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F E D ER AL R ESE R VE B A N K OF NEW Y O R K Fiscal A gen t o f the U nited States r Circular No. 5 9 3 6 1 L January 27, 1967 J CASH OFFERING 4% Percent Treasury Notes of Series B-1968 4% Percent Treasury Notes of Series A-1972 To All Banking Institutions, and Others Concerned, in the Second Federal Reserve D istrict: The subscription books will be open Monday, January 30, fo r one day only, for a Treasury offering of — 4 % percent Treasury Notes o f Series B-1968, dated February 15, 1967, maturing M ay 15, 1968, at 99.875, and 4 % percent Treasury Notes o f Series A-1972, dated February 15, 1967, m aturing February 15, 1972, at 99.625, in the amount of $7.5 billion, or thereabouts. Subscriptions will be subject to allotment. Payment must be made by February 15, in cash, or in 3% percent Treasury Notes of Series B-1967, or 4 percent Treasury Notes of Series C-1967, both maturing February 15, 1967. Payment cannot be made by credit to Treasury Tax and Loan Accounts. The terms of the offering are set forth in Treasury Department Circulars No. 1-67 and No. 2-67, Public Debt Series; a copy of each is printed on the following pages. Subscriptions from all subscribers, except banking institutions for their own account and others as specified in Section III of the Treasury circulars, must be accompanied by payment of 2 percent (in cash or in maturing securities) of the amount of securities applied for. I f subscribers required to make deposits desire to deposit the maturing securities but do not have the denominations to meet exactly the minimum deposit requirement, they are urged to leave any excess on deposit to avoid denominational exchanges and unnecessary movement of securities. Only commercial banks may submit subscriptions for account of customers, provided the names of the customers are set forth in such subscriptions. On subscriptions for account of customers of correspondent banks, the names of such customers, and if not individuals, their locations, must be furnished. Others than commercial banks may submit subscriptions only for their own account. Commercial banks are urged to retain the required deposits (cash or maturing securities) of their customers until after allotment of the new securities; if the maturing securities are retained, the risk and expense involved in forwarding them to this Bank will thus be avoided. Commercial banks are urged to enter subscriptions for their own account, and for account of their customers, with the Federal Reserve Bank or Branch in the District in which they are located. Subscriptions eligible for full allotment. — A subscription by or for account of any State, political subdivision or instrumentality thereof, public pension and retirement and other public fund, international organization in which the United States holds membership, foreign central bank, foreign State, Government Investment Account, or Federal Reserve Bank will be allotted in full if accompanied by a certification that at 4 p.m., Eastern Standard time, January 25, 1967, it owned or had contracted to purchase for value the maturing securities in an amount equal to or greater than the amount of its subscription, and that such securities will be submitted in payment for its subscription. Any such subscriber may enter an additional subscription, which will be subject to a percentage allotment. Copies of a certification form are enclosed for all commercial banks and public institutions of the types listed above. Subscriptions will be received by this Bank as fiscal agent of the United States. Sub scriptions should be submitted immediately on the enclosed Form A -l for the 4% percent 15-month notes or Form B -l for the 4% percent 5-year notes; if maturing securities accompany a subscription, the enclosed Form A-2 or B-2 should be submitted with Form A -l or B -l, respectively. I f filed by telegram or letter, the subscriptions should be confirmed immediately by mail on the forms provided. The subscription books will remain open fo r one day only, Monday, January 30. Any subscription addressed to a Federal Reserve Bank or Branch or to the Treasury Department and placed in the mail before midnight, Monday, will be considered timely. A lfred H ayes, President. UNITED STATES OF AMERICA 4% PERCENT TREASURY NOTES OF SERIES B-1968 Dated and bearing interest from February 15, 1967 Due May 15, 1968 TREASU RY DEPARTM ENT, D EPAR T M EN T CIRCULAR O f f ic e o f t h e I. O F F E R IN G O F N O T E S II. 1. The Secretary o f the Treasury, pursuant to the authority o f the Second Liberty Bond A ct, as amended, offers $5,500,000,000, or thereabouts, o f notes o f the United States, designated 4 % percent Treasury Notes o f Series B-1968, at 99.875 percent o f their face value and accrued interest. The follow ing notes, maturing February 15, 1967, will be accepted at par in payment or exchange, in whole or in part, to the extent subscriptions are allotted b y the T reasu ry: 3 % percent Treasury Notes o f Series B-1967; or 4 percent Treasury Notes o f Series C-1967. The books will be open only on January 30, 1967, fo r the receipt o f subscriptions. Secretary, Washington, January 26,1967. Public Debt Series — No. 1-67 2 D E S C R IP T IO N O F N O TE S 1. The notes will be dated February 15, 1967, and will bear interest from that date at the rate o f 4 3 4 percent per annum, payable on a semiannual basis on M ay 15 and November 15, 1967, and on M ay 15, 1968. They will mature M ay 15, 1968, and will not be sub ject to call fo r redemption prior to maturity. 2. The income derived from the notes is subject to all taxes imposed under the Internal Revenue Code o f 1954. The notes are subject to estate, inheritance, gift or other excise taxes, whether Federal or State’ but are exempt from all taxation now or hereafter imposed on the principal or interest thereof by any State, or any o f the possessions o f the United States, or by any local taxing authority. 3. The notes will be acceptable to secure deposits o f public moneys. They will not be acceptable in paym ent o f taxes. respect to the purchase or sale or other disposition o f any notes o f this issue at a specific rate or price, until after midnight January 30, 1967. 4. Bearer notes with interest coupons attached, and notes registered as to principal and interest, will be issued in denominations o f $1,000, $5,000, $10,000, $100,000, $1,000,000, $100,000,000 and $500,000,000. Provision will be made fo r the interchange o f notes of different denominations and o f coupon and registered notes, and fo r the transfer o f registered notes, under rules and regulations prescribed b y the Secretary of the Treasury. 3. Commercial banks in submitting subscriptions will be required to certify that they have no beneficial interest in any o f the subscriptions they enter fo r the account o f their customers, and that their customers have no beneficial interest in the banks’ subscriptions fo r their own account. 4. Under the Second Liberty Bond A ct, as amended, the Secretary o f the Treasury has the authority to reject or reduce any subscription, to allot less than the amount o f notes applied for, and to make different percentage allotments to various classes o f subscribers when he deems it to be in the public interest; and any action he may take in these respects shall be final. Subject to the exercise o f that authority, subscriptions will be a llotted : 5. The notes will be subject to the general regula tions o f the Treasury Department, now or hereafter prescribed, governing United States notes. III. S U B S C R IP T IO N AN D A L L O T M E N T 1. Subscriptions accepting the offer made by this circular will be received at the Federal Reserve Banks and Branches and at the Office o f the Treasurer o f the United States, W ashington, D. C. 20220. Only the Federal Reserve Banks and the Treasury Department are authorized to act as official agencies. Commercial banks, which for this purpose are defined as banks accepting demand deposits, may submit subscriptions fo r account o f customers provided the names o f the customers are set forth in such subscriptions. Others than commercial banks will not be permitted to enter subscriptions except fo r their own account. Subscrip tions from commercial banks fo r their own account will be restricted in each case to an amount not exceeding 50 percent o f the combined capital (not including capital notes or debentures), surplus and undivided profits o f the subscribing bank. Subscrip tions will be received without deposit from banking institutions for their own account, Federally-insured savings and loan associations, States, political sub divisions or instrumentalities thereof, public pension and retirement and other public funds, international organizations in which the United States holds mem bership, foreign central banks and foreign States, dealers who make prim ary markets in Government securities and report daily to the Federal Reserve Bank o f New Y ork their positions with respect to Government securities and borrowings thereon, Federal Reserve Banks and Government Investment Accounts. Subscriptions from all others must be accompanied b y payment (in cash or in notes o f the two issues enumerated in paragraph 1 o f Section I hereof, which will be accepted at par) o f 2 percent o f the amount o f notes applied for, not subject to withdrawal until after allotment. Registered securities submitted as deposits should be assigned as provided in Section V hereof. Follow ing allotment, any portion o f the 2 per cent payment in excess o f 2 percent o f the amount o f notes allotted may be released upon the request o f the subscribers. (1) in full if the subscription is fo r a State, polit ical subdivision or instrumentality thereof, public pension and retirement and other public fund, international organization in which the United States holds membership, foreign cen tral bank and foreign State, Federal Reserve Bank, or Government Investment A ccount and such subscriber certifies in w riting that at 4 p.m., Eastern Standard time, January 25, 1967, it owned or had contracted to purchase for value notes o f the two issues enumerated in paragraph 1 o f Section I hereof, in an aggre gate amount equal to or greater than the amount o f such subscription (any such sub scriber m ay enter an additional subscription subject to a percentage a llotm en t); and (2) on a percentage basis, to be publicly announced. Allotm ent notices will be sent out prom ptly upon allotment. IV . 