YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY DEDUCTION TO BE LOANED TO PERSHING OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS AGREEMENT. By signing this Agreement, you affirm that you are of full legal age in the state or jurisdiction in which you reside and have the capacity to enter into this Agreement. You further affirm that you have read, understood and agree to the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature CREDITED AS FOLLOWS: SAVINGS ACCT # $ CHECKING ACCT # $ CHRISTMAS CLUB ACCT # $ OTHER ACCT # $ OTHER ACCT # $ X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody AccountsSIGNATURE SOCIAL SECURITY # DATE CREDIT UNION STAFF

Certification instructions. You must cross out check the box in Item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (“IRA”), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. If you are an exempt payee (if you are unsure, ask us for a complete set of IRS instructions), enter your exempt payee code (if any) here: _______________________ If you are exempt from FATCA reporting (if you are unsure, ask us for a complete set of IRS instructions), enter your exemption from FATCA reporting code (if any) here: _____________________________________ The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholding. BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING COR CLEARING, LLC OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS ACCOUNT APPLICATION AND AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS ACCOUNT APPLICATION AND AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS ACCOUNT APPLICATION AND AGREEMENT. By signing this Agreement, you affirm that you are of full legal age in the state or jurisdiction in which you reside and have the capacity to enter into this Agreement. You further affirm that you have read, understood and agree to the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody Accounts.

Certification instructions. You must cross out Item item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (“IRA”), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. If you are an exempt payee (if you are unsure, ask us for a complete set of IRS instructions), enter your exempt payee code (if any) here: If you are exempt from FATCA reporting (if you are unsure, ask us for a complete set of IRS instructions), enter your exemption from FATCA reporting code (if any) here: The IRS Internal Revenue Service does not require your consent to any provision of this document other than the above-referenced certifications required to avoid backup withholding. BY SIGNING THIS Sign Here Signature of U.S. person € Date€ M25312_0610 BMO222.004 P27.005 MUTUAL OF OMAHA INSURANCE COMPANY UNITED OF OMAHA LIFE INSURANCE COMPANY UNITED WORLD LIFE INSURANCE COMPANY REPRESENTATIVE AGREEMENT YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING OR LOANED OUT TO OTHERSMUTUAL OF OMAHA INSURANCE COMPANY UNITED OF OMAHA LIFE INSURANCE COMPANY UNITED WORLD LIFE INSURANCE COMPANY By: Name: Title: Vice President Customer Service Administration Date: Please do not complete this page. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS AGREEMENT. By signing this AgreementIf approved, you affirm that will receive an executed copy of this contract page. M25312_0610 BMO222.004 MUTUAL OF OMAHA INSURANCE COMPANY COMPANION LIFE INSURANCE COMPANY REPRESENTATIVE AGREEMENT MUTUAL OF OMAHA INSURANCE COMPANY COMPANION LIFE INSURANCE COMPANY By: Name: Title: Date: Please do not complete this page. If approved, you are will receive an executed copy of full legal age in this contract page. M25312_0610 BMO222.004 P27.005 CONFIDENTIALITY AND SECURITY AMENDMENT This Confidentiality and Security Amendment (this “Amendment”) is made part of and incorporated into the state Representative Agreement between Representative and Company (“Agreement”) and is effective on the later of March 1, 2010 or jurisdiction in which you reside and have the capacity to enter into this effective date of the Agreement. You further affirm that you have read, understood This Amendment revokes and agree to replaces in its entirety any prior Confidentiality and Privacy Amendment made a part of and incorporated into the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms To the extent any provisions of the Agreement conflict with or are inconsistent with any provisions of this Amendment, the provisions of this Amendment shall control. All other terms and Conditions conditions of Your Brokerage Custody Accountsthe Agreement not inconsistent with the terms of this Amendment shall remain in full force and effect.

Certification instructions. You must cross out Item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (“IRA”), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. If you are an exempt payee (if you are unsure, ask us for a complete set of IRS instructions), enter your exempt payee code (if any) here: If you are exempt from FATCA reporting (if you are unsure, ask us for a complete set of IRS instructions), enter your exemption from FATCA reporting code (if any) here: The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholding. BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING ADVISOR SOLUTIONS OR PERSHING OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS ACCOUNT APPLICATION AND AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IVIII, PARAGRAPHS Y AND Z ON PAGE 7 6 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS ACCOUNT APPLICATION AND AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS ACCOUNT APPLICATION AND AGREEMENT. By signing this Agreementagreement, you affirm that you are of full legal age in the state or of jurisdiction in which you reside and have the capacity to enter into this Agreementagreement. You further affirm that you have read, understood and agree to the Terms and Conditions attached to this Account Application and Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody AccountsCash and Xxxxxx Accounts PERSHING ADVISOR SOLUTIONS LLC Overview This document outlines the terms and conditions that apply to the Account Application and Agreement among you (collectively, the “Agreement”), Pershing LLC (“Pershing”), and Pershing Advisor Solutions LLC (“Pershing Advisor Solutions”).

