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FEDERAL RESERVE BANK
OF NEW YORK
Fiscal Agent of the United States
/■Circular No. 5 9 7 6 1
L April 28, 1967 J

Refunding of Treasury Notes, Bonds, and Certificates Maturing
May 15, June 15, and August 15, 1967

To All Banking Institutions, and Others Concerned,
in the Second Federal Reserve D istrict:

The subscription books will be open Monday, May 1, through Wednesday, May 3, for
an offering of—
414 percent Treasury Notes o f Series C-1968, dated M ay 15, 1967,
maturing August 15, 1968, and
4 % percent Treasury Notes o f Series B-1972, dated M ay 15, 1967,
maturing M ay 15, 1972,

in exchange for the eligible series of Treasury notes, bonds, and certificates maturing May 15,
June 15, and August 15, 1967, as set forth in Treasury Department Circulars Nos. 5-67 and
6-67, Public Debt Series, both dated April 27, 1967; a copy of each is printed on the following
pages. Any gain or loss on this exchange will be fully recognized under the Internal Revenue
Code. Holders of the securities maturing August 15 may exchange them only for the 4% per­
cent notes.
Coupons dated May 15, 1967 on the securities maturing on that date should be detached
and cashed when due. Coupons dated June 15 and August 15, 1967 on securities maturing on
those dates must be attached. Tables 1 and 2 on page 6 show details of interest and other
adjustments, and approximate investment yields.
Only banking institutions may submit subscriptions for account of customers. On such
subscriptions, the customers’ names must be furnished. On subscriptions for account of
customers other than individuals, their locations must also be furnished. On subscriptions for
account of customers of correspondent banks, the names of such customers and, if not
individuals, their locations must be furnished.
Subscribers are required to certify that at the time the subscription is entered the
securities surrendered were owned and delivery was accepted by the subscriber, or that such
securities were contracted for purchase for value by the subscriber for delivery to the sub­
scriber prior to the closing of the subscription books.
Subscriptions will be received by this Bank as fiscal agent of the United States. Subscrip­
tions should be submitted in triplicate on official subscription forms, copies of whch are
enclosed, and should be mailed immediately. If filed by telegram or letter, the subscriptions
should be confirmed immediately by mail on the forms provided. The subscription books will
remain open for three days, May 1 through May 3. Any subscription addressed to a Federal
Reserve Bank or Branch or to the Treasury Department and placed in the mail before midnight
Wednesday, May 3, will be considered timely.
Cash subscriptions will not be received.




A

lfred

H

ayes,

President.

UNITED STATES OF AMERICA
m

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 C - 1 9 6 8

Dated and bearing interest fro m May 15, 1967

D ue August 15, 1968

D EPAR T M EN T CIRCULAR

TREASU RY DEPARTM ENT,
O f f ic e

Public Debt Series— No. 5 -67

of t h e

S ecretary,

W ashington, A p ril 27,1967.
I.

OFFERING OF NOTES

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,
g ift 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 of the possessions o f the United States,
or by any local taxing authority.

1. The Secretary o f the Treasury, pursuant to
the authority o f the Second Liberty Bond A ct, as
amended, offers notes o f the United States, designated
4 1 4 percent Treasury Notes o f Series C -1968:
(1 ) at 99.95 percent o f their face value in ex­
change for 4 % percent Treasury Notes o f Series
D-1967, dated November 15, 1965, due M ay 15,
1967; or

3. The notes will be acceptable to secure deposits
o f public moneys. They will not be acceptable in pay­
ment o f taxes.

(2) at 99.95 percent o f their face value, plus a
payment o f $1.00 per $1,000 to the United States,
in exchange fo r 2 V2 percent Treasury Bonds
o f 1962-67, dated May 5, 1942, due June 15, 1967,
in amounts o f $1,000 or multiples thereof.

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
o f different denominations and o f coupon and regis­
tered notes, and fo r the transfer o f registered notes,
under rules and regulations prescribed by the Secre­
tary o f the Treasury.

Interest will be adjusted on the bonds o f 1962-67 as
o f M ay 15, 1967. Cash payments due to subscribers
will be made as set forth in Section I V hereof. The
amount o f this offering will be limited to the amount
o f eligible securities tendered in exchange. The books
will be open only on May 1 through M ay 3, 1967, for
the receipt o f subscriptions.

5. The notes will be subject to the general regula­
tions o f the Treasury Department, now or hereafter
prescribed, governing United States notes.