1. Payment at 99.875 percent o f their face value and accrued interest, if any, fo r notes allotted here under must be made or com pleted on or before Feb ruary 15, 1967, or on later allotment. Payment will not be deemed to have been completed where regis tered notes are requested if the appropriate iden tify ing number as required on tax returns and other documents submitted to the Internal Revenue Serviee (an individual’s social security number or an employer identification number) is not furnished. In every case where fu ll payment is not completed, the payment with application up to 2 percent o f the amount o f notes allotted shall, upon declaration made b y the Secretary o f the Treasury in his discretion, be forfeited to the United States. Payment may be made fo r any notes allotted hereunder in cash or b y exchange o f notes of the two issues enumerated in paragraph 1 o f Section I hereof, which will be accepted at par. A cash adjust 2. A ll subscribers are required to agree not to purchase or to sell, or to make any agreements with PAYM ENT 3 name as the notes surrendered, the assignment should be to “ The Secretary o f the Treasury fo r 4 % percent Treasury Notes o f Series B -1968” ; if the new notes are desired registered in another name, the assignment should be to “ The Secretary o f the Treasury fo r 4 % percent Treasury Notes o f Series B-1968 in the name o f ............................................. if new notes in coupon form are desired, the assignment should be to “ The Secretary o f the Treasury fo r 4 % percent Treasury Notes o f Series B-1968 in coupon form to be delivered ment will be made fo r the difference ($1.25 p er $1,000) between the par value o f m aturing notes accepted in exchange and the issue price o f the new notes. The pay ment will be made b y check or by credit in any account maintained b y a banking institution with the Federal Reserve Bank o f its District, follow ing acceptance o f the maturing notes. In the case o f registered notes, the payment will be made in accordance with the assign ments on the notes surrendered. W hen payment is made with notes in bearer form , coupons dated Feb ruary 15, 1967, should be detached and cashed when due. W hen payment is made with registered notes, the final interest due on February 15, 1967, will be paid by issue o f interest checks in regular course to holders o f record on January 13, 1967, the date the transfer books closed. V. , yy V I. G E N E R A L P R O V IS IO N S 1. As fiscal agents o f the United States, Federal Reserve Banks are authorized and requested to receive subscriptions, to make such allotments as may be pre scribed by the Secretary o f the Treasury, to issue such notices as may be necessary, to receive payment fo r and make delivery o f notes on full-paid subscrip tions allotted, and they may issue interim receipts pending delivery o f the definitive notes. A SSIG N M E N T O F R E G IS T E R E D N O T E S 1. Treasury notes in registered form tendered as deposits and in payment fo r notes allotted hereunder should be assigned by the registered payees or assignees thereof, in accordance with the general regulations of the Treasury Department, in one o f the form s hereafter set forth. Notes tendered in payment should be sur rendered to a Federal Reserve Bank or Branch or to the Office o f the Treasurer o f the United States, W ashington, D. C. 20220. The m aturing notes must be delivered at the expense and risk o f the holder. I f the new notes are desired registered in the same 2. The Secretary o f the Treasury may at any time, or from time to time, prescribe supplemental or amen datory rules and regulations governing the offering, which will be communicated prom ptly to the Federal Reserve Banks. H E N R Y H. FO W LE R , Secretary o f the Treasury. UNITED STATES OF AMERICA 4% PERCENT TREASURY NOTES OF SERIES A-1972 Dated and bearing interest from February 15, 1967 Due February 15, 1972 TREASU RY DEPARTM ENT, O f f ic e o f t h e DEPARTMENT CIRCULAR Washington, January 26,1967. Public Debt Series — No. 2-67 I. O F F E R IN G O F N O TE S The books will be open only on January 30, 1967, for the receipt o f subscriptions. 1. The Secretary o f the Treasury, pursuant to the authority o f the Second Liberty Bond A ct, as amended, offers $2,000,000,000, or thereabouts, o f notes o f the United States, designated 4 % percent Treasury Notes o f Series A-1972, at 99.625 percent of their face value and accrued interest. The follow ing notes, maturing February 15, 1967, will be accepted at par in payment or exchange, in whole or in part, to the extent subscriptions are allotted by the T reasu ry: II. D E S C R IP T IO N O F N O TE S 1. The notes will be dated February 15, 1967, and will bear interest from that date at the rate o f 4 % percent per annum, payable semiannually on August 15, 1967, and thereafter on February 15 and August 15 in each year until the principal amount becomes payable. They will mature February 15, 1972, and will not be subject to call for redemption prior to maturity. 3 % percent Treasury Notes o f Series B-1967; or 4 percent Treasury Notes o f Series C-1967. Secretary, 4 deposits should be assigned as provided in Section Y hereof. Follow ing allotment, any portion o f the 2 per cent payment in excess o f 2 percent o f the amount o f notes allotted may be released upon the request o f the subscribers. 2. The income derived from the notes is subject to all taxes imposed under the Internal Revenue Code o f 1954. The notes are subject to estate, inheritance, gift or other excise taxes, whether Federal or State, but are exempt from all taxation now or hereafter imposed on the principal or interest thereof b y any State, or any o f the possessions o f the United States, or by any local taxing authority. 2. A ll subscribers are required to agree not to purchase or to sell, or to make any agreements with respect to the purchase or sale or other disposition o f any notes o f this issue at a specific rate or price, until after midnight January 30, 1967. 3. The notes will be acceptable to secure deposits o f public moneys. They will not be acceptable in paym ent o f taxes. 3. Commercial banks in submitting subscriptions will be required to certify that they have no beneficial interest in any o f the subscriptions they enter fo r the account o f their customers, and that their customers have no beneficial interest in the banks’ subscriptions for their own account. 4. Bearer notes with interest coupons attached, and notes registered as to principal and interest, will be issued in denominations o f $1,000, $5,000, $10,000, $100,000, $1,000,000, $100,000,000 and $500,000,000. Provision will be made for the interchange o f notes o f different denominations and o f coupon and registered notes, and fo r the transfer o f registered notes, under rules and regulations prescribed b y the Secretary o f the Treasury. 4. Under the Second Liberty B ond Act, as amended, the Secretary o f the Treasury has the authority to reject or reduce any subscription, to allot less than the amount o f notes applied for, and to make different percentage allotments to various classes o f subscribers when he deems it to be in the public interest; and any action he may take in these respects shall be final. Subject to the exercise o f that authority, subscriptions will be allotted : 5. The notes will be subject to the general regula tions o f the Treasury Department, now or hereafter prescribed, governing United States notes. III. S U B S C R IP T IO N A N D A L L O T M E N T 1. Subscriptions accepting the offer made by this circular will be received at the Federal Reserve Banks and Branches and at the Office o f the Treasurer o f the United States, W ashington, D. C. 20220. Only the Federal Reserve Banks and the Treasury Department are authorized to act as official agencies. Commercial banks, which fo r this purpose are defined as banks accepting demand deposits, may submit subscriptions fo r account o f customers provided the names o f the customers are set forth in such subscriptions. Others than commercial banks will not be permitted to enter subscriptions except fo r their own account. Subscrip tions from commercial banks fo r their own account will be restricted in each ease to an amount not exceeding 50 percent o f the combined capital (not including capital notes or debentures), surplus and undivided profits o f the subscribing bank. Subscrip tions will be received without deposit from banking institutions fo r their own account, Federally-insured savings and loan associations, States, political sub divisions or instrumentalities thereof, public pension and retirement and other public funds, international organizations in which the United States holds mem bership, foreign central banks and foreign States, dealers who make prim ary markets in Government securities and report daily to the Federal Reserve Bank o f New Y ork their positions with respect to Government securities and borrowings thereon, Federal Reserve Banks and Government Investment Accounts. Subscriptions from all others must be accompanied by payment (in cash or in notes o f the two issues enumerated in paragraph 1 o f Section I hereof, which will be accepted at par) o f 2 percent o f the amount o f notes applied for, not subject to withdrawal until after allotment. Registered securities submitted as 5 (1) in fu ll if the subscription is fo r a State, polit ical subdivision or instrumentality thereof, public pension and retirement and other public fund, international organization in which the United States holds membership, foreign cen tral bank and foreign State, Federal Reserve Bank, or Government Investment A ccount and such subscriber certifies in w riting that at 4 p.m., Eastern Standard time, January 25, 1967, it owned or had contracted to purchase for value notes o f the two issues enumerated in paragraph 1 o f Section I hereof, in an aggre gate amount equal to or greater than the amount o f such subscription (any such sub scriber may enter an additional subscription subject to a percentage a llotm en t); and (2) on a percentage basis, to be publicly announced. Allotm ent notices will be sent out prom ptly upon allotment. IV . PAYM ENT 1. Payment at 99.625 percent o f their face value and accrued interest, if any, fo r notes allotted here under must be made or completed on or before Feb ruary 15, 1967, or on later allotment. Payment will not be deemed to have been completed where regis tered notes are requested if the appropriate iden tify ing number as required on tax returns and other documents submitted to the Internal Revenue Service (an individual’s social security number or an employer identification num ber) is not furnished. In every case where full payment is not completed, the payment with application up to 2 percent o f the amount o f notes W ashington, D. C. 20220. The maturing notes must be delivered at the expense and risk o f the holder. I f the new notes are desired registered in the same name as the notes surrendered, the assignment should be to “ The Secretary o f the Treasury fo r 4 % percent Treasury Notes o f Series A -1972” ; if the new notes are desired registered in another name, the assignment should be to “ The Secretary o f the Treasury fo r 4 % percent Treasury Notes o f Series A-1972 in the name o f ............................................. i f new notes in coupon form are desired, the assignment should be to “ The Secretary o f the Treasury fo r 4% percent Treasury Notes o f Series A-1972 in coupon form to be delivered allotted shall, upon declaration made by the Secretary of the Treasury in his discretion, be forfeited to the United States. Payment may be made fo r any notes allotted hereunder in cash or b y exchange o f notes o f the two issues enumerated in paragraph 1 o f Section I hereof, which will be accepted at par. A cash adjust ment will be made fo r the difference ($3.75 per $1,000) between the par value o f maturing notes accepted in exchange and the issue price o f the new notes. The pay ment will be made b y check or by credit in any account maintained b y a banking institution with the Federal Reserve Bank o f its District, follow ing acceptance of the m aturing notes. In the case o f registered notes, the payment will be made in accordance with the assign ments on the notes surrendered. W hen paym ent is made with notes in bearer form , coupons dated Feb ruary 15, 1967, should be detached and cashed when due. W hen payment is made with registered notes, the final interest due on February 15, 1967, will be paid by issue o f interest checks in regular course to holders o f record on January 13, 1967, the date the transfer books closed. V. V I. 1. As fiscal agents o f the United States, Federal Reserve Banks are authorized and requested to receive subscriptions, to make such allotments as may be pre scribed by the Secretary o f the Treasury, to issue such notices as may be necessary, to receive payment for and make delivery o f notes on full-paid subscrip tions allotted, and they may issue interim receipts pending delivery o f the definitive notes. A SSIG N M E N T O F R E G IS T E R E D N O T E S 1. Treasury notes in registered form tendered as deposits and in payment fo r notes allotted hereunder should be assigned b y the registered payees or assignees thereof, in accordance with the general regulations o f the Treasury Department, in one o f the form s hereafter set forth. Notes tendered in payment should be sur rendered to a Federal Reserve Bank or Branch or to the Office o f the Treasurer o f the United States, G E N E R A L P R O V IS IO N S 2. The Secretary o f the Treasury may at any time, or from time to time, prescribe supplemental or amen datory rules and regulations governing the offering, which will be communicated prom ptly to the Federal Reserve Banks. H E N R Y H. FO W LE R, Secretary o f the Treasury. 6 Subscription No. Subscriber’ s Reference No. Securities Accompanying Subscription For United States of America 4% Percent Treasury Notes of Series B-1968 Dated February 15,1967, Due May 15, 1968 ork, Dated at ......................................................... Fiscal A gent o f the United States, New York, N. Y . 