Certification instructions. You must cross out Item item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (“IRA”), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. If you are an exempt payee (if you are unsure, ask us for a complete set of IRS instructions), enter your exempt payee code (if any) here: If you are exempt from FATCA reporting (if you are unsure, ask us for a complete set of IRS instructions), enter your exemption from FATCA reporting code (if any) here: return The IRS Internal Revenue Service does not require your consent to any provision provisions of this document other than the certifications required to avoid back-up withholding. Sign Here Signature of U.S. person u Date u YOU MUST COMPLETE THE FOLLOWING CERTIFICATION IF YOU ENTERED “APPLIED FOR” IN PART I OF SUBSTITUTE FORM W-9 CERTIFICATION OF AWAITING TAXPAYER IDENTIFICATION NUMBER I certify, under penalties of perjury, that a taxpayer identification number has not been issued to me, and either (a) I have mailed or delivered an application to receive a taxpayer identification number to the appropriate Internal Revenue Service Center or Social Security Administration Office, or (b) I intend to mail or deliver an application in the near future. I understand that I must provide a taxpayer identification number to the Exchange Agent within 60 days of submitting this Substitute Form W-9 and that I will be subject to backup withholding at the applicable rate on all reportable payments until I provide my taxpayer identification number to the Exchange Agent. I also understand that if I provide my taxpayer identification number to the Exchange Agent within 60 days, the Exchange Agent will refund any amounts backup withheld from reportable payments made during the 60-day period, and if I do not provide the Exchange Agent with my taxpayer identification number within the 60-day period, the Exchange Agent will remit such previously retained amounts to the IRS as backup withholding. BY SIGNING Signature Date NOTE: FAILURE TO COMPLETE AND RETURN THIS AGREEMENT SUBSTITUTE FORM W-9 MAY RESULT IN BACKUP WITHHOLDING AT A CURRENT RATE OF 28% ON ANY PAYMENT MADE TO YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED PURSUANT TO PERSHING OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS MERGER AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY GUIDELINES FOR CERTIFICATION OF THIS AGREEMENTTAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 Guidelines For Determining the Proper Identification Number to Give the Payer – Social Security Numbers (“SSNs”) have nine digits separated by two hyphens: i.e., 000-00-000. By signing Employer Identification Numbers (“EINs”) have nine digits separated by only one hyphen: i.e., 00-0000000. The table below will help determine the number to give the payer. For this Agreement, you affirm that you are type of full legal age in account: Give the state or jurisdiction in which you reside Name and have the capacity to enter into this Agreement. You further affirm that you have read, understood and agree to the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody AccountsSocial Security Number

Certification instructions. You must cross out Item 2 item (2) above if you have been notified by the IRS that you are currently subject to backup withholding. However, if after being notified by the IRS that you were subject to backup withholding because you have failed to report all interest and dividends on your tax return. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (“IRA”), and generally, payments other than interest and dividends, you are not required to sign received another notification from the certification, but you must provide your correct TIN. If you are an exempt payee (if you are unsure, ask us for a complete set of IRS instructions), enter your exempt payee code (if any) here: If you are exempt from FATCA reporting (if you are unsure, ask us for a complete set of IRS instructions), enter your exemption from FATCA reporting code (if any) here: The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholding. BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS AGREEMENT. By signing this Agreement, you affirm that you are no longer subject to backup withholding, do not cross out item (2). Signature Date ----------------------------------------- --------------------- IF YOU CHECKED THE BOX IN PART III OF THIS SUBSTITUTE FORM W-9, YOU MUST SIGN AND DATE THE FOLLOWING CERTIFICATION: CERTIFICATION OF PAYEE AWAITING TAXPAYER IDENTIFICATION NUMBER I certify, under penalties of full legal age perjury, that a Taxpayer Identification Number has not been issued to me, and that I mailed or delivered an application to receive a Taxpayer Identification Number to the appropriate IRS Center or Social Security Administration Office (or I intend to mail or deliver an application in the state near future). I understand that if I do not provide a Taxpayer Identification Number to the payer, 31% of all payments shall be withheld until I provide a Taxpayer Identification Number to the payer and that, if I do not provide my Taxpayer Identification Number within sixty (60) days, such retained amounts shall be remitted to the IRS as backup withholding and 31% of all reportable payments made to me thereafter will be withheld and remitted to the IRS until I provide a Taxpayer Identification Number. Signature Date ----------------------------------------- --------------------- ------------------------------------------------------------------------------- ------------------------------------------------ ----------------------------------------------------------------------- SUBSTITUTE Under penalties of perjury, I certify that: FORM W-8 DEPARTMENT OF THE TREASURY, [ ] For INTEREST PAYMENTS, I am not a U.S. citizen or jurisdiction in which you reside and have resident INTERNAL REVENUE SERVICE (or I am filing for a foreign corporation, partnership, estate or trust); CERTIFICATE OF FOREIGN HOLDERS WHO ARE INDIVIDUALS [ ] For DIVIDENDS, I am not a U.S. citizen or resident (or I am filing for a foreign corporation, partnership, estate or trust); AND [ ] For BROKER TRANSACTIONS or BARTER EXCHANGES, I am an exempt foreign person. ----------------------------------------------------------------------- Signature Date ----------------------------------------------------- ------------------------------------------------ Print Name ----------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------- NOTE: FAILURE TO COMPLETE AND RETURN THE SUBSTITUTE FORM W-9, OR, IF A FOREIGN PERSON, THE SUBSTITUTE FORM W-8, MAY RESULT IN BACKUP WITHHOLDING OF 31% OF ANY CASH PAYMENTS MADE TO YOU PURSUANT TO THE REORGANIZATION AGREEMENT. FOR ADDITIONAL DETAILS, PLEASE REVIEW SUPPLEMENTAL INSTRUCTIONS 11, 12 AND 13. ================================================================================ TAX BASIS INFORMATION Please provide the capacity to enter into this Agreement. You further affirm that total tax basis you have read, understood and agree to the Terms and Conditions attached in all Xxxxxx Shares delivered pursuant to this AgreementForm of Election or, if such information is maintained for you by Xxxxxxxxx & Xxxxxxxx, Ltd., please indicate below your authorization for Xxxxxxxxx & Xxxxxxxx, Ltd. to provide tax basis information to McClatchy Newspapers, Inc. (Tax basis information provided herein will have no effect upon your election to receive stock and/or cash). Account Holder/Trustee/Corporate Officer Total tax basis in all Xxxxxx Shares delivered pursuant to this Form of Election: ---------------------------------------------------------------------- I hereby authorize Xxxxxxxxx & Xxxxxxxx, Ltd. to provide tax basis information respecting my Xxxxxx Shares to McClatchy Newspapers, Inc. ----------------------------------------- Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody Accounts================================================================================ SUPPLEMENTAL INSTRUCTIONS TO FORM OF ELECTION

