Common use of Form of Ownership Clause in Contracts

Form of Ownership. Check the appropriate box (one only) to indicate form of ownership. If the subscriber is a Custodian, Corporation, Partnership or Trust, please provide the additional information requested. o Individual o Joint Tenants with Right of Survivorship (Both signatures must appear on page 6.) o Corporation, Limited Liability Company or Partnership (Corporate Resolutions, Operating Agreement or Partnership Agreement must be enclosed.) o Trust Trustee’s Name: _________________________________________ Trust Date: _____________________________________________ o Other: Provide detailed information in the space immediately below. _________________________________________________________ _________________________________________________________

Form of Ownership. Check the appropriate box (one only) to indicate form of ownership. If the subscriber is a Custodian, Corporation, Partnership or Trust, please provide the additional information requested. o [ ] Individual o [ ] Joint Tenants with Right of Survivorship (Both signatures must appear on page 6.in Item 7) o Corporation, Limited Liability Company [ ] Corporation or Partnership (Corporate Resolutions, Operating Agreement Resolutions or Partnership Agreement must be enclosed.) o [ ] ▇▇▇ [ ] ▇▇▇▇▇ [ ] Pension or Profit Sharing Plan [ ] Trust Trustee’s 's Name: __________________________________________ Trust Date: ______________________________________________ o [ ] Other: Provide detailed information in the space immediately below. _________________________________________________________ _________________________________________________________.

Form of Ownership. Check the appropriate box (one only) to indicate form of ownership. If the subscriber is a Custodian, Corporation, Partnership or Trust, please provide the additional information requested. o / / Individual o / / Joint Tenants with Right of Survivorship (Both signatures must appear on page Page 6.) o / / Corporation, Limited Liability Company or Partnership (Corporate Resolutions, Operating Agreement or Partnership Agreement must be enclosed.) o / / Trust Trustee’s 's Name: :__________________________________________ Trust Date: :______________________________________________ o / / Other: Provide detailed information in the space immediately below. ____________________________________________________________ ____________________________________________________________ ____________________________________________________________

Form of Ownership. Check the appropriate box (one only) to indicate form of ownership. If the subscriber is a Custodian, Corporation, Partnership or Trust, please provide the additional information requested. o (__) Individual o (__) Joint Tenants with Right of Survivorship (Both signatures must appear on page 6.in Item 7) o Corporation, Limited Liability Company (__) Corporation or Partnership (Corporate Resolutions, Operating Agreement Resolutions or Partnership Agreement must be enclosed.) o (__) ▇▇▇ (__) ▇▇▇▇▇ (__) Pension or Profit Sharing Plan (__) Trust Trustee’s 's Name: __________________________________________ Trust Date: ______________________________________________ o (__) Other: Provide detailed information in the space immediately below. _________________________________________________________ _________________________________________________________.

Form of Ownership. Check the appropriate box (one only) to indicate form of ownership. If the subscriber is a Custodian, Corporation, Partnership or Trust, please provide the additional information requested. o Individual o Joint Tenants with Right of Survivorship (Both signatures must appear on page 6Page 8.) o Corporation, Limited Liability Company or Partnership (Corporate Resolutions, Operating Agreement or Partnership Agreement must be enclosed.) o Trust Trustee’s Name: __________________________________________ Trust Date: ______________________________________________ o Other: Provide detailed information in the space immediately below. __________________________________________________________ __________________________________________________________ __________________________________________________________

Form of Ownership. Check the appropriate box (one only) to indicate form of ownership. If the subscriber is a Custodian, Corporation, Partnership or Trust, please provide the additional information requested. o Individual o Joint Tenants with Right of Survivorship (Both signatures must appear on page 67.) o Corporation, Limited Liability Company or Partnership (Corporate Resolutions, Operating Agreement or Partnership Agreement must be enclosed.) o Trust Trustee’s Name: _________________________________________ Trust Date: _____________________________________________ o Other: Provide detailed information in the space immediately below. _________________________________________________________ _________________________________________________________

Form of Ownership. Check the appropriate box (one only) to indicate form of ownership. If the subscriber is a Custodian, Corporation, Partnership or Trust, please provide the additional information requested. o / / Individual o / / Joint Tenants with Right of Survivorship (Both signatures must appear on page 6.below) o Corporation, Limited Liability Company / / Corporation or Partnership (Corporate Resolutions, Operating Agreement Resolutions or Partnership Agreement must be enclosed.) o / / ▇▇▇ / / ▇▇▇▇▇ / / Pension or Profit Sharing Plan / / Trust Trustee’s 's Name: _________________________________________ Trust Date: ______________________________________________ o / / Other: Provide detailed information in the space immediately below. _________________________________________________________ _________________________________________________________.

