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�� • <br /> M, y985-P86 <br /> Date Tax <br /> Opened: 04/22/1994 Term: 12 Months ID:521-60-5697 Number: 400290 <br /> CERTIFICATE OF DEPOSIT COPY AND <br /> -CERTIFICATE OF DEPOSIT SIGNATURE CARD Account Number: 350007899 <br /> Dollar <br /> Amount of <br /> Deposit: Fifteen Thousand One Dollars And No Cents $15,001.00 <br /> This Time Deposit is Issued to: Issuer: FIRST SOUTHWEST BANK <br /> GARY C BOYCE <br /> RANCHO ROSADO <br /> ASSIGNED TO ST OF COLMLRB 2060 E Highway 112 <br /> 1313 SHERMAN ST RM 215 Center CO 81125, <br /> : DENVER, CO 80203 <br /> • <br /> Not Negotiable-Not Transferable -Additional terms are below. By <br /> Additional Terms and Disclosures <br /> This form contains the terms for your time deposit. It is also the Minimum Balance Requirement: You must make a minimum deposit to <br /> Truth-in-Savings disclosure for those depositors entitled to one. There <br /> are additional terms and disclosures on page two of this form, some of open this account of$ 1,000.00 <br /> which <br /> ormplain or expand on those below. You should keep one copy of <br /> this ® You must maintain this minimum balance on a daily basis to earn the <br /> Maturity Date:This account matures 04/22/2014 annual percentage yield disclosed. <br /> (See below for renewal information.) Withdrawals of Interest: Interest ❑ accrued ® credited during a <br /> Rate Information: The interest rate for this account is .25% term can be withdrawn: <br /> with an annual percentage yield of .2504%. This rate will be <br /> paid until the maturity date specified above. Interest begins to accrue on Early Withdrawal Penalty: If we consent to a request for a withdrawal <br /> 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 <br /> Interest will be compounded daily . penalty will be an amount equal to: one(1)month <br /> Interest will be credited Monthly <br /> . interest on the amount withdrawn. <br /> IN The annual percentage yield assumes that interest remains on deposit Renewal Policy: <br /> until maturity. A withdrawal of interest will reduce earnings. ❑ Single Maturity: If checked, this account will not automatically <br /> ❑ If you close your account before interest is credited, you will not renew. Interest ❑ will ❑ will not accrue after maturity. <br /> receive the accrued interest. ® Automatic Renewal: If checked, this account will automatically <br /> The NUMBER OF ENDORSEMENTS needed for withdrawal or any renew on the maturity date. (see page two for terms) <br /> other purpose is: one(1) . Interest ® will El will not accrue after final maturity. <br /> ACCOUNT OWNERSHIP: (select one and initial) <br /> tie Single Party Account 42:7____ <br /> TIN: 521-60-5697 <br /> ❑ Multiple Party Account Social Security or Employer's I.D. Number: Under <br /> Trust -Separate Agreement dated:72 <br /> penalties of perjury I certify that the above number is my <br /> correc xpayer Identification Number. <br /> • <br /> Rights at Death:(select one and initial) X �;, DATF�f�'0 4( 29�/P <br /> © Single Party Account BA.; reit ho 'i,. -Under penalties of er'dr I ti <br /> ❑ Multiple Party Account with Right of Survivorship that I am . .. . person (including a U.S. resident alien) <br /> and that I am not subject to backup withholding, either <br /> ❑ Multiple Party Account without Right of Survivorship because I have not been notified that cam subject to backup <br /> ❑ Single Party Account with Pay on Death withhol.'ng as a result of a failure to report all interest or <br /> divideA or ti• nternal Revenue Service has notified me <br /> ❑ Multiple Party Account with Right of Survivorship and Pay on Death that MT..• on!, subject to backup withholding. <br /> Pay On Death Beneficiaries: To add Pay On Death Beneficiaries' X DATE t 4 <br /> name one or more: Z 'Y <br /> RECEIVEDSIGN S:I AGREE TOT •S S DON PAGE ONE AND PAGE WO. <br /> X � <br /> MAR 'O14 x <br /> � DIVISION OF 7,ECLAMATIC)N_ X <br /> Ec ? ©1993 Bankes Systems,Inc.,o ICloud*oa E(-LAZ-CO(2) 11/1/2011 READ PAGE TWO FOR ADDITIONAL TERMS (page 1 of 2) <br />