Certification instructions. You must cross out Item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (“IRA”), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. If you are an exempt payee (if you are unsure, ask us for a complete set of IRS instructions), enter your exempt payee code (if any) here: If you are exempt from FATCA reporting (if you are unsure, ask us for a complete set of IRS instructions), enter your exemption from FATCA reporting code (if any) here: The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholding. BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS AGREEMENT. By signing this Agreement, you affirm that you are of full legal age in the state or jurisdiction in which you reside and have the capacity to enter into this Agreement. You further affirm that you have read, understood and agree to the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody AccountsAccounts PERSHING ADVISOR SOLUTIONS LLC

Certification instructions. You must cross out Item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (“IRA”), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. If you are an exempt payee (if you are unsure, ask us for a complete set of IRS instructions), enter your exempt payee code (if any) here: _______________________ If you are exempt from FATCA reporting (if you are unsure, ask us for a complete set of IRS instructions), enter your exemption from FATCA reporting code (if any) here: _____________________________________ The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholding. BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING COR CLEARING, LLC OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS ACCOUNT APPLICATION AND AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS ACCOUNT APPLICATION AND AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS ACCOUNT APPLICATION AND AGREEMENT. By signing this Agreement, you affirm that you are of full legal age in the state or jurisdiction in which you reside and have the capacity to enter into this Agreement. You further affirm that you have read, understood and agree to the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody Accounts.

Certification instructions. You must cross out Item item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (“IRA”), and generally, payments other than interest and dividends, you are not required to sign the certificationCertification, but you must provide your correct TIN. C152008 TYPE NAME OF AUTHORIZED AGENT: DATE: XXXXXX MUST ELECTRONICALLY COMPLETE AND SIGN THIS DOCUMENT PRIOR TO BID Please be aware that typing in your password acts as your electronic signature, which is just as legal and binding as an original signature . (See Electronic Signatures in Global and National Commerce Act for more information.) *************VENDOR REGISTRATION FORM************* INSTRUCTIONS: Please mark all that apply to you or your company. dbcef bdcef dbcef dbcef Sole Proprietor/Individual Owned Partnership Limited Liability Company (LLC) Lawyer/Attorney bdecf bdcef bdecf bdecf Medical Provider Corporation Non - Profit (Per IRS 501C3 Regs) Government bdcef dbecf bdcef bdcef New Vendor One- Time Vendor Address Change Federal Tax ID Number Change PURCHASE ORDER ADDRESS: PAYMENT REMITTANCE ADDRESS: NAME (AS SHOWN ON YOUR INCOME TAX RETURN) BUSINESS NAME, IF DIFFERENT FROM ABOVE: STREET OR PO BOX CITY, STATE, ZIP CONTACT PERSON: E- MAIL ADDRESS: TELEPHONE NUMBER: FAX NUMBER NAME (AS SHOWN ON YOUR INCOME TAX RETURN) BUSINESS NAME, IF DIFFERENT FROM ABOVE: STREET OR PO BOX CITY, STATE, ZIP CONTACT PERSON: E- MAIL ADDRESS: TELEPHONE NUMBER: FAX NUMBER Any vendor who accepts payment confirms the following: the invoice is true and correct; the work, service or materials as shown by the invoice or claim have been completed or supplied in accordance with the plans, specifications, orders or requests furnished the vendor; and the vendor has made no payment, directly or indirectly, to any elected official, officer or employee of this City, of money or any other thing of value to obtain payment 62 O.S. § 310.9 and 74 O.S. § 3109. City of Oklahoma City and its Trusts Bid OCPPA 152000 Do you wish to receive payments by electronic funds transfer? bdcef Yes dbecf No If you checked Yes on the above question and are an exempt payee selected for contract award, you will be contacted by a Procurement Services staff member to obtain banking information. I certify that the information supplied herein is correct and that neither the applicant nor any person (if you are unsureor concern) in any connection with the applicant as a principal or officer is now debarred or otherwise declared ineligible by a public agency for bidding or furnishing materials, ask us for a complete set of IRS instructions)supplies or services, enter your exempt payee code (if any) here: If you are exempt from FATCA reporting (if you are unsure, ask us for a complete set of IRS instructions), enter your exemption from FATCA reporting code (if any) here: The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholdingpublic agency thereof. BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION NOTE: Article IV, PARAGRAPHS Y Section 11 of the City Charter prohibits employees of the City from having a proprietary interest in City Contracts §11- 8 - 113. Type Name of Authorized Agent Date C152008 Title XXXXXX MUST ELECTRONICALLY COMPLETE AND Z ON PAGE SIGN THIS DOCUMENT PRIOR TO SUBMITTING INTO THE ELECTRONIC BID SYSTEM Please be aware that typing in your password acts as your electronic signature, which is just as legal and binding as an original signature. (See Electronic Signatures in Global and National Commerce Act for more information.) The City of City of Oklahoma City and its Trusts Bid OCPPA 152000 OKLAHOMA CITY and its Trusts ELECTRONIC BID PACKET CLUB CAR GOLF CAR PARTS, REPLACEMENT PARTS AND FACTORY AUTHORIZED SERVICES TABLE OF CONTENTS NOTICE TO BIDDERS 1 GENERAL INSTRUCTION AND REQUIREMENTS FOR BIDDERS 2 OKLAHOMA OPEN RECORDS ACT AND CONFIDENTIAL INFORMATION 4 BID SPECIFICATIONS 5 INTENT 6 SCOPE OF PRICING AGREEMENT/CONTRACT 6 SUBSTITUTE OFFERS 6 CONTRACTING ENTITY 6 PRICING AGREEMENT/CONTRACT PERIOD 6 PRICING AGREEMENT/CONTRACT RENEWAL OPTION 6 DELIVERY 7 INSPECTION AND ACCEPTANCE AT DESTINATION 7 F.O.B. DESTINATION 7 COMMERCIAL PACKAGING 7 ESTIMATED ANNUAL REQUIREMENTS (NO GUARANTEE) 7 ORDER OF THE TERMS AND CONDITIONS ACCOMPANYING THIS AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY PRECEDENCE 8 PAYMENT METHODS 8 PAYMENT/INVOICE 8 WARRANTY 9 GENERAL PROVISIONS 10 MATERIAL SAFETY DATA SHEETS 10 OTHER PROVISIONS 11 TECHNICAL SPECIFICATIONS 12 LETTER OF THIS AGREEMENT. By signing this Agreement, you affirm that you are AUTHORIZATION 14 C152008 C152008 City of full legal age Oklahoma City and its Trusts Bid OCPPA 152000 (Published in the state or jurisdiction in which you reside Journal Record March 19, 2014 and have the capacity to enter into this Agreement. You further affirm that you have readMarch 26, understood and agree to the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody Accounts2014)

