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2008-12-01_REVISION - M1995030 (5)
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2008-12-01_REVISION - M1995030 (5)
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Last modified
6/16/2021 2:10:21 PM
Creation date
12/4/2008 1:36:45 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1995030
IBM Index Class Name
REVISION
Doc Date
12/1/2008
Doc Name
SO Approval
From
DRMS
To
Green Brothers, Inc.
Type & Sequence
SO1
Email Name
MET
Media Type
D
Archive
No
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ate <br />Opened: 06/08/2000 Term: 60 <br />Certificate of Deposit <br />Amount of <br />Account Number: <br />332083 <br />4350005261 <br />Deposit: Four thousand Eight hundred 0/100 * * * * $ 4,800.00 <br />This Time Deposit is Issued to: Issuer: <br />GREEN BROTHERS INC COMMUNITY FIRST NATIONAL BANK <br />ASSIGNED TO STATE OF COLORADO 120 E KIOWA AVE <br />MLRB FORT MORGAN CO 80701 <br />1313 SHERMAN ST STE 215 970-867-8281 <br />DENVER CO 80203-2243 <br />Not Negotiable - Not Transferable - Additional terms are below. B <br />,? PLEDGED TO STATE OF COLORADO/MLRB DPA11010004005101 <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 $ 500.00 <br />which explain or expand on those below. You should keep one copy of <br />this form. ® You must maintain this minimum balance on a daily basis to earn the <br />Maturity Date: This account matures 06/08/2005 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Rate Information: The interest rate for this account is 6.0500 % term can be withdrawn-. <br />with an annual percentage yield of 6.19 %. 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 N/A penalty will be an amount equal to:6 MONTHS' <br />Interest will be credited QUARTERLY <br />BY CHECK interest on the amount withdrawn. <br />® 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: 1 Interest ? will ® will not accrue after final maturity. <br />ACCOUNT OWNERSHIP: (select one and initial) <br />? Single Party Account <br />? Multiple Party Account <br />? Trust - Separate Agreement dated: <br />? <br />Rights at Death: (select one and initial) <br />? Single Party Account <br />? Multiple Party Account with Right of Survivorship <br />? Multiple Party Account without Right of Survivorship <br />? Single Party Account with Pay on Death <br />? Multiple Party Account with Right of Survivorship and Pay on Death <br />Pay On Death Beneficiaries: To add Pay On Death Beneficiaries' <br />name one or more: r <br />0 1993 Bankers Systems, Inc., St. Cloud, MN (1-800-397-2341) Form CD-AA-CO (1) 7/26/96 <br />MONTHS <br />Tax <br />ID.. E 84-0506269 Number: <br />TIN: E 84-0506269 <br />Social Security or Employer's I.D. Number: A correct <br />taxpayer identification number is required for almost <br />every type of account. A certification of this number is <br />also required and is contained on the first copy of this <br />certificate. <br />Backup Withholding - A certification that you are not <br />subject to backup withholding is necessary for almost all <br />accounts (except for persons who are exempt altogether). <br />This certification is contained on the first copy of this <br />form. Failure to provide this certification when required <br />will cause us to withhold 31% of the interest earned (for <br />payments to the IRS). Providing a false certification can <br />result in serious federal penalties. <br />ENDORSEMENTS - SIGN ONLY WHEN YOU REQUEST WITHDRAWAL <br />X <br />X <br />X <br />READ PAGE TWO FOR ADDITIONAL TERMS (page 1 of 2)
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