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Please Type or Print Sample Clauses

Please Type or Print. Please provide a listing of Fund officers or other individuals who will be CALLED BACK to verify the initiation of repetitive wires of $10 million or more and all non-repetitive wire instructions:
Please Type or Print. Please provide a listing of Fund officers or other individuals who will be CALLED BACK to verify the initiation of repetitive wires of $10 million or more and all non-repetitive wire instructions: NAME CALLBACK PHONE NUMBER DOLLAR LIMITATION (IF ANY) SUBCUSTODIANS – SCHEDULE A MARKET SUBCUSTODIAN Argentina Citibank, N.A. Australia Citigroup Pty. Limited The Hongkong and Shanghai Banking Corporation Limited Austria UniCredit Bank Austria AG Bahrain HSBC Bank Middle East Limited (as delegate of The Hongkong and Shanghai Banking Corporation Limited) Bangladesh Standard Chartered Bank Belgium Deutsche Bank AG, Netherlands (operating through its Amsterdam branch with support from its Brussels branch) Benin via Société Générale de Banques en Côte d’Ivoire, Abidjan, Ivory Coast Bermuda HSBC Bank Bermuda Limited Federation of Bosnia and Herzegovina UniCredit Bank d.d. Botswana Standard Chartered Bank Botswana Limited Brazil Citibank, N.A. Bulgaria ING Bank N.V. UniCredit Bulbank AD Burkina Faso via Société Générale de Banques en Côte d’Ivoire, Abidjan, Ivory Coast Canada State Street Trust Company Canada Chile Banco Itaú Chile People’s Republic of China HSBC Bank (China) Company Limited (as delegate of The Hongkong and Shanghai Banking Corporation Limited) China Construction Bank Corporation (for A-share market only) Colombia Cititrust Colombia S.A. Sociedad Fiduciaria Costa Rica Banco BCT S.A. Croatia Privredna Banka Zagreb d.d. Zagrebacka Banka d.d.
Please Type or PrintComplete the entire application.
Please Type or PrintBeneficial Owner’s First Name MI Beneficial Owner’s Last Name Co-Beneficial Owner’s First Name MI Co-Beneficial Owner’s Last Name Entity Name (if claimant is not an individual) Representative or Custodian Name (if different from Beneficial Owner(s) listed above) Address1 (street name and number) Address2 (apartment, unit, or box number) City State ZIP/Postal Code Foreign Country (only if not USA) Social Security Number Taxpayer Identification Number Telephone Number (home) Telephone Number (work) Email address Account Number (if filing for multiple accounts, file a separate Proof of Claim for each account) Claimant Account Type (check appropriate box): □ Individual (includes joint owner accounts) □ Pension Plan □ Trust □ Corporation □ Estate □ XXX/401K □ Other (please specify)
Please Type or PrintAggrieved Person:
Please Type or Print. Please provide a listing of Fund officers or other individuals who will be CALLED BACK to verify the initiation of repetitive wires of $10 million or more and all non-repetitive wire instructions: SUBCUSTODIANS- SCHEDULE A MARKET SUBCUSTODIAN Argentina Citibank, N.A. Australia Citigroup Pty. Limited The Hongkong and Shanghai Banking Corporation Limited Austria UniCredit Bank Austria AG Bahrain HSBC Bank Middle EastLimited (as delegate of The Hongkong and Shanghai Banking Corporation Limited) Bangladesh Standard Chartered Bank Belgium Deutsche Bank AG, Netherlands (operating through its Amsterdam branch with support from its Brussels branch) Benin via Societe Generale de Banques en Cote d’Ivoire, Abidjan, Ivory Coast Bermuda HSBC Bank Bermuda Limited Federation of UniCredit Bank d.d. Bosnia and Herzegovina Botswana Standard Chartered Bank Botswana Limited Brazil Citibank, N.A. Bulgaria ING Bank N.V. UniCredit Bulbank AD Burkina Faso via Societe Generale de Banques en Cote d’Ivoire, Abidjan, Ivory Coast Canada State Street Trust Company Canada Chile Banco ltau Chile People’s Republic of China HSBC Bank (China) Company Limited (as delegate of The Hongkong and Shanghai Banking Corporation Limited) China Construction Bank Corporation (for A-share market only) Colombia Cititrust Colombia S.A. Sociedad Fiduciaria Costa Rica Banco BCT S.A. Croatia Privredna Banka Zagreb d.d. Zagrebacka Banka d.d.
Please Type or Print. Please provide a listing of Fund officers of other individuals who will be CALLED BACK to verify the initiation of repetitive wires of $10 million or more and all non repetitive wire instructions: NAME CALLBACK PHONE NUMBER DOLLAR LIMITATION (IF ANY) _______________________________ _______________________________ _______________________________
Please Type or Print. Clearly State of Kansas, County of Secured
Please Type or Print. PART I: CLAIMANT IDENTIFICATION Owner’s Name (First, Middle, Last) Street Address City State or Province Zip Code or Postal Code Country Social Security Number or Taxpayer Identification Number Individual Corporation/Other Area Code Telephone Number (work) Area Code Telephone Number (home) E-Mail Address PART II: SCHEDULE OF TRANSACTIONS IN RUBICON COMMON STOCK
Please Type or PrintThe agreement must be signed by an owner, officer, director, partner, principal, or other person legally authorized to bind the company.