Certification instructions. You must cross out Item 2 item (2) above if you have been notified by the IRS that you are currently subject to backup withholding because of under-reporting interest or dividends on your tax return. However, if after being notified by the IRS that you have failed are subject to backup withholding, you received another notification from the IRS that you are no longer subject to backup withholding, do not cross out item (2). ----------------------------------------------------------------------------------------------------------------------------- SIGNATURE DATE , 1998 --------------------------------------------------------------------- ------------------------------- NOTE: FAILURE TO COMPLETE THIS FORM MAY RESULT IN BACKUP WITHHOLDING OF 31% OF ANY PAYMENTS MADE TO YOU. PLEASE REVIEW ENCLOSED GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 FOR ADDITIONAL DETAILS. GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 WHAT IS BACKUP WITHHOLDING? -- Persons making certain payments to you are required to withhold and pay to IRS 31% of such payments under certain conditions. This is called "backup withholding." Payments that could be subject to backup withholding include interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee compensation, and certain payments from fishing boat operators, but do not include real estate transactions. If you give the requester your correct TIN, make the appropriate certifications, and report all your taxable interest and dividends on your tax return, your payments will not be subject to backup withholding. Payments you receive will be subject to backup withholding if: (1) You do not furnish your TIN to the requester, or (2) IRS notifies the requester that you furnished an incorrect TIN, or (3) You are notified by IRS that you are subject to backup withholding because you failed to report all your interest and dividends on your tax return (for interest and dividend accounts only), or (4) You fail to certify to the requester that you are not subject to backup withholding under (3) above (for interest and dividend accounts opened after 1983 only), or (5) You fail to certify your TIN. This applies only to interest, dividend, broker or barter exchange accounts opened after 1983, or broker accounts considered inactive in 1983. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (“IRA”), and generally, payments other than interest and dividendspayments, you are not required subject to sign the certificationbackup withholding only if (1) or (2) above applies. Certain Payees and payments are exempt from backup withholding and information reporting. See payees and Payments Exempt From Backup Withholding, but you must provide your correct TIN. If below, and Exempt Payees and Payments under Specific Instructions below if you are an exempt payee (if you are unsure, ask us for a complete set of IRS instructions), enter your exempt payee code (if any) here: If you are exempt from FATCA reporting (if you are unsure, ask us for a complete set of IRS instructions), enter your exemption from FATCA reporting code (if any) here: The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholding. BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS AGREEMENT. By signing this Agreement, you affirm that you are of full legal age in the state or jurisdiction in which you reside and have the capacity to enter into this Agreement. You further affirm that you have read, understood and agree to the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody Accountspayee.

Certification instructions. You must cross out Item item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (“IRA”), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. If you are an exempt payee (if you are unsure, ask us for a complete set of IRS instructions), enter your exempt payee code (if any) here: If you are exempt from FATCA reporting (if you are unsure, ask us for a complete set of IRS instructions), enter your exemption from FATCA reporting code (if any) here: The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholding. BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID Signature of Subscriber/Representative Subscriber Authorized Signatory X Date Signature of Co-Subscriber #1 (if necessary) X Date Name (Print) of Subscriber/Representative Subscriber Authorized Signatory Name (Print) of Subscriber/Representative Subscriber Authorized Signatory Capacity (Print) of Subscriber/Representative Subscriber Authorized Signatory (if necessary) Capacity (Print) of Subscriber/Representative Subscriber Authorized Signatory (if necessary) Signature of Co-Subscriber #2 (if necessary) X Date Name (Print) of Subscriber/Representative Subscriber Authorized Signatory Capacity (Print) of Subscriber/Representative Subscriber Authorized Signatory (if necessary) SIGNATURE OF YOUR FINANCIAL ADVISOR (REQUIRED FOR MAY BE LOANED TO PERSHING OR LOANED OUT TO OTHERSENTITY SUBSCRIBERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS AGREEMENT. By signing this Agreement, you affirm that (If you are an IRA, your Financial Advisor does not need to sign below) Signature of full legal age Financial Advisor X Date Name (Print) of Signatory Title (Print) of Signatory (MUST BE SIGNED BY CUSTODIAN OR TRUSTEE IF PLAN IS ADMINISTERED BY A THIRD PARTY) Supporting Document Requirements Please provide the following supporting documentation based on your account type. Individual If a non-US person, Form W-8BEN and Passport or National ID Joint (including JTWROS, Tenants in Common, Community Property) For each non-US Person account holder, Form W-8BEN and Passport or National ID IRA (including XXXX, SEP, Rollover, Inherited) None Pension Plan (Non-ERISA) Plan documents Trust Certificate of Trust or Declaration of Trust Appropriate Form W-8 (see xxxxx://xxx.xxx.xxx/forms-pubs/about-form-w-8) Estate Letters of testamentary or letters of administration dated within 60 days unless accompanies by a medallion signature guarantee Corporation (including C Corporation, S Corporation, LLC) Formation documents Articles of incorporation or operating agreement Authorized signatory list Appropriate Form W-8 (see xxxxx://xxx.xxx.xxx/forms-pubs/about-form-w-8) If the state entity is a fund (mutual fund, private equity fund, hedge fund), provide the prospectus or jurisdiction in which you reside and have offering memorandum Partnership Formation documents Partnership agreement Authorized signatory list Appropriate Form W-8 (see xxxxx://xxx.xxx.xxx/forms-pubs/about-form-w-8) If the capacity to enter into this Agreement. You further affirm that you have readentity is a fund (mutual fund, understood and agree to private equity fund, hedge fund), provide the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody Accountsprospectus or offering memorandum Annex A PART A: FOR ALL SUBSCRIBERS