10045 ..................................................................1967 F e d e r a l R e se r v e B a n k of New Y G entlem en : R eferring to subscription entered in the amount of $................................................... for United States of Am erica 4 % percent Treasury Notes of Series B-1968, the undersigned delivers the follow ing securities herewith, with coupons detached: F a ce a m ou n t 3 % % Treasury Notes o f Series B-1967 ................................................................... $............................... 4 % Treasury Notes o f Series C-1967 ....................................................................... ............................... T o t a l .......................... $............................... Submitted by .................................................................................................. A dd ress............................................................................................................. SECURITY RECORDS “ IN T IC K E T ” S u b s c r ib e r ’ s FORM A -2 (Submit in triplicate) Reference No. Subscription No. Securities Accompanying Subscription For United States of America 4% Percent Treasury Notes of Series B-1968 Dated February 15,1967, Due May 15, 1968 ork, Dated at ......................................................... Fiscal Agent o f the United States, New York, N. Y . 10045 ..................................................................1967 F e d e r a l R e se r v e B a n k of New Y G entlem en : R eferring to subscription entered in the amount o f $................................................... fo r United States o f Am erica 4 % percent Treasury Notes of Series B-1968, the undersigned delivers the follow ing securities herewith, with coupons detached: F a ce am ou nt 3 % % Treasury Notes of Series B-1967 ................................................................... $ 4 % Treasury Notes of Series C-1967 ....................................................................... . T o t a l .......................... $ ( D o n ot fill in b o x e s b e lo w ) G o ver n m en t B ond D Received Checked Cancelled CONTROL COPY iv is io n Submitted by A dd ress......... Subscriber’ s Reference No. Subscription No. NONNEGOTIABLE RECEIPT To Subscriber: of N e w Y o r k , Fiscal A gent of the United States, hereby acknowledges receipt of securities deposited in the amount indicated below with subscription numbered as above in exchange for F e d e r a l R e se r v e B a n k 434 P E R C E N T T R E A S U R Y N O TE S OF S E R IE S B-1968 c. 11 4-^a n W r m t i n n will he delivered on X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Securities allotted on this csubscription will De delivered 0 X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X F e b r u a r y 15, 1967, in accordance w ith y o u r in stru ctio n s. X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Teller . . Government Bond Division— Issues & Redemption Section To F ederal F is c a l R eserve B Agent of a n k of N ew Y F a ce a m ou n t ork, the United States 3% % Notes, B-1967 (Date) You are hereby authorized to deliver to (Name of representative) whose signature appears below, <jj...................................... par amount of securities issued pursuant to this subscription. Name 4 % Notes, C-1967 Total Submitted by Address ......... (Please print) (Official signature required) (Signature of authorized representative) To Subscriber: I f securities are to be delivered over the counter at this Bank to your representative, the authority in the box to the left should be executed on the date of delivery. FORM B-2 (Submit in triplicate) Subscriber’s Reference No. Subscription No. Securities Accompanying Subscription For United States of America 4% Percent Treasury Notes of Series A-1972 Dated February 15,1967, Due February 15,1972 ork, Dated a t ......................................................... Fiscal A gent o f the United States, New York, N. Y . 10045 ..............................1967 F e d e r a l R e se r v e B a n k of N ew Y G entlem en : R eferring to subscription entered in the amount o f $ fo r United States of Am erica 4 % percent Treasury Notes o f Series A-1972, the undersigned delivers the follow ing securities herewith, with coupons detached: F a ce a m ou n t 3 % % Treasury Notes of Series B-1967 .................................................................. $............................... 4 % Treasury Notes o f Series C-1967 ....................................................................... ............................... T o t a l .......................... $ ............................... ( D o n o t fill in b o x e s b e lo w ) G o vernm ent B ond D Received Checked Cancelled CONTROL COPY iv is io n Submitted by Address ......... Subscriber’ s Reference No. Subscription No. NONNEGOTIABLE RECEIPT To Subscriber: Fiscal A gent of the United States, hereby acknowledges receipt of securities deposited in the amount indicated below with subscription numbered as above in exchange for F e d e r a l R e se r v e B a n k of New Y ork, 43^ P E R C E N T T R E A S U R Y N O TE S OF S E R IE S A-1972 ni w +pH on on th k subscription subscription win will be delivered on on X XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX Securities allotted this oe delivered X X X X X XX X XX XX X XX XX X XX X XX XX X XX XX X X XX XX X February 15, 1967, in accordance with your instructions. X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Teller . Government Bond Division— Issues & Redemption Section To F ederal R eserve B a n k of N ew Y ork, F a ce a m ou n t Fiscal Agent of the United States (Date) You are hereby authorized to deliver to (Name of representative) 3% % Notes, B-1967 $ 4 % Notes, C-1967 Total .......... whose signature appears below, |...................... 1....... ....... par amount Submitted by of securities issued pursuant to this subscription. A dd ress.......... Name ................ (Please print) (Official signature required) (Signature of authorized representative) To Subscriber: I f securities are to be delivered over the counter at this Bank to your representative, the authority in the box to the left should be executed on the date o f delivery. Subscriber’ s Reference No. Subscription No. Securities Accompanying Subscription For United States of America 4% Percent Treasury Notes of Series A-1972 Dated February 15, 1967, Due February 15, 1972 F ed eral R eserve B a n k of N e w Y o r k , Dated at ......................................................... Fiscal Agent o f the United States, New York, N. Y . 10045 ..................................................................1967 G entlem en : Referring to subscription entered in the amount of $ for United States of America 4 % percent Treasury Notes o f Series A-1972, the undersigned delivers the follow ing securities herewith, with coupons detached: F a ce am ou nt 3 % % Treasury Notes of Series B-1967 .............................................................. • 4 % Treasury Notes o f Series C-1967 ....................................................................... T o t a l .......................... Submitted by Address .......... SECURITY RECORDS “ IN T IC K E T ” * •_ $ (Submit with subscription) Certification by States, P olitical Subdivisions or Instrumentalities Thereof, P ublic Pension and Retirem ent and Other P u blic Funds, International Organi zations in W hich the United States H olds M em bership, Foreign Central Banks, Foreign States, Federal Reserve Banks, or Governm ent Investment Accounts, Pursuant to Section III, Paragraph 4 ( 1 ) , Treasury Departm ent Circu lars Nos. 1-67 and 2-67, P u blic Debt Series (This certificate may be executed by a subscriber in one o f the classes listed above or by a commercial bank entering a subscription fo r account o f such a subscriber.) 1967 To the Federal Reserve Bank o f New Y ork: The undersigned hereby certifies: (1) That it is one of the types of subscribers designated above and has entered for preferred full allotment under the provisions o f Section III, paragraph 4(1 ), of Treasury Department Circu lar No. 1-67 or 2-67, Public Debt Series, subscription(s) in the amount of $................................................; (2) That at 4 p.m., Eastern Standard time, January 25, 1967, it owned or had contracted to purchase for value 3% percent Treasury Notes of Series B-1967 and 4 percent Treasury Notes o f Series C-1967 in an amount equal to or greater than the amount of said su bscription (s); and (3) That such securities will be submitted in payment for said subscription (s). (Name of organization) ............................................... . .................... ..... (Official signature) (Title) (A commercial bank executing this certificate should sign below) (Name of bank) ............................................................................. ....................... '•••• (Official signature) for above-named organization. (Title) FORM A -l (Please type or print legibly) Subscriber’s Reference No. Subscription No. SUBSCRIPTION— SUBJECT TO ALLOTMENT For United States of America 4% Percent Treasury Notes of Series B-1968 Dated February 15, 1967, Due May 15, 1968 IM PO R TAN T INSTRUCTIONS P a y m en t. P a ym en t at 9 9 .8 7 5 f o r the n otes to b e a llo tte d h e re u n d e r m ay b e m a d e in ca sh , o r b y e x ch a n g e o f 3 % % T r e a s u ry N otes o f S eries B -1 9 6 7 or 4 % T re a s u ry N otes o f S eries C -1 9 6 7 , b oth m a tu rin g F eb ru a ry 15, 1 9 6 7 . C o u p o n s d a te d F eb ru a ry 15, 1 9 6 7 sh ou ld b e d e ta c h e d fr o m the m aturing secu rities in b e a re r fo r m a nd ca sh e d w h en d u e. P a y m e n t f o r th e n ew n o te s ca n n o t b e m a d e b y c r e d it th rou g h T re a s u r y T a x an d Loan A c c o u n t. D e p o s it. S e ctio n III o f scrip tio n s fr o m o f the a m ou n t to retain th e ir p a y a b le to th e S u b scrip tion s fr o m b a n k in g in stitu tion s f o r th eir ow n a cco u n t a nd fr o m ce rta in oth ers as sp e cifie d in T re a s u ry D ep a rtm en t C ircu la r N o. 1 -6 7 , P u b lic D e b t S eries, w ill be r e c e iv e d w ith ou t d e p o s it. S u b all oth ers m ust b e a c c o m p a n ie d b y p a y m e n t (in ca sh o r in m aturing s e c u r itie s ) o f n ot less than 2 % o f n otes a p p lie d fo r , e x c e p t that co m m e r c ia l banks su b scrib in g f o r a cco u n t o f cu stom ers a re u rg e d cu s to m e r s ’ d e p o s its until a ft e r a llotm en t. C h eck s a cco m p a n y in g th e su b scrip tion s sh ou ld b e m ad e F e d e ra l R e s e rv e B an k o f N ew Y o rk . S u b scrip tio n a m ou n ts. A m o u n t o f n otes a p p lie d f o r m ust b e in m u ltip les o f $ 1 ,0 0 0 . The subscription books will be open only on January 30 for the receipt of subscriptions. ork, Dated a t .......................................................... Fiscal A gent o f the United States, New York, N. Y . 10045 .................................................................... 1967 F e d e r a l R e se r v e B a n k of N ew Y Attention : Government Bond Division G entlem en : Pursuant to the provisions o f Treasury Department Circular No. 1-67, Public Debt Series, dated January 26, 1967, the undersigned hereby subscribes at 99.875 for United States of Am erica 4 % percent Treasury Notes o f Series B-1968 as fo llo w s : F or own account ...................................................................................................................... $ F or our customers, shown on reverse side (fo r use o f commercial banks) . . . . $ Total subscription ............................................................ $ ( I f se cu ritie s a re su b m itted w ith this su b scrip tio n , th e secu rities sh ou ld b e a c c o m p a n ie d b y F orm A -2 , w h ich fo r m shall b e m a d e a p a rt o f y o u r s u b s c r ip tio n .) ( I f the subscriber is, or is subscribing for account of, a member o f one o f the investor classes listed below, a check in the appropriate box should be indicated. A subscription from or fo r account o f such member will receive full allotment only if accompanied by a written certification that at 4 p.m., Eastern Standard time, January 25, 1967, it owned or had contracted to purchase for value, an equal or greater amount o f 3 % percent Treasury Notes o f Series B-1967 or 4 percent Treasury Notes o f Series C-1967, both maturing February 15, 1967, and that such securities will be submitted in paym ent for its subscription. A form fo r the certification is enclosed. Subscriptions accompanied by such certifications should not be included on the same form with other subscriptions. I f the investor classes listed below desire to enter an additional subscription, to be subject to allotment, a separate subscription form must be used.) □ States, political subdivisions or instrumentalities thereof □ Public pension and retirement and other public funds □ International organizations in which the United States holds membership □ Foreign central banks and foreign States ( I f a commercial bank is subscribing for its own account or for account o f customers, the following certifications are made a part of this subscription.) W e H e r e b y C e r t i f y that we have received applications from our customers in the amounts set opposite the custom ers’ names on the list which is made a part o f this subscription; that there has been paid to us by each such customer as required by official offering circular, not subject to withdrawal until after allotment, not less than 2 percent o f the amount applied f o r ; that we have not made unsecured loans, or loans collateralized in whole or in part by the securities applied for, to supply the amounts o f such payments to any o f such custom ers; that we have no beneficial interest in the applications o f such customers, and that none of our customers has any beneficial interest in the amount subscribed fo r our own account. W e F u r t h e r C e r t i f y that all subscribers for whom subscriptions are hereby entered have agreed not to purchase or to sell, or to make any agreements with respect to the purchase or sale or other disposition o f any notes o f this issue at a specific rate or price, until after midnight, January 30, 1967. W e F u r t h e r C e r t i f y th at the su b scrip tio n fo r our ow n acco u n t does n ot exceed 5 0 p e rc e n t o f our com b in ed c a p ita l (n o t in c lu d in g c a p ita l n otes or d e b e n tu r e s ), su rp lu s, an d u n d iv id e d pro fits. W e F u r t h e r C e r t i f y that applications received by us, if any, from other commercial banks for their own account and for the account o f their customers have been entered with us under the same conditions, agreements, and certifications as set forth in this subscription form . The undersigned agrees not to purchase or to sell, or to make any agreements with respect to the p u r chase or sale or other disposition of any notes o f this issue at a specific rate or price until after midnight, January 30, 1967. TO S U B S C R IB E R : Mark ( X ) in proper space to indicate if this i s : (Fill in all required spaces before signing) (Name of subscriber— Please print or typewrite) Original s u b s c r ip tio n ........... □ By (Official signature) Confirmation o f a telegram . □ Confirmation of a letter . . . . □ (Title) A d dress ( D o n ot w rite in s p a ce b e lo w ) Deposit received by ................................................................. Allotm ent $............................................... Figured ....................... Advised ( I f a ck n o w le d g m e n t o f this s u b s crip tio n is d e s ire d , co m p le te this s tu b ) Receipt is acknowledged o f your subscription for $ .............................................. o f 4 % % Treasury Notes o f Series B-1968, dated February 15, 1967, maturing May 15, 1968. For use o f Federal Reserve Bank Time Stamp To (Name) (Address) (F o r use o f commercial bank subscribers on ly) Lists of Accounts Included in this Subscription (I f space is insufficient in schedule below, attach separate listing) Leave blank Name and location (City and State) of ultimate purchaser (Location of individuals not required) A m ount Subscribed Leave blank (Note— Do not include subscriptions entitled to full allotment on the same form as other subscriptions.) FORM B -l (Please type or print legibly) Subscriber’s Reference No. Subscription No. SUBSCRIPTION— SUBJECT TO ALLOTMENT For United States of America 4% Percent Treasury Notes of Series A-1972 Dated February 15, 1967, Due February 15, 1972 IM PO R TAN T INSTRUCTIONS P a y m en t. P a ym en t at 9 9 .6 2 5 f o r the n otes to b e a llo tte d h e re u n d e r m ay b e m a d e in ca sh , o.' b y e x ch a n g e o f 3 % p e r ce n t T r e a s u ry N otes o f S eries B -1 9 6 7 o r 4 p e r ce n t T r e a s u ry N otes o f S eries C -1 9 6 7 , b oth m aturing F e b ru a ry 15, 1 9 6 7 . C o u p o n s d a te d F eb ru a ry 15, 1 9 6 7 sh ou ld b e d e ta c h e d fr o m the m aturing secu rities in b e a re r fo rm and ca s h e d w h en d u e. P a y m en t f o r th e n ew n o te s ca n n o t b e m a d e b y c r e d it th rou g h T re a s u r y T a x and L oa n A c c o u n t. D e p o s it. S u b scrip tion s fr o m b a n k in g in stitu tion s f o r th eir ow n a cco u n t a nd fr o m ce rta in oth ers as sp e cifie d in S e ctio n III o f T r e a s u ry D ep a rtm en t C ircu la r N o. 2 -6 7 , P u b lic D eb t S eries, w ill b e r e c e iv e d w ith ou t d e p o s it. S u b s crip tio n s fr o m all oth ers m ust b e a c c o m p a n ie d b y p a y m en t ( in ca sh o r in m atu rin g s e c u r itie s ) o f n ot less than 2 % o f th e a m ou n t o f n otes a p p lie d fo r , e x c e p t that co m m e rcia l banks su b scrib in g f o r a cco u n t o f cu stom ers are u rg e d to re ta in th e ir cu s to m e r s ’ d e p o s its until a ft e r a llotm en t. C h eck s a cco m p a n y in g the su b scrip tion s sh ou ld b e m ad e p a y a b le to th e F e d e ra l R e s e rv e B an k o f N ew Y o rk . S u b scrip tio n a m ou n ts. A m o u n t o f n otes a p p lie d f o r m ust b e in m u ltiples o f $ 1 ,0 0 0 . The subscription books will be open only on January 30 for the receipt of subscriptions. F ederal R e se r v e B a n k of N ew Y Dated at ork, Fiscal A gent o f the United States, New York, N. Y . 10045 A ttention : 19(57 Government Bond Division G entlem en : Pursuant to the provisions o f Treasury Department Circular No. 2-67, Public Debt Series, dated January 26, 1967, the undersigned hereby subscribes at 99.625 for United States o f America 4 % percent Treasury Notes o f Series A-1972, as follow s: F or own account ............................................................................... <t F or our customers, shown on reverse side (fo r use o f commercial banks) . . . . $ Total subscription ..................................................... $ ( I f secu rities are su b m itted w ith this s u b scrip tio n , the secu rities sh ou ld b e a cco m p a n ie d b y F orm B -2, w hich fo r m shall b e m ad e a p a rt o f y o u r s u b s c r ip tio n .) ( I f the subscriber is, or is subscribing for account of, a member o f one o f the investor classes listed below, a check in the appropriate box should be indicated. A subscription from or for account o f such member will receive full allotment only if accompanied by a written certification that at 4 p.m., Eastern Standard time, January 25, 1967, it owned or had contracted to purchase for value, an equal or greater amount o f 3 % percent Treasury Notes o f Series B-1967 or 4 percent Treasury Notes o f Series C-1967, both maturing February 15, 1967, and that such securities will be submitted in payment for its subscription. A form for the certification is enclosed. Subscriptions accompanied by such certifications should not be included on the same form with other subscriptions. I f the investor classes listed below desire to enter an additional subscription, to be subject to allotment, a separate subscription form must be used.) □ States, political subdivisions or instrumentalities thereof □ Public pension and retirement and other public funds □ International organizations in which the United States holds membership □ Foreign central banks and foreign States ( I f a commercial bank is subscribing for its own account or for account of customers, the following certifications are made a part of this subscription.) W e H e r e b y C e r t i f y that we have received applications from our customers in the amounts set opposite the custom ers’ names on the list which is made a part o f this subscription; that there has been paid to us by each such customer as required by official offering circular, not subject to withdrawal until after allotment, not less than 2 percent o f the amount applied f o r ; that we have not made unsecured loans, or loans collateralized in whole or in part by the securities applied for, to supply the amounts o f such payments to any of such custom ers; that we have no beneficial interest in the applications o f such customers, and that none of our customers has any beneficial interest in the amount subscribed for our own account. W e F u r t h e r C e r t if y that all subscribers for whom subscriptions are hereby entered have agreed not to purchase or to sell, or to make any agreements with respect to the purchase or sale or other disposition o f any notes of this issue at a specific rate or price, until after midnight, January 30, 1967. W e F u r t h e r C e r t if y th at the su b scrip tion fo r our ow n a cco u n t does n ot exceed 5 0 p e rce n t o f our com b in ed c a p ita l (n o t in c lu d in g c a p ita l notes or d e b e n tu r e s ), su rp lu s, an d u n d iv id e d profits. W e F u r t h e r C e r t i f y that applications received by us, if any, from other commercial banks for their own account and for the account o f their customers have been entered with us under the same conditions, agreements, and certifications as set forth in this subscription form. The undersigned agrees not to purchase or to sell, or to make any agreements with respect to the p u r chase or sale or other disposition of any notes of this issue at a specific rate or price until after midnight January 30, 1967. TO S U B S C R IB E R : Mark ( X ) in proper space to indicate if this i s : Original s u b s c r ip tio n .......... (Fill in all required spaces before sijning) (Name of subscriber— Please print or typewrite) □ By (Official signature) Confirmation of a telegram . □ Confirmation o f a letter . . . . □ (Title) Address ( D o n ot w rite in s p a ce b e lo w ) Deposit received by .. Allotm ent $ Figured Advised ( I f a ck n o w le d g m e n t o f this s u b s crip tio n is d e s ire d , co m p le te this s tu b ) Receipt is acknowledged of your subscription for $............................. Series A-1972, dated February 15, 1967, maturing February 15, 1972. o f 4 % % Treasury Notes o f For use o f Federal Reserve Bank Time Stamp To (Name) (Address) (F o r use o f commercial bank subscribers on ly) Lists of Accounts Included in this Subscription ( I f space is insufficient in schedule below, attach separate listing) Leave blank Name and location (City and State) of ultimate purchaser (Location of individuals not required) A m ount Subscribed Leave blank (Note— Do not include subscriptions entitled to full allotment on the same form as other subscriptions.) 1 Subscription Number FEDERAL. R E S E R V E B A N K OF N EW YORK F isc a l Ag en t o f t h e U n ited s t a t e s NOTICE OF ALLOTMENT For United States of America 4 % Percent Treasury Notes of Series A-1972 To S ubscriber: On your subscription, numbered as above, fo r $ (par amount) o f— UNITED STATES OF AMERICA 4 % PERCENT TREASURY NOTES OF SERIES A -1972 DATED FEBRUARY 15, 1967, DUE FEBRUARY 15, 1972 which you filed pursuant to the provisions o f Treasury Department Circular No. 2-67, Public Debt Series, dated January 26, 1967, the Secretary of the Treasury has allotted notes to you in the amount of— $ Important 1. To expedite delivery of the notes allotted to you and to facilitate prom pt com pletion of this transaction, please fill in, sign and return immediately the attached Letter of Instructions to the Federal Reserve Eank of New York, Fiscal Agent of the United States, New York, N. Y . 