2018-08-03_REVISION - M1997039 (6)

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Date Tax M I g a l "l Opened: 07/28/2003 ' Term: 12 Months ID:84-1188469 Number: 3910 Certificate of Deposit Account Number: 3910 Dollar Amount of 40,000.00 Deposit: FORTY THOUSAND DOLLARS AND 00 CENTS $ This Time Deposit is Issued to: Issuer: Mountain valley Bank — CO Walden, CO ` WYATT REDI MIX COMPANY ASSIGNED TO STATE OF COLORADO, MLRB 461 Main St 1313 SHERMAN ST P.O. Box 758 DENVER,CO 80203-2236 Walden,CO 80480-0758 PDPA# 010004005101 Not Negotiable -Not Transferable -Additional terms are below. &kau� Additional Terms and Disclosures This form contains the terms for your time deposit. It is also the Minimum Balance Requirement: You must make a minimum deposit to Truth-in-Savings disclosure for those depositors entitled to one. There are additional terms and disclosures on page two of this form, some of open this account of$ which explain or expand on those below. You should keep one copy of this form. ® you must maintain this minimum balance on a daily basis to earn the Maturity Date: This account matures 0 7/2 8/2 015 annual percentage yield disclosed. (See below for renewal information.) Withdrawals of Interest: Interest ® accrued ® credited during a Rate Information: The interest rate for this account is .6 5 0 0% term can be withdrawn: If interest credited is with an annual percentage yield of 0.65 %. This rate will be removed during current term — no penalty paid until the maturity date specified above. Interest begins to accrue on Early Withdrawal Penalty: If we consent to a request for a withdrawal the business day you deposit any noncash item(for example, a check). that is otherwise not permitted you may have to pay a penalty. The Interest will be compounded . penalty will bean amount equal to: 90 days Interest will be credited by transfer to Acct# 103283 Monthly interest on the amount withdrawn. ® The annual percentage yield assumes that interest remains on deposit Renewal Policy: until maturity. A withdrawal of interest will reduce earnings. ❑ Single Maturity: If checked, this account will not automatically ❑ If you close your account before interest is credited, you will not renew. Interest ❑ will ❑ will not accrue after maturity. receive the accrued interest. ® Automatic Renewal: If checked, this account will automatically The NUMBER OF ENDORSEMENTS needed for withdrawal or any renew on the maturity date. (see page two for terms) other purpose is: Interest ® will ❑ will not accrue after final maturity. ACCOUNT OWNERSHIP: (select one and initial) ❑ Single Party Account TIN: 8 4—118 8 4 6 9 ❑ Multiple Party Account Social Security or Employer's I.D. Number: A correct taxpayer identification number is required for almost El Trust-Separate Agreement dated: PV k4 K) f�6 every type of account. A certification of this number is also required and is contained on the first copy of this Rights at Death: (select one and initial) certificate. ❑ Single Party Account Backup Withholding - A certification that you are not ❑ Multiple Pa Account with Right of Survivorship subject to backup withholding is necessary for almost all P Party t P ❑ Multiple Par Account without Right of Survivorship accounts (except for persons who are exempt altogether). P Party � P This certification is contained on the first copy of this ❑ Single Party Account with Pay on Death form. Failure to provide this certification when required ❑ Multiple Party Account with Right of Survivorship and Pay on Death will cause us to withhold a percentage of the interest earned (for payments to the IRS). Providing a false Pay On Death Beneficiaries: To add Pay On Death Beneficiaries' certification can result in serious federal penalties. name one or more: ENDO=IIDi AAII�YOU REQUEST WITHDRAWAL X - x `7TiZA/..',S F&< UPtc x ® 01993 Bankers Systems,Inc.,St.Cloud,MN Form CO-AA•LAZ-CO(1) 11/1/2011 READ PAGE TWO FOR ADDITIONAL TERMS (page 1 of 2)