Certification instructions. You must cross out Item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (“IRA”), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. If you are an exempt payee (if you are unsure, ask us for a complete set of IRS instructionsplease consult your tax professional), enter your exempt payee code (if any) here: If you are exempt from FATCA reporting (if you are unsure, ask us for a complete set of IRS instructionsplease consult your tax professional), enter your exemption from FATCA reporting code (if any) here: The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholding. BY SIGNING THIS AGREEMENT AGREEMENT, YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING AXOS CLEARING LLC OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS ACCOUNT APPLICATION AND AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS ACCOUNT APPLICATION AND AGREEMENT, WHICH GOVERNS DISPUTES YOU MAY HAVE WITH AXOS CLEARING LLC. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS ACCOUNT APPLICATION AND AGREEMENT. By signing this AgreementSHOULD YOU HAVE A DISPUTE WITH YOUR ADVISOR, you affirm that you are of full legal age in the state or jurisdiction in which you reside and have the capacity to enter into this Agreement. You further affirm that you have read, understood and agree to the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody AccountsPLEASE REFER TO THE TERMS AND CONDITIONS OF YOUR AGREEMENT WITH YOUR ADVISOR TO DETERMINE HOW IT REQUIRES RESOLUTION OF ANY SUCH DISPUTES.

Certification instructions. You must cross out Item 2 item (2) above if you have been notified by the IRS that you are currently subject to backup withholding because of under-reporting interest or dividends on your tax return. However, if after being notified by the IRS that you have failed are subject to backup withholding, you received another notification from the IRS that you are no longer subject to backup withholding, do not cross out item (2). ------------------------------------------------------------------------------- SIGNATURE ____________________________ DATE ____________ , 1998 ------------------------------------------------------------------------------- NOTE: FAILURE TO COMPLETE THIS FORM MAY RESULT IN BACKUP WITHHOLDING OF 31% OF ANY PAYMENTS MADE TO YOU. PLEASE REVIEW ENCLOSED GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 FOR ADDITIONAL DETAILS. GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 WHAT IS BACKUP WITHHOLDING? -- Persons making certain payments to you are required to withhold and pay to IRS 31% of such payments under certain conditions. This is called "backup withholding." Payments that could be subject to backup withholding include interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee compensation, and certain payments from fishing boat operators, but do not include real estate transactions. If you give the requester your correct TIN, make the appropriate certifications, and report all your taxable interest and dividends on your tax return, your payments will not be subject to backup withholding. Payments you receive will be subject to backup withholding if: (1) You do not furnish your TIN to the requester, or (2) IRS notifies the requester that you furnished an incorrect TIN, or (3) You are notified by IRS that you are subject to backup withholding because you failed to report all your interest and dividends on your tax return (for interest and dividend accounts only), or (4) You fail to certify to the requester that you are not subject to backup withholding under (3) above (for interest and dividend accounts opened after 1983 only), or (5) You fail to certify your TIN. This applies only to interest, dividend, broker or barter exchange accounts opened after 1983, or broker accounts considered inactive in 1983. For mortgage interest paidother payments, acquisition you are subject to backup withholding only if (1) or abandonment of secured property(2) above applies. Certain Payees and payments are exempt from backup withholding and information reporting. See payees and Payments Exempt From Backup Withholding, cancellation of debt, contributions to an individual retirement arrangement (“IRA”)below, and generally, payments other than Exempt Payees and Payments under Specific Instructions below if you are an exempt payee. PAYEES AND PAYMENTS EXEMPT FROM BACKUP WITHHOLDING. -- The following is a list of payees exempt from backup withholding and for which no information reporting is required. For interest and dividends, you all listed payees are not required to sign the certificationexempt except item (9). For broker transactions, but you must provide your correct TIN. If you are an exempt payee payees listed in (if you are unsure, ask us for a complete set of IRS instructions1) through (13), enter your and a person registered under the Investment Advisers Act of 1940 who regularly acts as a broker are exempt. Payments subject to reporting under sections 6041 and 6041A are generally exempt payee code from backup withholding only if made to payees described in items (if any1) here: If you through (7), except that a corporation that provides medical and health care services or bills and collects payments for such services is not exempt from backup withholding or information reporting. Only payees described in items (2) through (6) are exempt from FATCA reporting (if you are unsurebackup withholding for barter exchange transactions, ask us for a complete set of IRS instructions)patronage dividends, enter your exemption from FATCA reporting code (if any) here: The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholding. BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS AGREEMENT. By signing this Agreement, you affirm that you are of full legal age in the state or jurisdiction in which you reside and have the capacity to enter into this Agreement. You further affirm that you have read, understood and agree to the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody Accountspayments by certain fishing boat operators.