1 00 45 . Payment 2. Payment at 99.625 for notes allotted must be made on or before February 15, 1967, as fo llo w s : By Check— The check should be made payable to the order o f the FEDERAL RESERVE BANK OF NEW YORK, FISCAL AGENT OF THE UNITED STATES. The notes will not be delivered by this Bank until the proceeds of a check have been collected. The proceeds o f a check drawn on the Federal Reserve Bank o f New York are immediately available. By By Cash— Payment may be made in cash. Charge__ A member bank may make payment by requesting us to charge its reserve account, or a nonmember clearing bank may make payment by requesting us to charge its clearing account. By M a tu r in g S e c u r itie s — Payment may be made by exchange of 3 % % Treasury Notes of Series B-1967 or 4% Treasury Notes of Series C 1967 both maturing February 15, 1967. The coupons due February 15, 1967 should be detached from the securities and cashed in regular course. Delivery 3 (a) D elivery of the notes allotted will be made by the Federal Reserve Bank of New Y ork at its H ead Office in New Y ork City, and will not be made before February 15, 1967. (b ) The notes allotted may be received over the counter by a representative of the subscriber, provided the repre sentative presents a letter of authority identifying him and signed officially by the subscriber. Safekeeping 4. Notes allotted to member banks fo r their own account may be left with this Bank fo r safekeeping pursuant to the terms of our Operating Circular No. 14. F e d e r a l R e se r v e B a n k of N e w Y Fiscal Agent o f the United States. Checked by ork, 2 (This letter o f in s t r u c t io n s , a c c o m p a n i e d b y a tta ch ed ! th r e e c o p ie s , s h o u ld be filled in and returned to Federal Reserve Bank o f New York) Subscription Number LETTER OF INSTRUCTIONS T o F e d e r a l R e se r v e B a n k op New Y ork, Fiscal A gent o f the United States, Federal Reserve P. 0 . Station, New York, N. Y . 10045 A tten tion: Government B ond Division— 2nd F loor F rom (Name and address o f Subscriber) Dated a t .......................................................... ....................................................................1967 On onr subscription, numbered as above, fo r $ (par am ount) o f— U N IT E D S T A T E S O F A M E R IC A 4 % P E R C E N T T R E A S U R Y N O T E S O F SE R IE S A -1 9 7 2 D A T E D F E B R U A R Y 15, 1 9 6 7 , D U E F E B R U A R Y 15, 1 9 7 2 which we filed pursuant to the provisions of Treasury Department Circular No. 2-67, Public Debt Series, dated January 26, 1967, we have received you r notice o f allotment stating that the Secretary of the Treasury has allotted notes to us in the amount of— $ and, as requested, we send you the follow ing instructions: Deposit has been made— B y check or c a s h ......................................................................................................... $................................ B y m aturing 3 % % Treasury Notes of Series B-1967 .................................. (p a r a m o u n t) B y m aturing 4 % Treasury Notes of Series C-1967 ....................................... (p a r a m o u n t) Balance due, if any— Q □ B y charge to our reserve account, which you are authorized to make B y check □ B y Cash 3 % % Treas. Notes Series B-1967 B y m aturing securities— Delivered to you herewith 4% Treas. Notes Series C-1967 ................................ To be withdrawn from safekeeping with you To be delivered b y ............................................... T o t a l ................................................................. I f paym ent fo r the notes allotted is by m aturing securities, pay the discount o f $3.75 per $1,000 on the issue price o f the new securities, as follow s : □ B y check □ B y credit to our reserve account I f the amount o f maturing securities delivered is in excess of the amount of new notes allotted, redeem excess amount indicated below in accordance with Form G.B.311 (Request for Redem ption o f Bearer Securities). Excess amount of m aturing securities to be r e d e e m e d .................................. (use Form G.B.311) B E A R E R NOTES DESIRED (F or REGISTERED notes— use only reverse side) Denomi nation $ Face amount Dispose of securities issued, as follow s: (Leave this space blank) 1,000 □ □ □ □ □ Deliver over the counter to the undersigned H old in safekeeping (fo r member bank o n ly )* H old as collateral fo r Treasury Tax and Loan A ccou nt 1 4. Ship to the undersigned 5. Special instructions: 1. 2. CO sees $................................ 5,000 10,000 * If this item is ch eck ed , the u ndersigned certifies that the allotted n otes w ill be ow n ed solely b y the u ndersigned. 100,000 1,000,000 TO TAL (I M P O R T A N T : b e a c c e p t e d .) ! This letter of instructions must be signed officially in the space provided and re turned immediately to Federal Reserve Bank of New York, Submitted by N o ch a n g es in d e liv e ry in stru ction s w ill (Please print) ............... . By By .......... . (A uthorized signature(s) required) Title Title Fiscal Agent o f the United States. A d d r e s s .................................................................................................... (S p a c e s b e lo w a re f o r th e u se o f th e F ed era l R e s e rv e B ank o f N ew Y o r k ) --------------------------— ------- Governm ent B ond S a f e k e e p in g D iv is io n D iv is io n Received Checked Cancelled Deliver against payment of $........................................... T'PT TVERY RECEIPT Received from Federal Reserve Bank of New York, Fiscal A>rent o f the United States, the above described securities allotted in the amount indicated above Date........................................ Subscriber........................... ................................. B y ............................ ............... Schedule for Issue of Registered Notes Name in which notes shall be registered, taxpayer identifying^ number (Social Security Account Number or Employer Identification Number;, and post-office address for interest checks and other mail. (Please print or typewrite) (Indicate under appropriate denominations, number of notes desired.) Amount $ 1,000 $5,000 $ 10,000 $ 100,000 $1,000,0 0 0 Name......... Ident. No.. Address,.... Name...... . id e n t No, Address.... Name. Ident. No, Address... Name, Ident. No. Address... (Tf registered notes, which are mailed directly by Treasury Department, Washington, D. C., are not to be sent to the registered owner, give mailing instructions below.) Mail registered notes to Subscription Number (D U P L IC A T E F O R U SB OF F E D E R A L R E S E R V E B A N K OF N E W Y O R K ) BLOTTER RECORD— GOVERNMENT BOND DIVISION To F e d e r a l R e s e r v e B a n k of N e w Y Fiscal A gent o f the United States, Federal Reserve P. 0 . Station, New York, N. Y . 10045 ork, A tten tion : Government Bond Division— 2nd F loor Dated at .............. From (Name and address o f Subscriber) .1967 On our subscription, numbered as above, fo r $ (par amount) of— UNITED STATES OF AMERICA 4 % PERCENT TREASURY NOTES OF SERIES A -1972 DATED FEBRUARY 15, 1967, DUE FEBRUARY 15, 1972 which we filed pursuant to the provisions of Treasury Department Circular No. 2-67, Public Debt Series, dated January 26, 1967, we have received you r notice of allotment stating that the Secretary of the Treasury has allotted notes to us in the amount of— $ and, as requested, we send you the follow ing instructions: Deposit has been made— B y check or c a s h ......................................................................................................... $................................ B y m aturing 3% % Treasury Notes o f Series B-1967 ..................................... $ (par amount) B y maturing 4 % Treasury Notes o f Series C-1967 ......................................... $ (par amount) Balance due, if any— □ □ B y charge to our reserve account, which you are authorized to make B y check □ B y Cash 4% Treas. Notes Series C-1967 3 % % Treas. Notes Series B-1967 B y m aturing securities— Delivered to you herewith ................................................................................ To be withdrawn from safekeeping with y o u ............................................. $.. To be delivered b y ............................................................................................... T o t a l ............................................. .................................................................. ........................ $- $.............................. .75 per $1,000 on the issue price of I f payment fo r the notes allotted is by maturing securities, pay the discount of the new securities, as fo llo w s : □ B y check □ B y credit to our reserve account I f the amount o f maturing securities delivered is in excess of the amount of new notes allotted, redeem excess amount indicated below in accordance with Form G.B.311 (Request fo r Redemption of Bearer Securities). Excess amount of maturing securities to be re d e e m e d ................................... (use Form G.B.311) BE ARER NOTES DESIRED (For REGISTERED notes— use only reverse side) eces Denomi nation $ Face amount $................................ Dispose of securities issued, as follow s: (Leave this spaee blank) 1,000 □ □ □ □ □ 1. 2. 3. 4. 5. Deliver over the counter to the undersigned H old in safekeeping (fo r member bank on ly )* H old as collateral for Treasury Tax and Loan Account* Ship to the undersigned Special instructions: 5,000 10,000 * If this item is ch e ck e d , the undersigned certifies that the allotted notes will be ow n ed solely by the undersigned. 100,000 1,000,000 (I M P O R T A N T : b e a c c e p t e d .) TOTAL This letter o f instructions must be signed Submitted by officially in the space provided and returned immediately to ^ Federal Reserve Bank of New York, N o ch a n ges in d e liv e ry in stru ction s w ill (Please print) By (Authorized signature(s) required) ................... T i t l e ............... T i t l e ................. Fiscal Agent o f the United States. Address...................................................... ............................................. (S p a c e s b e lo w a re fo r the u se o f the F e d e ra l R e se rv e Bank o f N ew Y o r k ) G overnm ent B ond S a f e k e e p in g D iv is io n D iv is io n Received Checked Cancelled Deliver against payment of $........................................... 1'PT.rVEBY EErETPT Received from F ederal Reserve Bank of New York, Fiscal A^ent of the United States, the above described securities allotted in the amouni indicated above. D a t e .................................................. S u b s c r ib e r . By. Schedule for Issue of Registered Notes Name in which notes shall be registered, taxpayer identifying number (Social Security Account Number or Employer Identification Number), and post-office address for interest checks and other mail. (Please print or typewrite) (Indicate under appropriate denominations, number of notes desired.) Amount $ 1,000 $5,000 $ 10,000 $ 100,000 $ 1,000,000 Name........ Ident. No. Address.... Name........ ident. No. Address.... Name....... Ident. No. Address.... Name....... Ident. No. Address.... ( I f registered notes, which are mailed directly by Treasury Department, Washington, D. C., are not to be sent to the registered owner, give mailing instructions below.) Mail registered notes to -------- _ . —---- 4 (T R IP L IC A T E F O R U SE OF F E D E R A L R E S E R V E B A N K OF N E W Y O R K ) Subscription Number DELIVERY TICKET— SAFEKEEPING DIVISION To F e d e r a l R e se r v e B a n k of N e w Y Fiscal A gen t o f the United States, Federal Reserve P. 0 . Station, New Y ork, N. Y . 10045 ork, A tten tion: Government Bond Division— 2nd F loor From (Name and address o f Subscriber) Dated at ......................................................... ................................................................... 1967 On our subscription, numbered as above, fo r $ (par amount) of— U N IT E D S T A T E S O F A M E R IC A 4 % P E R C E N T T R E A S U R Y N O T E S O F S E R IE S A -1 9 7 2 D A T E D F E B R U A R Y 15, 1 9 6 7 , D U E F E B R U A R Y 15, 1 9 7 2 which we filed pursuant to the provisions of Treasury Department Circular No. 2-67, Public Debt Series, dated January 26, 1967, we have received your notice o f allotment stating that the Secretary of the Treasury has allotted notes to us in the amount of— $ and, as requested, we send you the follow ing instructions: Deposit has been made— B y check or c a s h ......................................................................................................... $ ................................ B y m aturing 3 % % Treasury Notes of Series B-1967 ..................................... $ (par amount) B y maturing 4 % Treasury Notes of Series C-1967 ......................................... $. (par amount) Balance due, if any— □ B y charge to our reserve account, which you are authorized to make □ B y check □ By Cash 3 % % Treas. Notes Series B-1967 B y maturing securities— Delivered to you herewith 4% Treas. Notes Series C-1967 ................................................................................ To be withdrawn from safekeeping with y o u ............................................. $.. ........................ $.............................. To be delivered b y ............................................................................................... ........................ $.............................. T o t a l ................................................................................................................ ........................ $.............................. I f payment for the notes allotted is by maturing securities, pay the discount of the new securities, as fo llo w s : □ B y check □ .75 per $1,000 on the issue price of B y credit to our reserve account I f the amount o f maturing securities delivered is in excess of the amount of new notes allotted, redeem excess amount indicated below in accordance with Form G.B.311 (Request for Redemption of Bearer Securities). Excess amount of maturing securities to be re d e e m e d ................................... (use Form G.B.311) B E A R E R NOTES DESIRED (For REGISTERED notes— use only reverse side) Face amount Dispose o f securities issued, as follow s: (Leave this space blank) 1,000 □ □ □ □ □ 1. Deliver over the counter to the undersigned H old in safekeeping (fo r member bank o n ly )* H old as collateral for Treasury Tax and Loan Account* 4. Ship to the undersigned 5. Special instructions: 2. CO e cea Denomi nation $................................ 5 ,0 0 0 10,000 100,000 * If this item is ch e ck e d , the u ndersigned certifies that the a llotted n otes will be ow n ed solely b y the undersigned. 1,000,000 (IM P O R T A N T : b e a c c e p t e d .) TOTAL This letter of instructions must be signed Submitted by officially in the space provided and re turned immediately to By Federal Reserve Bank of New York, N o ch a n g es in d e liv e r y in stru ction s w ill (Please print) By (Authorized signature(s) required) ................... Title T i t l e ................. Fiscal Agent o f the United States. Address .................................................................................................... (S p a c e s b e lo w a re f o r th e u se o f the F ed era l R e s e rv e B ank o f N ew Y o r k ) G overnm ent B ond S a f e k e e p in g D iv is io n D iv is io n Received Checked Cancelled Deliver against payment of $............................................ D E LIV E R Y RECEIPT Received from Federal Reserve Bank of New York, Fiscal Agent of the United States, the above described securities allotted in the amount indicated above. D ate................................................ Subscriber. By. Schedule for Issue of Registered Notes (Indicate under appropriate denominations, number of notes desired.) Name in which notes shall be registered, taxpayer identifying number (S ocial Security A ccoun t Number or Employer Identification N um ber), and post-office address for interest checks and other mail. (Please print or typewrite) Amount $1,000 $5,000 $10,000 $100,000 $1,000,000 ( I f r e g is t e r e d n o t e s , w h ic h are mailed directly by Treasury Department, Washington, D. C., are not to be sent to the registered owner, give mailing instructions below.) Mail registered notes to (Q U AD RUPLICATE FOR USE OF F E D E R A L RESERVE BANK OF N EW Y O R K ) Subscription Number RELOCATION OFFICE— OUT To F e d e r a l R e s e r v e B a n k o f N e w Y o r k , Fiscal A gent o f the United States, Federal Reserve P. 0 . Station, New York, N. Y . 10045 A ttention: Government Bond Division— 2nd F loor From (Name and address o f Subscriber) Dated at .............. .1967 On our subscription, numbered as above, fo r $ U N IT E D S T A T E S OF A M E R IC A 4 % DATED FEBRU ARY (p ar amount) o f__ P E R C E N T T R E A S U R Y N O T E S O F S E R IE S A -1 9 7 2 15, 1 9 6 7 , D U E F E B R U A R Y 15, 19 7 2 which we filed pursuant to the provisions of Treasury Department Circular No. 2-67, Public Debt Series, dated January 26, 1967, we have received your notice o f allotment stating that the Secretary of the Treasury has allotted notes to us in the amount of— $ and, as requested, we send you the follow ing instructions: Deposit has been made— B y check or c a s h ......................................................................................................... $....................... B y m aturing 3 % % Treasury Notes of Series B-1967 .................................. (par amount) B y maturing 4 % Treasury Notes of Series C-1967 ....................................... (par amount) Balance due, if any— Q B y charge to our reserve account, which you are authorized to make □ B y check □ B y Cash S % % Treas. Notes Series B-1967 B y m aturing securities— Delivered to you herewith .......................................................................................$................................. To be withdrawn from safekeeping with y o u ............................................. .......$................................. d% Treas. Notes Series C-1967 $ $................................ To be delivered b y ............... ................................................. ............................. .......$ ...................................... $ T o t a l ...................................................................................................................... $................................. ..... $................................. I f payment fo r the notes allotted is by maturing securities, pay the discount of $3.75 per $1,000 on the issue price of the new securities, as fo llo w s : □ B y check □ B y credit to our reserve account I f the amount o f m aturing securities delivered is in excess of the amount of new notes allotted, redeem excess amount indicated below in accordance with Form G.B.311 (Request for Redem ption of Bearer Securities). Excess amount of maturing securities to be r e d e e m e d .................................. (use Form G.B.311) B E A R E R NOTES DESIRED (For REGISTERED notes— use only reverse side) es Denomi nation $ Face amount $................................ Dispose of securities issued, as follow s: (Leave this space blank) 1,000 □ □ □ □ 2. 3. 4. 5. Deliver over the counter to the undersigned H old in safekeeping (fo r member bank on ly )* H old as collateral for Treasury Tax and Loan Account* Ship to the undersigned Special instructions: 5,000 10,000 100,000 * If this item is ch e ck e d , the u ndersigned certifies that the a llotted n otes will be ow n ed solely b y the undersigned. 1,000,000 (I M P O R T A N T : b e a c c e p t e d .) TO TAL This letter of instructions must be signed Submitted by officially in the space provided and re turned immediately to By Federal Reserve Bank of New York, N o ch a n g es in d e liv e ry in stru ction s w ill (Please print) By (A uthorized signature(s) required) ................... Title T i t l e ................. Fiscal Agent o f the United States. Address .................................................................................................... (S p a c e a b e lo w a re f o r the u se o f the F ed era l R e s e rv e B ank o f N ew Y o r k ) Governm ent B ond S a f e k e e p in g D iv is io n D iv is io n Received Checked Cancelled Checked . . Delivered Deliver against payment of $........................................... DELIVE RY RECEIPT Received from Federal Reserve Bank o f New York, Fiscal Agent o f the United States, the above described securities allotted in the amount indicated above. Date. Subscriber.............................................................................By. Schedule for Issue of Registered Notes (Indicate under appropriate denominations, number of notes desired.) Name in which notes shall be registered, taxpayer identifying number (S ocial Security A ccoun t Number or Employer Identification N um ber), and post-office address for interest checks and other mail. (Please print or typewrite) Am ount ( I f r e g is t e r e d notes, which are mailed directly by Treasury Department, Washington, D. owner, give mailing instructions below.) $5,000 $1,000 C ., $10,000 $100,000 $1,000,000 are not to be sent to the registered Mail registered notes to it ALLOTMENT NOTICE FOR GOVERNMENT BOND DIVISION S u b s c rip tio n ........................ $ (par amount) o f— U N IT E D S T A T E S O F A M E R IC A 4 % P E R C E N T T R E A S U R Y N O T E S O F SE R IE S A -1 9 7 2 D A T E D F E B R U A R Y 15, 1 9 6 7 , D U E F E B R U A R Y 15, 197 2 Allotm ent ............................ $ D I S P O S I T I O N DEPOSIT Over Counter Check or C a s h .............................................................................................. | 3 % % Treasury Notes Series B-1967 .................................................. Safekeeping 4% Treasury Notes Series C-1967 ...................................................... T. T. & L. Excess amount Treasury Notes Series B-1967 to be redeemed Excess amount Treasury Notes Series C-1967 to be redeemed Ship Excess cash payment to be refunded .................................................. Balance due T re a su ry ............................................................................... PAYM EN T Check or C a s h .............................................................................................. Treasury Notes Series B-1967 .............................................................. Treasury Notes Series C-1967 ............................................................... Reserve account .......................................................................................... Balance ........................................................................................................ Special Instructions ALLOTMENT NOTICE FOR SECURITIES DEPARTMENT S u b s c rip tio n ........................ $ (par amount) o f— UNITED S T A T E S OF A M E R IC A 4?4 PERCEN T T R E A S U R Y N O TES OF SERIES A -1 97 2 D A T E D FEB RU A RY 15, 1967, DUE FEB RU A RY 15, 1972 Allotm ent $ ALLOTMENT NOTICE FOR SECURITY FILES S u b s c rip tio n ........................ $ (par amount) of— U N IT E D S T A T E S O F A M E R IC A 4 % P E R C E N T T R E A S U R Y N O T E S O F SE R IE S A -1 9 7 2 D A T E D F E B R U A R Y 15, 1 9 6 7 , D U E F E B R U A R Y 15, 1 9 7 2 Allotm ent 1 Subscription Number FE D ER A L R ESERVE BANK OF NEW YORK Fisc a l A g en t of t h e U nited s t a t e s NOTICE OF ALLOTMENT For United States of America 4 % Percent Treasury Notes of Series B-1968 To S ubscriber: On your subscription, numbered as above, fo r $ U N IT E D S T A T E S (par amount) o f— O F A M E R IC A 4 ? i P E R C E N T T R E A S U R Y N O T E S O F S E R IE S B -1 9 6 8 D A T E D F E B R U A R Y 15, 1 9 6 7 , D U E M A Y 15, 1 9 6 8 which you filed pursuant to the provisions o f Treasury Department Circular No. 1-67, Public Debt Series, dated January 26, 1967, the Secretary of the Treasury has allotted notes to you in the amount of— $ Important 1. To expedite delivery of the notes allotted to you and to facilitate prom pt com pletion of this transaction, please fill in, sign and return immediately the attached Letter o f Instructions to the Federal Reserve Bank of New York, Fiscal Agent of the United States, New York, N. Y. 10045. Payment 2. Paym ent at 99.875 for notes allotted must be made on or before February 15, 1967, as fo llo w s : B y C heck __ The check should be made payable to the order o f the FEDERAL RESERVE BANK OF NEW YORK, FISCAL AGENT OF THE UNITED STATES The notes will not be delivered by this Bank until the proceeds o f a check have been collected. The proceeds o f a check drawn on the Federal Reserve Bank o f New York are immediately available. B y Cash — Payment may be made in cash. B y C h a r g e __ A member bank may make payment by requesting us to charge its reserve account, or a nonmember clearing bank may make payment by requesting us to charge its clearing account. B y M a tu r in g S e c u r itie s __ Payment may be made by exchange o f 3 % % Treasury Notes of Series B-1967 or 4% Treasury Notes of Series C-1967 both maturing February 15, 1967. The coupons due February 15, 1967 should be detached from the securities and cashed in regular course. Delivery 3. (a) Delivery of the notes allotted will be made by the Federal Reserve Bank of New Y ork at its H ead Office in New Y ork City, and will not be made before February 15, 1967. (b ) The notes allotted may be received over the counter by a representative of the subscriber, provided the rep sentative presents a letter of authority identifying him and signed officially by the subscriber. Safekeeping 4. Notes allotted to member banks for their own account may be left with this Bank fo r safekeeping pursuant to the terms of our Operating Circular No. 14. F ederal R eserve B a n k o f N e w Y o r k , Fiscal Agent of the United States. Checked by 2 (This letter of instructions, accompanied by attached three copies, should be filled in and returned to Federal Reserve Bank of New York) Subscription Number LETTER OF INSTRUCTIONS To F ederal R eserve B a n k of N e w Y ork , Fiscal A gent o f the United States, Federal Reserve P. 0 . Station, New Y ork, N. Y . 10045 A tten tion: Government B ond Division— 2nd Floor Dated a t ......................................................... From (Name and address o f Subscriber) ....................................................................1967 On our subscription, numbered as above, fo r $ U N IT E D S T A T E S (par am ount) o f— O F A M E R IC A 4 % P E R C E N T T R E A S U R Y N O T E S O F SE R IE S B -1 9 6 8 D A T E D F E B R U A R Y 15, 1 9 6 7 , D U E M A Y 15, 1 9 6 8 which we filed pursuant to the provisions o f Treasury Department Circular No. 1-67, Public Debt Series, dated January 26, 1967, we have received you r notice of allotment stating that the Secretary of the Treasury has allotted notes to us in the amount o f— $ and, as requested, we send you the follow ing instructions: Deposit has been made— B y check or c a s h ......................................................................................................... $................................ B y m aturing 3 % % Treasury Notes of Series B-1967 ..................................... $................................ (par amount) B y maturing 4 % Treasury Notes o f Series C-1967 ......................................... $................................ (par amount) Balance due, if any— Q B y charge to our reserve account, which you are authorized to make □ B y check □ B y Cash 3 % % Treas. Notes Series B-1967 B y m aturing securities— Delivered to you herewith 4% Treas. Notes Series C-1967 ................................ To be withdrawn from safekeeping with you To be delivered b y ............................................... T o t a l ................................................................. I f payment fo r the notes allotted is by maturing securities, pay the discount of $1.25 per $1,000 on the issue price of the new securities, as fo llo w s : □ B y check □ B y credit to our reserve account I f the amount of maturing securities delivered is in excess of the amount of new notes allotted, redeem excess amount indicated below in accordance with Form G.B.311 (Request for Redem ption o f Bearer Securities). Excess amount o f maturing securities to be re d e e m e d .................................. $................................ (use Form G.B.311) Dispose of securities issued, as follow s: B E A R E R NOTES DESIRED (F o r REGISTERED notes— use only reverse side) ces Denomi nation $ Face amount (Leave this space blank) 1,000 □ □ □ □ □ 1. 2. 3. 4. 5. Deliver over the counter to the undersigned H old in safekeeping (fo r member bank on ly )* H old as collateral fo r Treasury Tax and Loan Account* Ship to the undersigned Special instructions: 5,000 10,000 * If this item is ch eck ed , the undersigned certifies that the allotted notes will be ow n ed solely by the undersigned. 100,000 1,000,000 (I M P O R T A N T : b e a c c e p t e d .) TOTAL This letter of instructions must be signed officially in the space provided and re turned immediately to Federal Reserve Bank of New York, Fiscal Agent o f the United States. N o ch a n ges in d e liv e r y in stru ction s w ill Submitted b j .......................................................................... (Please print) By ....................................................................... By ..............•••• T i t l e ......................................................................... T i t l e ................. (Authorized signature(s) required) Address ............................................................................................... (S p a c e s b e lo w a re fo r the u se o f the F e d e ra l R e se rv e B ank o f N ew Y o r k ) G overnm ent B ond S a f e k e e p in g D iv is io n D iv is io n Received D e liv e r a g a in s t p a y m e n t C h e ck e d Cancelled of $........................................... HFTJVERY RECEIPT K( re veil from Federa. Reserve Bank of New York, FiscaJ \ o f the United States, the above described securities allotted in the amount indicated above. ......................................................... Subscriber............................................................................. B y ........................................................................................................ Schedule for Issue of Registered Notes Name in which notes shall be registered, taxpayer identifying number (Social Security Account Number or Employer Identification Number), and post-office address for interest checks and other mail. ( Please print or typewrite) (Indicate under appropriate denominations, number of notes desired.) Amount $1,000 $5,000 $10,000 $100,000 $1,000,000 Idexit No....................................................................... .................... Address............................................................................................... [dent N o ........................................................................................... Address............................................................................................... rdent. N o............................................................................................. Address..... ......................................................................................... ( I f registered notes, which are mailed directly by Treasury Department, Washington, D. C., are not to be sent to the registered owner, give mailing instructions below.) Mail registered notes to (D U PLIC A TE FOE USE OF F E D E R A L RESERVE BAN K OF N EW Y O RK ) Subscription Number BLOTTER RECORD— GOVERNMENT BOND DIVISION To F ederal R eserve B a n k of N e w Y o rk , Fiscal A gen t o f the United States, Federal Reserve P. 0 . Station, New York, N. Y . 10045 A tten tion : Government B ond Division— 2nd F loor Dated at .............. From (Name and address o f S ubscriber) .1967 On our subscription, numbered as above, fo r $ (p ar amount) o f__ UNITED S T A T E S OF A M E R IC A 4 % PERCEN T T R E A S U R Y N OTES OF SERIES B-1968 D A T E D FE B RU A RY 15, 1967, DUE M A Y 15, 1968 which we filed pursuant to the provisions o f Treasury Department Circular No. 1-67, Public Debt Series, dated January 26, 1967, we have received you r notice o f allotment stating that the Secretary o f the Treasury has allotted notes to us in the amount of— and, as requested, we send you the follow ing instructions: Deposit has been made— B y cheek or c a s h ..................................................................................................... B y m aturing 3% % Treasury Notes o f Series B-1967 ................................ (par amount) B y m aturing 4 % Treasury Notes o f Series C-1967 ..................................... (par amount) Balance due, if any— □ B y charge to our reserve account, which you are authorized to make □ B y check □ B y Cash 3 % % Treas. Notes Series B-1967 B y maturing securities— Delivered to you herewith 4% Treas. Notes Series C-1967 ............................................... ......................................$ To be withdrawn from safekeeping with y o u ............................................. .......$ To be delivered b y ..................................................................................................... $ T o t a l ............... ................................................................................... ................... ft $- It payment fo r the notes allotted is by maturing securities, pay the discount of $1.25 per $1,000 on the issue price of the new securities, as fo llo w s : □ B y check □ B y credit to our reserve account I f the amount o f maturing securities delivered is in excess of the amount of new notes allotted, redeem excess amount indicated below in accordance with Form G.B.311 (Request fo r Redem ption o f Bearer Securities). Excess amount o f .maturing securities to be r e d e e m e d ................................... (use Form G.B.311) BEARER NOTES DESIRED (For REGISTERED notes —use only reverse side) Denomi nation $ Faee amount $................................ Dispose of securities issued, as follow s: (Leave this space blank) 1,000 □ □ □ □ □ 1. 2. 3. 4. 5. Deliver over the counter to the undersigned H old in safekeeping (fo r member bank o n ly )* H old as collateral fo r Treasury Tax and Loan Account* Ship to the undersigned Special instructions: 5 ,0 0 0 10,000 100,000 * If this item is ch e ck e d , the u ndersigned certifies that the a llotted n otes w ill be ow n ed solely b y the u ndersigned. 1, 000,000 (IM P O R T A N T : b e a c c e p t e d .) TO TAL This letter of instructions must be signed officially in the space provided and re turned immediately to Federal Reserve Bank of New York, Submitted by N o ch a n g es in d e liv e r y in stru ctio n s w ill (Please print) By By (Authorized signature(s) required) ................... Title T i t l e ................. Fiscal Agent o f the United States. Address .................................................................................................... ( S p a c e s b e lo w a re f o r th e u se o f th e F ed era l R e s e rv e B ank o f N ew Y o r k ) S a f e k e e p in g D iv is io n G o v e r n m e n t B o n d D iv is io n Received Checked Cancelled D ELIVE RY RECEIPT Received from Federal Reserve Bank o f New York, Fiscal Agent o f the United States, the above described securities allotted in the amount indicated above. Date. Subscriber............................................................................. By. Schedule for Issue of Registered Notes (Indicate under appropriate denominations, number of notes desired.) Name in which notes shall be registered, taxpayer identifying number (S ocial Security A ccoun t N um ber or Employer Identification N um ber), and post-office address for interest checks and other mail. (Please print or typewrite) Id fT lt \ T0 Amount $1,000 $5,000 $10,000 $100,000 $1,000,000 .................................................... ................................. *.............. ( I f registered notes, which are mailed directly by Treasury Department, Washington, D. C., are not to be sent to the registered owner, give mailing instructions below.) Mail registered notes to 4 (T R IP L IC A T E F O R U SE OF F E D E R A L R E S E R V E B A N K OF N E W Y O R K ) Subscription Number DELIVERY TICKET— SAFEKEEPING DIVISION To F e d e r a l R e s e r v e B a n k o f N e w Y o r k , Fiscal A gent o f the United States, Federal Reserve P. 0 . Station, New Y ork, N. Y . 