Form of Ownership. Check the appropriate box (one only) to indicate form of ownership. If the subscriber is a Custodian, Corporation, Partnership or Trust, please provide the additional information requested. o / / Individual o / / Joint Tenants with Right of Survivorship (Both signatures must appear on page 6.in Item 7) o Corporation, Limited Liability Company / / Corporation or Partnership (Corporate Resolutions, Operating Agreement Resolutions or Partnership Agreement must be enclosed.) o / / ▇▇▇ / / ▇▇▇▇▇ / / Pension or Profit Sharing Plan / / Trust Trustee’s 's Name: _________________________________________________ Trust Date: _____________________________________________________ o / / Other: Provide detailed information in the space immediately below. _________________________________________________________ _________________________________________________________.

Form of Ownership. Check the appropriate box (one only) to indicate form of ownership. If the subscriber is a Custodian, Corporation, Partnership or Trust, please provide the additional information requested. o Individual o Joint Tenants with Right of Survivorship (Both signatures must appear on page 6.) o Corporation, Limited Liability Company or Partnership (Corporate Resolutions, Operating Agreement or Partnership Agreement must be enclosed.) o Trust Trustee’s Name: __________________________________________ Trust Date: ______________________________________________ o Other: Provide detailed information in the space immediately below. _________________________________________________________ _________________________________________________________

Form of Ownership. Check the appropriate box (one only) to indicate form of ownership. If the subscriber is a Custodian, Corporation, Partnership or Trust, please provide the additional information requested. o / / Individual o / / Joint Tenants with Right of Survivorship (Both signatures must appear on page 6.below) o Corporation, Limited Liability Company / / Corporation or Partnership (Corporate Resolutions, Operating Agreement Resolutions or Partnership Agreement must be enclosed.) o / / ▇▇▇ / / ▇▇▇▇▇ / / Pension or Profit Sharing Plan / / Trust Trustee’s 's Name: _________________________________________ Trust Date: _____________________________________________ o / / Other: Provide detailed information in the space immediately below. _________________________________________________________ _________________________________________________________.

Form of Ownership. Check the appropriate box (one only) to indicate form of ownership. If the subscriber is a Custodian, Corporation, Partnership or Trust, please provide the additional information requested. o Individual o Joint Tenants with Right of Survivorship (Both signatures must appear on page 6.) o Corporation, Limited Liability Company or Partnership (Corporate Resolutions, Operating Agreement or Partnership Agreement must be enclosed.) o Trust Trustee’s Name: ______________________________________________________________ Trust Date: __________________________________________________________________ o Other: Provide detailed information in the space immediately below. ______________________________________________________________________________ ______________________________________________________________________________

Form of Ownership. Check the appropriate box (one only) to indicate form of ownership. If the subscriber is a Custodian, Corporation, Partnership or Trust, please provide the additional information requested. o / / Individual o / / Joint Tenants with Right of Survivorship (Both signatures must appear on page 6.in Item 7) o Corporation, Limited Liability Company / / Corporation or Partnership (Corporate Resolutions, Operating Agreement Resolutions or Partnership Agreement must be enclosed.) o / / ▇▇▇ / / ▇▇▇▇▇ / / Pension or Profit Sharing Plan / / Trust Trustee’s 's Name: _________________________________________ Trust Date: _____________________________________________ o / / Other: Provide detailed information in the space immediately below. _________________________________________________________ _________________________________________________________.

Form of Ownership. Check the appropriate box (one only) to indicate form of ownership. If the subscriber is a Custodian, Corporation, Partnership or Trust, please provide the additional information requested. o [ ] Individual o [ ] Joint Tenants with Right of Survivorship (Both signatures must appear on page Page 6.) o [ ] Corporation, Limited Liability Company or Partnership (Corporate Resolutions, Operating Agreement or Partnership Agreement must be enclosed.) o [ ] Trust Trustee’s 's Name: _________________________________________ Trust Date: _____________________________________________ o [ ] Other: Provide detailed information in the space immediately below. _____________________________________________________________ _____________________________________________________________ _____________________________________________________________

Form of Ownership. Check the appropriate box (one only) to indicate form of ownership. If the subscriber is a Custodian, Corporation, Partnership or Trust, please provide the additional information requested. o Individual o Joint Tenants with Right of Survivorship (Both signatures must appear on page 67.) o Corporation, Limited Liability Company or Partnership (Corporate Resolutions, Operating Agreement or Partnership Agreement must be enclosed.) o Trust Trustee’s Name: _________________________________________ Trust Date: _____________________________________________ o ¨ Other: Provide detailed information in the space immediately below. _________________________________________________________ _________________________________________________________