Certification instructions. You must cross out Item item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (“IRA”XXX), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. If you are an exempt payee (if you are unsureFor further certification and exemption instructions on form W-9, ask us for a complete set of IRS instructions), enter go to xxxxx://xxx.xxx.xxx/forms-instructions. Social Security Number _ _ Employer Identification Number _ or Enter your exempt payee code (if any) here: If you are exempt from FATCA reporting (if you are unsure, ask us for a complete set of IRS instructions), enter your exemption from FATCA reporting code (if any) here: TIN in the appropriate box above. The IRS does not require your consent to any provision of this document other than TIN provided must match the certifications required name given below to avoid backup withholding. BY SIGNING For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity see the W-9 instructions. Also, if the account is in more than one name see the W-9 instructions. Name (As shown on your income tax return) Business Name or disregarded entity name (if different from above) Check appropriate box for federal tax classification Individual/Sole Proprietor/ or single member LLC C Corporation S Corporation Partnership Trust/Estate Limited Liability Company. Enter the Tax Classification below (C = C Corporation, S = S Corporation, P= Partnership) Exemptions (See W-9 Instructions) Exempt Payee Code(if any) FATCA Exemption Reporting Code (For a single-member LLC that is disregarded, do not check LLC; check the appropriate box in the line above.) Other (See Instructions) > Xxxxxxx (Xxxxxx, Xxxxxx, xxx xxx xx xxxxx xx.) Xxxx, Xxxxx and ZIP Code Requestor’s Name and Address (Optional) _ _ List Account Number(s) here (optional) THE INTERNAL REVENUE SERVICE DOES NOT REQUIRE YOUR CONSENT TO ANY PROVISIONS OF THIS AGREEMENT YOU DOCUMENT OTHER THAN THE CERTIFICATIONS TO AVOID BACKUP WITHHOLDING. I HEREBY ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS RECEIPT OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS CUSTOMER AGREEMENT, CONTAINING A PREDISPUTE ARBITRATION CLAUSE IN PARAGRAPH 64 ON PAGE 8. By signing this Agreement, you affirm that you are of full legal age in the state or jurisdiction in which you reside and have the capacity to enter into this Agreement. You further affirm that you have read, understood and agree to the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature Print Name (Additional Signatory) Print Name (Additional Signatory) Title (if applicable) Print Name Title (if applicable) Title (if applicable) Signature Signature Signature Date — — Signature X Terms Date Date Industrial & Commercial Bank of China Financial Services, LLC. 0000 Xxxxxxxx, 00xx Xxxxx Xxx Xxxx, XX 00000 Straight Through Processing CLEARANCE > CUSTODY > FINANCING CREDIT INTEREST POLICY Interest Period. Monthly interest is computed from the first calendar day through the last calendar day of each month. Interest will be pro- cessed to your account on the last business day of each month with the accrual through to the last calendar day the month. Interest is com- puted for each period on the basis of a 360-day year. Credit Balances. Interest is computed based on the actual net average daily free credit balance in your Account, beginning with the day the credit balance occurs. Funds must be received by 4:30pm Eastern Standard or Daylight Savings time and Conditions of Your Brokerage Custody Accountsdeposited into your account in order to be considered for same day interest computations. For security Sale transactions, interest will start accruing on settlement date providing the shares being sold are held or received in negotiable form.

Certification instructions. You must cross Cross out Item item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (“IRA”), Cross out item 3 and generally, payments other than interest and dividends, complete a W-8 BEN if you are not required a U.S. person. ACKNOWLEDGMENTS Credit Report Authorization: By signing below you authorize the credit For Credit Requests: By signing below you acknowledge that you have union to sign check your employment and credit history and to obtain credit received and agree to the certificationterms and conditions contained in the reports in connection with any request for membership or credit, but including LOANLINER Credit and Security Agreement including the Addendum, any update, increase, renewal, extension or collection of credit you must provide your correct TINdisclosures and information related to voluntary payment protection and receive. If you are an exempt payee (if request, the credit union will tell you the name and address to any amendments that may be made to any of these documents from of any credit bureau from which it received a credit report on you. The time to time; and you grant the credit union a security interest in all share credit union will rely on information you have provided. By signing below and/or deposit accounts that you own now and in the future to secure you affirm that all information on this document or that has been provided what you owe under the LOANLINER Credit and Security Agreement. elsewhere is correct. When you are unsurein default, ask us for a complete set of IRS instructions)you authorize the credit union to apply the For Account and/or Account Service Requests: By signing below you balance in these accounts to any amounts due. Shares and deposits in an acknowledge that you have received and agree to the terms and Individual Retirement Account, enter and any other account that would lose conditions contained in the Membership and Account Agreement, Truth in special tax treatment under state or federal law if given as security, are Savings Disclosure, Funds Availability Policy Disclosure, Electronic Funds not subject to the security interest you have given in your exempt payee code (if any) here: If you are exempt shares and Transfer Agreement and Disclosure and Privacy Notice and to any deposits. amendments to these documents that the credit union may make from FATCA reporting (if you are unsure, ask us for a complete set of IRS instructions), enter your exemption from FATCA reporting code (if any) here: time to time. The IRS Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding. BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID X X SIGNATURE DATE SIGNATURE DATE X X SIGNATURE DATE SIGNATURE DATE ENROLLMENT/APPLICATION AND SCHEDULE FOR MAY BE LOANED TO PERSHING OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWOVOLUNTARY PAYMENT PROTECTION CMFG Life Insurance Company Madison, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS AGREEMENT. By signing this Agreement, you affirm that you are of full legal age in the state or jurisdiction in which you reside and have the capacity to enter into this Agreement. You further affirm that you have read, understood and agree to the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody AccountsWI 00000-0000 Phone: 800/000-0000