10045 A tten tion: Government Bond Division— 2nd F loor From (Name and address o f S ubscriber) Dated at ......................................................... ....................................................................1967 On onr subscription, numbered as above, fo r $ UNITED S T A T E S OF A M E R IC A 4 % (par amount) o f— PERCEN T T R E A S U R Y NOTES OF SERIES B-1968 D A T E D FE B RU A RY 15, 1S67, DUE M A Y 15, 1S68 which we filed pursuant to the provisions of Treasury Department Circular No. 1-67, Public Debt Series, dated January 26, 1967, we have received you r notice o f allotment stating that the Secretary of the Treasury has allotted notes to us in the amount o f— and, as requested, we send you the follow ing instructions: Deposit has been made— B y check or c a s h ......................................................................................................... $ B y m aturing 3 % % Treasury Notes of Series B-1967 ..................................... $ (par amount) B y m aturing 4 % Treasury Notes of Series C-1967 .................................... $ (par amount) . Balance due, if any— □ □ B y charge to our reserve account, which you are authorized to make B y check □ B y Cash 3 % % Treas. Notes Series B-1967 B y maturing securities— Delivered to you herewith 4% Treas. Notes Series C-1967 .......................................................................................$................................. $................................ To be withdrawn from safekeeping with y o u ............................................. .......$................................. $................................ To be delivered b y ......................................................................................................$................................. $................................ T o t a l ............................................................................................................... .......$................................. $................................ I f payment fo r the notes allotted is by m aturing securities, pay the discount of $1.25 per $1,000 on the issue price of the new securities, as fo llo w s : □ B y check □ B y credit to our reserve account I f the amount o f m aturing securities delivered is in excess of the amount of new notes allotted, redeem excess amount indicated below in accordance with Form G.B.311 (Request fo r Redem ption of Bearer Securities). Excess amount of m aturing securities to be r e d e e m e d ................................... (use Form G.B.311) BEARER NOTES DESIRED (For REGISTERED notes— use only reverse side) $ Face amount Dispose of securities issued, as follow s: (Leave this space blank) 1,000 □ □ □ □ □ 1. Deliver over the counter to the undersigned H old in safekeeping (fo r member bank on ly )* H old as collateral fo r Treasury Tax and Loan Account* 4. Ship to the undersigned 5. Special instructions: 2. CO Denomi nation $................................ 5,000 10,000 * If this item is ch e ck e d , the u ndersign ed certifies that the allotted n otes w ill be ow n ed solely b y th e u n dersigned. 100,000 1 , 000,000 (I M P O R T A N T : b e a c c e p t e d .) TOTAL This letter of instructions must be signed Submitted by officially in the space provided and returned immediately to ^ Federal Reserve Bank of New York, N o ch a n g es in d e liv e r y in stru ction s w ill (Please print) By (A uthorized signature(s) required) ................... Title........... T i t l e ................. Fiscal Agent of the United States. Address .................................................................................................... (S p a c e s b e lo w a re f o r the u se o f the F e d e ra l R e s e rv e B an k o f N ew Y o r k ) Governm ent B ond S a f e k e e p in g D iv is io n D iv is io n Received Checked Cancelled Checked .. Delivered Deliver against payment of $........................................... . D E LIV E R Y RECEIPT Received from Federal Reserve Bank of New York, Fiscal Agent o f the United States, the above described securities allotted in the amount indicated above. Digitized FRASER p aj.0 for ............................................ Subscriber............................................................................. B y ................................................................................... • Schedule for Issue of Registered Notes Name in which notes shall be registered, taxpayer identifying^ number (Social Security Account Number or Employer Identification Number), and post-office address for interest checks and other mail. (Please print or typewrite) (Indicate under appropriate denominations, number of notes desired.) Amount $1,000 $5,000 $10,000 $100,000 $1,000,000 ( I f registered notes, which are mailed directly by Treasury Department, Washington, D. C., are not to be sent to the registered owner, give mailing instructions below.) Mail registered notes to 5 (Q U A D R U P L IC A T E F O R U SE OF F E D E R A L R E S E R V E B A N K OF N E W Y O R K ) Subscription Number RELOCATION O F F IC E -O U T To F ederal R eserve B a n k of N e w Y o r k , Fiscal A gent o f the United States, Federal Reserve P. 0 . Station, New Y ork, N. Y . 10045 A tten tion: Government B ond Division— 2nd F loor From (Name and address o f S ubscriber) Dated at ......................................................... ................................................................... 1967 On our subscription, numbered as above, fo r $ (par am ount) o f— U NITED S T A T E S OF A M E R IC A 4 94 PERCEN T T R E A S U R Y N OTES OF SERIES B-1968 D A T E D FEB RU A RY 15, 1967, DUE M A Y 15, 1S68 which we filed pursuant to the provisions of Treasury Department Circular No. 1-67, Public Debt Series, dated January 26, 1967, we have received you r notice of allotment stating that the Secretary o f the Treasury has allotted notes to us in the amount o f— and, as requested, we send you the follow ing instructions: Deposit has been made— B y check or c a s h ....................................................................................................... B y m aturing 3 % % Treasury Notes o f Series B-1967 ................................ (par amount) B y m aturing 4 % Treasury Notes o f Series C-1967 ..................................... (par amount) Balance due, if any— □ B y charge to our reserve account, which you are authorized to make □ B y check □ B y Cash 3% % Treas. Notes B y m aturing securities— Series B-1967 Delivered to you herewith 4% Treas. Notes Series C-1967 ...................................................................................... $ ................................. ..... $ ................................. To be withdrawn from safekeeping with y o u ............................................. ...... $................................. ..... $................................. To be delivered b y ............................................................................................... $................................ ..... $ ................................. T o t a l ................................................................................................................ $................................ ..... $................................. I f payment fo r the notes allotted is by maturing securities, pay the discount of $1.25 per $1,000 on the issue price of the new securities, as fo llo w s : □ B y check □ B y credit to our reserve account I f the amount of m aturing securities delivered is in excess of the amount of new notes allotted, redeem excess amount indicated below in accordance with Form G.B.311 (Request for Redem ption of Bearer Securities). Excess amount o f maturing securities to be re d e e m e d ................................... (use Form G.B.311) BEARE R NOTES DESIEED (For REGISTERED notes— use only reverse side) :ces Denomi nation $ Face amount $................................ Dispose of securities issued, as follow s: (Leave this space blank) 1,000 □ □ □ □ □ 1. 2. 3. 4. 5. Deliver over the counter to the undersigned H old in safekeeping (fo r member bank o n ly )* H old as collateral fo r Treasury Tax and Loan A ccount* Ship to the undersigned Special instructions: 5,000 10,000 * If this item is ch e ck e d , the u ndersigned certifies that the a llotted n otes will b e ow n ed solely b y the u ndersigned. 100,000 1,000,000 (IM P O R T A N T : b e a c c e p t e d .) TO TAL This letter of instructions must be signed officially in the space provided and re turned immediately to Federal Reserve Bank of New York, Submitted by N o ch a n g e s in d e liv e r y in stru ction s w ill (Please print) By By (Authorized signature(s) required) ................... rj T i t l e ................. Fiscal Agent o f the United States. Address .................................................................................................... ( S p a c e s b e lo w a re f o r th e u se o f th e F e d e ra l R e s e rv e B an k o f N ew Y o r k ) Governm ent B ond Received D e liv e r S a f e k e e p in g D iv is io n D iv is io n Cheeked C a n c e lle d against payment of $............................................ DELIVE RY RECEIPT Received from Federal Reserve Bank o f New York, Fiscal Agent o f the United States, the above described securities allotted in the amount indicated above. Digitized Date. for FRASER Subscriber............................................................................. B y. •todnur 'A noiJqiiaeduS ; /[> J 51 Schedule for Issue of Registered Notes Name in which notes shall be registered, taxpayer identifyingnumber (Social Security Account Number or Employer Identification Number), and post-office address for interest checks and other mail. (Please print or typewrite) (Indicate under appropriate denominations, number of notes desired.) Amount $1,000 $5,000 $10,000 $100,000 $1,000,000 ID01 Name. !lH Ident. No. Address.... V0U.B id ea T ^ .T i Name. .... ......... daQ ident. No.. 9 i{j ni m oi fZ B S lT b9d 2 od 9lli O 9Dlt0fl Address. i o i 9 ii i J Name............... I* rrfT Ident. N o........ Address......... Name. Ident. No. Address.... T;o 90nq 9 if?.ai 9 ri t n r e g is t e r e d (If notes, which are mailed directly by Treasury Department, Washington, D. C., are not to be sent to the registered owner, give mailing instructions below.) Tnnoiim ihSdZ'j mi; Mail registered notes to D9H^i8i9JDair 9 '(v in o irw d 19& iin oi’ I 'p g t d J b m r 9uj o j qui : 8noi bmJg/ii ffiiaeu & d i i » A t o A ih s a b sn 'g r n fs fc a u iis a f im im ii »iil v.d ylal' fliw *aoiJ90*tiaa! p • b 'iJ s s d l) i casJi n id i fe^rswo *>•'; IIfw *9loo I sJiofi •ntsr oH : V KLA 1 /IC 1 M I) M il artui bsv.vtfpO sooxm 9n,t ALLOTMENT NOTICE FOR GOVERNMENT BOND DIVISION S u b s c rip tio n ........................ $ (par amount) of- U N IT E D S T A T E S O F A M E R IC A 4 % P E R C E N T T R E A S U R Y N O T E S O F SE R IE S B -1 9 6 8 D A T E D F E B R U A R Y 15, 1 9 6 7 , D U E M A Y 15, 19 6 8 Allotm ent D I S P O S I T I O N DEPOSIT Over Counter Check or Cash Safekeeping 3 % % Treasury Notes Series B-1967 ..................................................... $. 4% Treasury Notes Series C-1967 ...................................................... ... $. T. T. & L. Excess amount Treasury Notes Series B-1967 to be redeemed . . . . $. Excess amount Treasury Notes Series C-1967 to be redeemed . . . . $. Ship Excess cash payment to be refunded .................................................. ... $. Special Instructions Balance due Treasury PAYM ENT Check or Cash Treasury Notes Series B-1967 .............................................................. ....$_ Treasury Notes Series C-1967 .............................................................. ....$_ Reserve account ..............................................................................................$. Balance ........................................................................................................ ALLOTMENT NOTICE FOR SECURITIES DEPARTMENT S u b s c rip tio n ........................ $ U N IT E D S T A T E S O F A M E R IC A 4 % P E R C E N T T R E A S U R Y D A T E D F E B R U A R Y 15, 1 9 6 7 , D U E M A Y Allotm ent ............................ $ (par amount) o f— N O T E S O F SE R IE S B -1 9 6 8 15, 1 9 6 8 8 ALLOTMENT NOTICE FOR SECURITY FILES S u b s c r ip tio n ........................ $ (par amount) of- U N IT E D S T A T E S O F A M E R IC A 4 % P E R C E N T T R E A S U R Y N O T E S O F S E R IE S B -1 9 6 8 D A T E D F E B R U A R Y 15, 1 9 6 7 , D U E M A Y 15, 196 8 Allotm ent