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Certificate of Deposit O"ate <br />pened:o9/09/05 <br /> <br />06 Month Certificate of Deposit <br />Amount of <br />Deposit: ***Four lbousand and no/100*** <br />$ 4,000.00 <br />This Time Deposit is Issued to Issuer <br />ZOWELL KLINGLESMITH MOUNTAIN VALLEY BANK - MEEKER <br />ASSIGNED TO COLORADO DIVISION OF 400 MAIN ST, PO BOX 718 <br />MINERALS AND GEOLOGY PH. 303-866-3567 MEEKER, CO 81641-0718 <br />PUBLIC FUNDS ACCOUNT <br />PDPA NUMBER 010004005101 <br />1313 SHERMAN ST, ROOM 215 <br />DENVER, CO 80203 <br />Not Negotiable - Not Transferable - Additional terms are below. By <br />Account features - These are some basic features of your <br />account. Your separate account disclosure contains more detailed <br />ini'oralw"on about these and other account features. <br />RATE - The interest rate is 3.250% with an annual percentage <br />yield of 3.28 %. You will be paid this rate until next maturity. <br />CREDITING, COMPOUNDING - Our policy is to credit interest <br />into this account at maturity, but we will permit crediting at <br />maturity into your savings account 405500613. Interest will be <br />compounded semiannually unless withdrawn or credited out of this <br />account. <br />TIME REQUIREMENTS - Your account has a term of 6 <br />month(s). Your account matures on March 9, 2006. <br />.................... <br />CALL FEATURE - We may terminate this adilii : out option` . <br />with a 30 day notice. <br />AUTOMATICALLY RENEWABLE - Your 12 <br />" <br />renews at maturity. Each renewal term will be"11ie isiurme as` ' <br />original term. The interest rate will be the rate we offer on new <br />certificates on the maturity date which have the same features as <br />the renewed certificate. You will have a grace period of ten <br />calendar day(s) after maturity to withdraw without penalty. You <br />may prevent renewal if you withdraw the funds at maturity or we <br />receive advance written notice. <br />OWNERSHIP: Single-Party Account (Tn'tial on Page 2.) <br />The undersigned agree to the terms of, and acknowledge receipt <br />of,, the completed original copy of pages 1 and 2 of this form <br />_-and-the following policy disclosure(s): Truth In Savings <br />[x <br />J <br />a <br />1. D. # D.O.B. <br />I X l <br />J <br />1. D. # D.O.B. <br />[x <br />J <br />1. D. # D.O.B. <br />EARLY WITHDRAWAL PENALTY - The penalty we may <br />i.*npase ,,All equal 90 days interest on the amomt withdrawn. <br />Some exceptions may apply. <br />INTEREST COMPUTATION - Interest will be calculated using <br />the daily balance method. <br />DEPOSIT LIMITS - You may not make additional deposits to the <br />account before maturity. <br />WMEIDRAWAL LIMITS - Early withdrawals of principal are <br />limited as disclosed separately. You can only withdraw interest <br />credited during the term, as disclosed separately. You can <br />withdraw interest only on the crediting dates. See the account <br />RECEIVED <br /> <br />BACKUP WITHHOLDING CERTIFICATIONS <br />TIN: <br />®.. TAXPAYER I.D. NUMBER - The Taxpayer Identification <br />Number shown above (TIN) is my correct taxpayer <br />identification number. <br />® BACKUP WITHHOLDING - I am not subject to backup <br />withholding either because I have not been notified that I am <br />subject to backup withholding as a result of a failure to report <br />all interest or dividends, or the Internal Revenue Service has <br />notified me that I am no ect to backup withholding. <br />? EXEMPT RECIPIENTS - I am an exempt recipient under <br />the Internal Revenue Service Regulations. <br />SIGNATURE: I certify under penalties of perjury the <br />stateme is checked in this section and that I am a U.S. <br />person (' clu g a S esident alie <br />X (Date) <br />Number of endorsements required for withdrawal 1 <br />ENDORSEMENTS - SIGN ONLY WHEN YOU REQUEST WITHDRAWAL <br />X <br />X <br />V04.10 IX <br />LEKp-_L-_rLJ6m ® 2001 Bankers Systems, Inc., St. Cloud, MN Form CDSC•ARTAD 8/16/2001 READ PAGE TWO FOR ADDITIONAL TERMS (Pace 1 of 2)