Certification instructions. You must cross out Item item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition acquisi- tion or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (“IRA”), IRS) and generally, payments other than interest and dividends, you are not required to sign the certificationCertification, but you must provide your correct TIN. If you are an exempt payee (if you are unsure, ask us See the instructions.) ce y ha am o ega age he age o ma o y o he s a e n wh ch es de have ca e u y ead he e ms and cond ons on he back o h s App ca on and Ag eemen he 4L e Po c es and P ocedu es and he I certify that I am of legal age (the age of majority) for a complete set of IRS instructions), enter your exempt payee code (if any) here: If you are exempt from FATCA reporting (if you are unsure, ask us for a complete set of IRS instructions), enter your exemption from FATCA reporting code (if any) here: The IRS does not require your consent to any provision the state in which I reside. I have carefully read the terms and conditions on the back of this document other than the certifications required to avoid backup withholding. BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS AGREEMENT. By signing this Application and Agreement, you affirm that you are of full legal age in the state or jurisdiction in which you reside 4Life Policies and Procedures and the Compensa on P an and ag ee o ab de by a e ms se o h n hese documen s Add ona y ag ee ha have the capacity to enter into this Agreement. You further affirm that you have read, understood comp e ed he W 9 Reques o Taxpaye den ca on Numbe and Ce ca on hones y and o 4Life Compensation Plan and agree to abide by all terms set forth in these documents. Additionally, I agree that I have completed the W-9 Request for Taxpayer Identification Number and Certification honestly and to the best of my knowledge. I hereby confirm that my signing of this application does not violate any other agreements or contracts to which I am a party. A PARTICIPANT IN THIS MULTILEVEL MARKETING PLAN HAS A RIGHT TO CANCEL AT ANY TIME, REGARDLESS OF REASON. CANCELLATION MUST BE SUBMITTED IN WRITING TO THE COMPANY AT ITS PRINCIPAL PLACE OF BUSINESS WITHIN 3 BUSINESS DAYS AFTER THE DATE OF THIS TRANSACTION. Applicant’s Signature Date Co-Applicant’s Signature Date Please mail or fax your completed Application and Agreement to 4Life to finalize the distributor enrollment process. If your Application and Agreement is not received within 30 days of enrollment, your Distributorship shall automatically be converted to a Customer status and you will no longer be eligible for bonuses or commissions. *This information can only be changed within 10 days of enrollment without receiving upline approval. 050305 Item#8052 Terms and & Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody Accountson reverse side White - 4Life Yellow - Applicant Pink - Sponsor

Certification instructions. You must cross out Item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (“IRA”), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. If you are an exempt payee (if you are unsure, ask us for a complete set of IRS instructions), enter your exempt payee code (if any) here: If you are exempt from FATCA reporting (if you are unsure, ask us for a complete set of IRS instructions), enter your exemption from FATCA reporting code (if any) here: The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholding. BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS AGREEMENT. By signing this Agreement, you affirm that you are of full legal age in the state or jurisdiction in which you reside and have the capacity to enter into this Agreement. You further affirm that you have read, understood and agree to the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody AccountsPERSHING ADVISOR SOLUTIONS LLC

Certification instructions. You must cross out Item item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (“IRA”), and generally, payments other than interest and dividends, you are not required to sign the certificationCertification, but you must provide your correct TIN. TYPE NAME OF AUTHORIZED AGENT: DATE: XXXXXX MUST ELECTRONICALLY COMPLETE AND SIGN THIS DOCUMENT PRIOR TO BID 4 Please be aware that typing in your password acts as your electronic signature, which is just as legal and binding as an original signature . (See Electronic Signatures in Global and National Commerce Act for more information.) *************VENDOR REGISTRATION FORM************* INSTRUCTIONS: Please mark all that apply to you or your company. bdecf bdecf dbcef bdecf Sole Proprietor/Individual Owned Partnership Limited Liability Company (LLC) Lawyer/Attorney bdcef bdecf dbecf bdcef Medical Provider Corporation Non - Profit (Per IRS 501C3 Regs) Government dbecf bdcef dbecf bdcef New Vendor One- Time Vendor Address Change Federal Tax ID Number Change PURCHASE ORDER ADDRESS: PAYMENT REMITTANCE ADDRESS: NAME (AS SHOWN ON YOUR INCOME TAX RETURN) BUSINESS NAME, IF DIFFERENT FROM ABOVE: STREET OR PO BOX CITY, STATE, ZIP CONTACT PERSON: E- MAIL ADDRESS: TELEPHONE NUMBER: FAX NUMBER NAME (AS SHOWN ON YOUR INCOME TAX RETURN) BUSINESS NAME, IF DIFFERENT FROM ABOVE: STREET OR PO BOX CITY, STATE, ZIP CONTACT PERSON: E- MAIL ADDRESS: TELEPHONE NUMBER: FAX NUMBER Any vendor who accepts payment confirms the following: the invoice is true and correct; the work, service or materials as shown by the invoice or claim have been completed or supplied in accordance with the plans, specifications, orders or requests furnished the vendor; and the vendor has made no payment, directly or indirectly, to any elected official, officer or employee of this City, of money or any other thing of value to obtain payment 62 O.S. § 310.9 and 74 O.S. § 3109. Do you wish to receive payments by electronic funds transfer? bdcef Yes dbecf No If you checked Yes on the above question and are an exempt payee selected for contract award, you will be contacted by a Procurement Services staff member to obtain banking information. I certify that the information supplied herein is correct and that neither the applicant nor any person (if you are unsureor concern) in any connection with the applicant as a principal or officer is now debarred or otherwise declared ineligible by a public agency for bidding or furnishing materials, ask us for a complete set of IRS instructions)supplies or services, enter your exempt payee code (if any) here: If you are exempt from FATCA reporting (if you are unsure, ask us for a complete set of IRS instructions), enter your exemption from FATCA reporting code (if any) here: The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholdingpublic agency thereof. BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION NOTE: Article IV, PARAGRAPHS Y Section 11 of the City Charter prohibits employees of the City from having a proprietary interest in City Contracts §11- 8 - 113. 1 Type Name of Authorized Agent Date 5 Title 2 XXXXXX MUST ELECTRONICALLY COMPLETE AND Z ON PAGE SIGN THIS DOCUMENT PRIOR TO SUBMITTING INTO THE ELECTRONIC BID SYSTEM Please be aware that typing in your password acts as your electronic signature, which is just as legal and binding as an original signature. (See Electronic Signatures in Global and National Commerce Act for more information.) The City of OKLAHOMA CITY and its Trusts ELECTRONIC BID PACKET C AGRICULTURAL CHEMICALS, FERTILIZERS, SUPPLIES, BLENDS AND SOIL TABLE OF CONTENTS 5 NOTICE TO BIDDERS 1 GENERAL INSTRUCTION AND REQUIREMENTS FOR BIDDERS 2 OKLAHOMA OPEN RECORDS ACT AND CONFIDENTIAL INFORMATION 4 BID SPECIFICATIONS 5 INTENT 6 SCOPE OF PRICING AGREEMENT/CONTRACT 6 SUBSTITUTE OFFERS 6 CONTRACTING ENTITY 6 PRICING AGREEMENT/CONTRACT PERIOD 6 PRICING AGREEMENT/CONTRACT RENEWAL OPTION 6 DELIVERY. 7 INSPECTION AND ACCEPTANCE AT DESTINATION 7 F.O.B. DESTINATION 7 COMMERCIAL PACKAGING 7 ESTIMATED ANNUAL REQUIREMENTS (NO GUARANTEE) 7 ORDER OF THE TERMS AND CONDITIONS ACCOMPANYING THIS AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY PRECEDENCE 8 PAYMENT METHODS 8 PAYMENT/INVOICE 8 WARRANTY 9 GENERAL PROVISIONS 10 MATERIAL SAFETY DATA SHEETS 10 OTHER PROVISIONS 11 TECHNICAL SPECIFICATIONS 13 LETTER OF THIS AGREEMENT. By signing this Agreement, you affirm that you are of full legal age AUTHORIZATION 15 (Published in the state or jurisdiction in which you reside and have the capacity to enter into this Agreement. You further affirm that you have readJournal Record March 26, understood and agree to the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable2014 ) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody AccountsC

