EX-4 2 ex4.htm EXHIBIT 4.2
   

EXHIBIT 4.2

     

DETACH HERE

TRANSACTION REQUEST FORM - You do not need to do anything with this form unless you wish to execute one of the transactions listed below.

DETACH HERE

     
 

Please refer to your Plan Brochure for any related transaction fees.

 
     
 

TERMINATE PARTICIPATION

BOX #3

[   ]

Optional cash contribution to my Plan account - All payments enclosed must be in U.S. dollars

$_ _ _,_ _ _,_ _ _
(Enter dollar amount)

Box #1

[   ]

ISSUE ALL PLAN SHARES AND TERMINATE PLAN PARTICIPATION

   

drawn on a U.S. bank and payable to American Stock Transfer and Trust Company

Next anticipated Investment Date

__________________

             
 

CONTINUE PARTICIPATION

Box #4

[   ]

Deposit certificate(s) shares into my Plan account. PLEASE ENCLOSE CERTIFICATE(S).

__ __ __ __ __ __ __
(Enter number of shares)

             

Box #2

[   ]

ISSUE ALL PLAN SHARES AND CONTINUE PLAN PARTICIPATION

WHOLE SHARES

__ __ __ __ __ __

Box #5

[   ]

MARK THIS BOX and then complete reverse side for change of address.

 
             

ALL REQUESTS MUST BE SIGNED BY ALL REGISTERED OWNERS

SIGNATURE

SIGNATURE

DAYTIME TELEPHONE NO.


MAKE NO CHANGES BELOW THIS LINE

_____________________________________________________________________________________________

 

 

 

CHANGE OF ADDRESS-FILL IN NEW INFORMATION BELOW, PLEASE PRINT

STREET

CITY

STATE

ZIP CODE

SIGNATURE

DATE

MAKE NO MARKING BELOW THIS LINE