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<br />----------------------------------------------------------------------------------~---------------- <br /> <br /> <br />PO !Io.n..I08EauGotf. <br />C.....da.CoI..,IlI04I..........0 <br />P,OB.....o7.UIS.M.I.. 0 <br />U..Uy.c..lo,H10.,............. <br />P,O.lIo.IOI9,nO!;,M.I.. 0 <br />1........r'.olo.810S2........... <br />P,OB...S2.IOSOM'h.. 0 <br />Sl'n"gfl.dd.Cnlo 11I07J........ <br />TI!R~:>;JJlQUS^NO_DOI.l"^RS.ANUJm/IOO---.~ <br />PAYABLE TO _^RK^NS^~LGRQU~~W^Tf~lt.J.ISt:RS......AC.cO.ClATJ.ON <br />ADDRess 100 WEST 1ST ST .P.D.BOX 7~ MANZANOLA. CO 81058-0007 <br /> <br />he ~l",O NQ, INIEIlfS n IN t~(S Pl,ll fREOUiNCY <br />L8Io-1268595 _ ~..~l_ I S~>H-^NNU^L <br />XX_AUTOMATIC RENEWAl. alNOLI! MATURITY <br />..ll FIXED RATE. The deposit evidenCed by thIs Cenificale will earn an annual Interest r6fltCJll %. <br />- VARIABLE RATE. The deposit evidenced by this Cerlillcate will earn an Interest rate based on the indelllndicated belOw <br />as adjusted by the Irequency indlcaled as "Adjustment Frequency". <br />Initlallnlerest Rale "I. Adjustment FreQuency FlrSI Adjuslment Dale <br />INDEX _ ~ _Plus _MinulI a margin 01 'I. <br />EARLY WITHDRAWAL f6NALTY ---2LDAYS_DLlNTEREST <br />Grace Perjod days. II this Is an automatically renewable certificate which Is withdrawn during the grac8 period the intereal Tate <br />lor lhe grace period wltl be eA. ~d2 <br />PAYMENT REQUESTED: METHOD OF PAYMENT: ..// /. . ~ /1 ____. /./ ^--- <br />o DEPOStT '~HAE$T TO ACCOUNT NO. n "'AtLt~HAESTCl-IECK ...f..L-[..t. "-1 ..ft..\...L- (;...-<77[. l..U <br />AOD1NHRESTTO PAt~CtPAL (AUTI1OAtZEO alONATUAEI <br /> <br />05-915384-24 <br /> <br />CEATlfl1S DEPOSITlD SUM Of <br /> <br />t./I .e <br />Celerade Ea.t <br />BANK & TRUST <br /> <br />, _:), OOg._ 00 <br /> <br />CERTIFICATE OF DEPOSIT <br /> <br />PERSONAL <br />o Individual <br />o Joint - With Survivorship <br />o Trust Account <br />B Sublecl 10 Separale Agreement Dated <br /> SUbject to Terms on this form. Benellclarleanamed below. <br />o Payable.On.Death. Benellclartes named below. <br />BUSINESS <br />OPartnefshtp o CorporatiOn <br />0 NON-PROfo'IT <br />o AulhOltlahon Daled <br />o Numbllrof Signatures rellulfed lcr wlthdl4twal or ot.hfIf purpose. 2 <br />N..me & Address 01 Benellclarles 01 frustor Ply-on-Del'hAccounts <br /> <br />N~ 36932 <br /> <br />MemberfDlC <br />TEAM _ONILn:A~ <br /> <br />----- DOLLARS <br /> <br />MIEOF <br /> <br />IolA'UlUN <br /> <br />.MGU~ Illl'llSllfll <br /> <br />11O/)1~8 <br /> <br /> <br />lOOt!! 1 <br /> <br />$..1.000.00 <br /> <br />NOncE: TERMS ANO COtIOITIOOII ON IIEVI!IIN' 5100 <br /> <br />I ha'i! te.1d and undernand IhfllernlSandCOftdMIOnsassel lorth abave and on the reverse side.lllhisisi <br />consu~account.la~eOgetecetPICllanActountlftSClosulftollltSaccounlbYSlgntngbtllow <br />X - C. . ~ ~ b- 'J-q 1 <br /> <br /> <br />X<-- <br />o BACKUP; ITHHOLDING - Utlder PenalllfS of Perjury I C1111ity lhall am nol subjecllo B.1:ckup <br />WllnrKll ng, elllWll because I have nol been r\(Illtie(l Ihat lam subjett tob.1ck wllnholdmg ua resullol <br />a lallure tll report all inlerest or dlvllfends. or the Internal Revtlnue Service nasnottliedmelhatlltl\no <br />Ion!lsrsubtecl10 backupwllhhollfmg. <br />o EXEMPT RECIPIENTS - Under Penallies 01 Perjury I C1U1t1y lhal r am an bempl RecipIent under <br />lhe law Qll\'erntOby Income Ta. RegtllatlOns 31 34S2lc), l{bllhrough (P). <br />o NONRESIDENT ALIENS - Under PenalHes of Perjury I certlly that I am not a citizen nor resident <br />otltleUnttedSlales. <br />o NOTICE: Soclal SecUtily or Employer's I,D. Number "Under Penally ot Perjury" I C&rttly lhalllle <br />SOc. Sec. Number shown aoo...e is my corrltCt TilJ:payer Idenllllcalion NumbllL <br />X <br /> <br />Endorsements lSign when requesting Wtlhdrawal) <br />X <br />X <br />X <br /> <br />"to <br />"to <br />"to <br />