Certification instructions. You must cross out Item 2 item (2) above if you have been notified by the IRS that you are currently subject to backup withholding because of under-reporting interest or dividends on your tax return. However, if after being notified by the IRS that you have failed are subject to backup withholding, you received another notification from the IRS that you are no longer subject to backup withholding, do not cross out item (2). ----------------------------------------------------------------------------------------------------------------------------- SIGNATURE__________________________________________________ DATE________________________, 1998 ----------------------------------------------------------------------------------------------------------------------------- NOTE: FAILURE TO COMPLETE THIS FORM MAY RESULT IN BACKUP WITHHOLDING OF 31% OF ANY PAYMENTS MADE TO YOU. PLEASE REVIEW ENCLOSED GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 FOR ADDITIONAL DETAILS. 8 GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 WHAT IS BACKUP WITHHOLDING? -- Persons making certain payments to you are required to withhold and pay to IRS 31% of such payments under certain conditions. This is called "backup withholding." Payments that could be subject to backup withholding include interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee compensation, and certain payments from fishing boat operators, but do not include real estate transactions. If you give the requester your correct TIN, make the appropriate certifications, and report all your taxable interest and dividends on your tax return, your payments will not be subject to backup withholding. Payments you receive will be subject to backup withholding if: (1) You do not furnish your TIN to the requester, or (2) IRS notifies the requester that you furnished an incorrect TIN, or (3) You are notified by IRS that you are subject to backup withholding because you failed to report all your interest and dividends on your tax return (for interest and dividend accounts only), or (4) You fail to certify to the requester that you are not subject to backup withholding under (3) above (for interest and dividend accounts opened after 1983 only), or (5) You fail to certify your TIN. This applies only to interest, dividend, broker or barter exchange accounts opened after 1983, or broker accounts considered inactive in 1983. For mortgage interest paidother payments, acquisition you are subject to backup withholding only if (1) or abandonment of secured property(2) above applies. Certain Payees and payments are exempt from backup withholding and information reporting. See payees and Payments Exempt From Backup Withholding, cancellation of debt, contributions to an individual retirement arrangement (“IRA”)below, and generally, payments other than Exempt Payees and Payments under Specific Instructions below if you are an exempt payee. PAYEES AND PAYMENTS EXEMPT FROM BACKUP WITHHOLDING. -- The following is a list of payees exempt from backup withholding and for which no information reporting is required. For interest and dividends, you all listed payees are not required to sign the certificationexempt except item (9). For broker transactions, but you must provide your correct TIN. If you are an exempt payee payees listed in (if you are unsure, ask us for a complete set of IRS instructions1) through (13), enter your and a person registered under the Investment Advisers Act of 1940 who regularly acts as a broker are exempt. Payments subject to reporting under sections 6041 and 6041A are generally exempt payee code from backup withholding only if made to payees described in items (if any1) here: If you through (7), except that a corporation that provides medical and health care services or bills and collects payments for such services is not exempt from backup withholding or information reporting. Only payees described in items (2) through (6) are exempt from FATCA reporting (if you are unsurebackup withholding for barter exchange transactions, ask us for a complete set of IRS instructions)patronage dividends, enter your exemption from FATCA reporting code (if any) here: The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholding. BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT SECURITIES NOT FULLY PAID FOR MAY BE LOANED TO PERSHING OR LOANED OUT TO OTHERS. IF YOU OR YOUR REPRESENTATIVE CHECKED THE MARGIN BOX ON PAGE TWO, YOU ACCEPT THE TERMS OF THE PERSHING LLC MARGIN AGREEMENT, AND ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THE MARGIN DISCLOSURE STATEMENT WHICH DETAILS THE RISKS ASSOCIATED WITH A MARGIN ACCOUNT. PLEASE NOTE THAT THIS AGREEMENT CONTAINS A PREDISPUTE ARBITRATION AGREEMENT IN SECTION IV, PARAGRAPHS Y AND Z ON PAGE 7 OF THE TERMS AND CONDITIONS ACCOMPANYING THIS AGREEMENT. YOU ACKNOWLEDGE RECEIVING A COPY OF THIS AGREEMENT. By signing this Agreement, you affirm that you are of full legal age in the state or jurisdiction in which you reside and have the capacity to enter into this Agreement. You further affirm that you have read, understood and agree to the Terms and Conditions attached to this Agreement. Account Holder/Trustee/Corporate Officer Signature Print Name Date — — Signature X Joint Account Holder/Trustee Signature (if applicable) Print Name Date — — Signature X Terms and Conditions of Your Brokerage Custody Accountspayments by certain fishing boat operators.