Form of Ownership. Check the appropriate box (one only) to indicate form of ownership. If the subscriber is a Custodian, Corporation, Partnership or Trust, please provide the additional information requested. o [ ] Individual o [ ] Joint Tenants with Right of Survivorship (Both signatures must appear on page Page 6.) o [ ] Corporation, Limited Liability Company or Partnership (Corporate Resolutions, Operating Agreement or Partnership Agreement must be enclosed.) o [ ] Trust Trustee’s 's Name: _________________________________________ Trust Date: _____________________________________________ o [ ] Other: Provide detailed information in the space immediately below. ______________________________________________________________ ______________________________________________________________ ______________________________________________________________

Form of Ownership. Check the appropriate box (one only) to indicate form of ownership. If the subscriber is a Custodian, Corporation, Partnership or Trust, please provide the additional information requested. o / / Individual o / / Joint Tenants with Right of Survivorship (Both signatures must appear on page 6.below) o Corporation, Limited Liability Company / / Corporation or Partnership (Corporate Resolutions, Operating Agreement Resolutions or Partnership Agreement must be enclosed.) o / / ▇▇▇ / / ▇▇▇▇▇ / / Pension or Profit Sharing Plan / / Trust Trustee’s 's Name: _________________________________________________ Trust Date: _________________________________________________ o / / Other: Provide detailed information in the space immediately below. _________________________________________________________ _________________________________________________________.

Form of Ownership. Check the appropriate box (one only) to indicate form of ownership. If the subscriber is a Custodian, Corporation, Partnership or Trust, please provide the additional information requested. o / / Individual o / / Joint Tenants with Right of Survivorship (Both signatures must appear on page 6.in Item 7) o Corporation, Limited Liability Company / / Corporation or Partnership (Corporate Resolutions, Operating Agreement Resolutions or Partnership Agreement must be enclosed.) o / / IRA / / ▇▇▇▇▇ / / Pension or Profit Sharing Plan / / Trust Trustee’s 's Name: _________________________________________ Trust Date: _____________________________________________ o / / Other: Provide detailed information in the space immediately below. _________________________________________________________ _________________________________________________________.

Form of Ownership. Check the appropriate box (one only) to indicate form of ownership. If the subscriber is a Custodian, Corporation, Partnership or Trust, please provide the additional information requested. o Individual o Joint Tenants with Right of Survivorship (Both signatures must appear on page Page 6.) o Corporation, Limited Liability Company or Partnership (Corporate Resolutions, Operating Agreement or Partnership Agreement must be enclosed.) o Trust Trustee’s Name: __________________________________________ Trust Date: ______________________________________________ o Other: Provide detailed information in the space immediately below. __________________________________________________________ __________________________________________________________ __________________________________________________________

Form of Ownership. Check the appropriate box (one only) to indicate form of ownership. If the subscriber is a Custodian, Corporation, Partnership or Trust, please provide the additional information requested. o [ ] Individual o [ ] Joint Tenants with Right of Survivorship (Both signatures must appear on page Page 6.) o [ ] Corporation, Limited Liability Company or Partnership (Corporate Resolutions, Operating Agreement or Partnership Agreement must be enclosed.) o [ ] Trust Trustee’s 's Name: _________________________________________ ----------------------------------------------- Trust Date: _____________________________________________ o --------------------------------------------------- [ ] Other: Provide detailed information in the space immediately below. _________________________________________________________ _________________________________________________________------------------------------------------------------------------ ------------------------------------------------------------------ ------------------------------------------------------------------

Form of Ownership. Check the appropriate box (one only) to indicate form of ownership. If the subscriber is a Custodian, Corporation, Partnership or Trust, please provide the additional information requested. o / / Individual o / / Joint Tenants with Right of Survivorship (Both signatures must appear on page 6.in Item 7) o Corporation, Limited Liability Company / / Corporation or Partnership (Corporate Resolutions, Operating Agreement Resolutions or Partnership Agreement must be enclosed.) o / / ▇▇▇ / / ▇▇▇▇▇ / / Pension or Profit Sharing Plan / / Trust Trustee’s 's Name: __________________________________________ Trust Date: ______________________________________________ o / / Other: Provide detailed information in the space immediately below. _________________________________________________________ _________________________________________________________.

Form of Ownership. Check the appropriate box (one only) to indicate form of ownership. If the subscriber is a Custodian, Corporation, Partnership or Trust, please provide the additional information requested. o Individual o Joint Tenants with Right of Survivorship (Both signatures must appear on page 65.) o x Corporation, Limited Liability Company or Partnership (Corporate Resolutions, Operating Agreement or Partnership Agreement must be enclosed.) o ¨ Trust Trustee’s Name: :_________________________________________ Trust Date: _____________________________________________ o Trust Date:______________________________________________________ ¨ Other: Provide detailed information in the space immediately below. _______________________________________________________________ _______________________________________________________________