2008-03-05_REVISION - M1985023 (8)

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ECTRA BANK COLORADO CERTIFICATE ACCOUNT AGREEMENT AND SIGNATURE CARD i//we'the undersigned authorized individual(s), agree to the terms and conditions of this account as contained in this account agreement and Vectra Bank Colorado's Rules and Regulations, which have been received and incorporated herein, as they may be amended. By signing this signature card I/we acknowledge receipt of a copy of and agree to the terms of the following disclosures: ? Personal Account Terms C7 Business Account Terms L Rate Information BACK UP WITHHOLDING CERTIFICATION- Under penalty of perjury, by my signature below on this signature card, I certify that: (Y The number shown on this form is my correct taxpayer identification number (TIN). 4 1 am not subject to backup withholding either because I have not been notified that 1 am subject to backup withholding as a result of a failure to report all interest or dividends, or the Internal Revenue Service fIRS) ties notified me that I am no longer subject to backup withholding. LI Exempt Recipients - I am an exempt recipient under the Internal Revenue Service Regulations. ? Nonresident Aliens - I am not a United States person or if I am an individual, I am neither a citizen nor a resident of the United States. HOLLENBECK INC "ASSIGNED TO" 494-950129-2 Account Title 9tftkmXtibN' Account Number 84-0684491 P 100040051010 09-05-00 Taxpayer I.D. Number (TIN) Mother's Maiden Name Data SUPERSEDES CARD DATED AUTHORIZED SIGNERS SIGNATURES GENE HOLLENBECK X ASSIGNMENT OF CERTIFICA DEPOSIT ATTACHED X X X OPENING DEPOSIT $15,716.00 PUBLIC FUNDS PDPA #0100040051010 CDL 11612445 Identification Employer ? NATURAL PERSONISI OR DBA ? SOLE PROPRIETORSHIP ? LIMITED LIABILITY CO. TRUST/TRUSTEE ? PARTNERSHIP/LLP $I PUBLIC FUNDS ? ASSOCIATION OR CLUB ? CORPORATION X LI INDIVIDUAL ? ESTATE ? JOINT CERTIFICATE OF DEPOSIT DATA PURCHASE AMOUNTS -***15,716.00 TERM _097 ? MONTHS CRDAYS NEXT MATURITY DATE 1 2 - I I - 0 0 INTEREST RATE 04 . 89 % ANNUAL PERCENTAGE YIELD 05. Ol % INTEREST PAYMENT FREQUENCY: INTEREST FOR THIS ACCOUNT IS: 6 AT MATURITY112 mos. or less) ? COMPOUNDED DAILY ? ANNUALLY ? SIMPLE ? QUARTERLY ? MONTHLY INTEREST PAYMENT METHOD: ? CAPITALIZED ? PAY BY CHECK Y] TRANSFER TO ACCOUNT f1 4948001683 10 CHECKING/MONEY MARKET ? SAVINGS Renewing certificates will automatically renew for the same maturity period if not presented for payment within ten 00) calendar days after any maturity date, or unless the Bank issues or mails notice otherwise to the address then on Bank records, at least thirty (30) days before any maturity date. This applies only to certificates with maturities over thirty (30) days. The renewal interest rate and annual pe-mcge yield will be those prevaiiing at the time or maturity for certificates of like duration and amount. Nomenewing certificates reaching maturity will remain in the account until withdrawal is requested. These certificates will not accrue interest after maturity unless transferred to another interest-bearing account. We use the daily balance method to calculate interest on your account. This method applies a periodic rate to the principal in thu account each day. H you withdraw any of the principal in the account before the maturity date, a penalty may be imposed as follows: For certificates with maturities of 12 months or less, the penalty shall be one month's interest; for certificates with maturities greater than one year, the penalty shall be three month's interest. Additional deposits are permitted to consumer accounts with an initial maturity date of 12 months or less. For accounts with initial maturities gre r than 12 months or with opening deposits greater then $ O ,0 0.00 a itiona de osits r to permitted. l_- 'ENED BY FOLD CARD AS INSTRUCTED BEFORE SEPARATING 1. FOLD THIS FLAP BACK T 2. FOLD THIS FLAP FORWARD 4 3. FOLD THIS FLAP FORWARD AND TUCK INSiVE T TEAR ALONG PERFORATION, AND DISCARD