2. In addition, holders o f the securities enumer­
ated in Paragraph 1 o f this Section are offered the
privilege o f exchanging all or any part o f them fo r
4 % percent Treasury Notes o f Series B-1972, which
offering is set forth in Department Circular, Public
Debt Series — No. 6-67, issued simultaneously with
this circular.
II.

III.

D ESCRIPTIO N OF NOTES

1.
The notes will be dated M ay 15, 1967, and will
bear interest from that date at the rate o f 4 1 per­
/4
cent per annum, payable on a semiannual basis on
A ugust 15, 1967, and on February 15 and August 15,
1968. They will mature A ugust 15, 1968, and will not
be subject to call fo r redemption p rior to maturity.




2

SURSCRIPTION AND ALLOTM ENT

1. Subscriptions accepting the offer made b y 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. Banking
institutions generally may submit subscriptions for
account o f customers, but only the Federal Reserve
Banks and the Treasury Department are authorized
to act as official agencies.
2. Under the Second Liberty B ond A ct, as
amended, the Secretary o f the Treasury has the
authority to reject or reduce any subscription, and to
allot less than the amount o f notes applied fo r 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, all sub­
scriptions will be allotted in full.

difference ($9.87088 per $1,000) will be paid to sub­
scribers.
V.

IV.

1.
Treasury securities in registered form tendered
in paym ent fo r notes offered hereunder should be
assigned by the registered payees or assignees thereof,
in accordance with the general regulations o f the
Treasury Department governing assignments for
transfer or exchange, in one o f the form s hereafter
set forth, and thereafter should be surrendered with
the subscription to a Federal Reserve Bank or Branch
or to the Office o f the Treasurer o f the United States,
Washington, D. C. 20220. The securities must be de­
livered at the expense and risk o f the holder. I f the
new notes are desired registered in the same name
as the securities surrendered, the assignment should
be to “ The Secretary o f the Treasury fo r exchange
for 4 1 4 percent Treasury-Notes o f Series C-1968” ; if
the new notes are desired registered in another name,
the assignment should be to “ The Secretary o f the
Treasury fo r exchange fo r 4 ^ percent Treasury
Notes o f Series C-1968 in the name o f ........................
if new notes in coupon form are desired, the assign­
ment should be to “ The Secretary o f the Treasury for
exchange fo r 4 ^ percent Treasury Notes o f Series
C-1968 in coupon form to be delivered t o .................

PAYM ENT

1. Payment fo r the face amount o f notes allotted
hereunder must be made on or before M ay 15, 1967,
or on later allotment, and may be made only in a
like face amount o f securities o f the two issues enu­
merated in Paragraph 1 o f Section I hereof, which
should accom pany the subscription. 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 em­
ployer identification number) is not furnished. Cash
payments due to subscribers will be made b y check or
b y credit in any account maintained by a banking
institution with the Federal Reserve Bank o f its Dis­
trict follow ing acceptance o f the securities surren­
dered. In the case o f registered securities, the payment
w ill be made in accordance with the assignments
thereon.
2. 4 1 4 percent notes o f Series B-1967. — W hen
payment is made with notes in bearer form , coupons
dated M ay 15, 1967, should be detached and cashed
when due. W hen payment is made with registered
notes, the final interest due on M ay 15, 1967, will be
paid by issue o f interest checks in regular course to
holders o f record on A p ril 14, 1967, the date the
transfer books closed. A cash payment o f $0.50 per
$1,000 on account o f the issue price o f the notes will
be made to subscribers.

V I.

GENERAL PROVISIONS

1. As fiscal agents o f the United States, Federal
Reserve Banks are authorized and requested to re­
ceive subscriptions, to make such allotments as may
be prescribed by the Secretary o f the Treasury, to
issue such notices as may be necessary, and to receive
payment fo r and make delivery o f notes on full-paid
subscriptions allotted, and they may issue interim
receipts pending delivery o f the definitive notes.

3. 2^/2 p ercen t bonds o f 1962-67. — W hen pay­
ment is made with bonds in bearer form , coupons
dated June 15, 1967, must be attached to the bonds
in bearer form when surrendered. A ccrued interest
from December 15, 1966, to May 15, 1967 ($10.37088
per $1,000), plus the payment ($0.50 per $1,000) due
to the subscriber on account o f the issue price o f the
new notes will be credited, the payment o f $1.00 per
$1,000 due the United States will be charged, and the




ASSIGNMENT OF REGISTERED SECURITIES

2. The Secretary o f the Treasury may at any time,
or from time to time, prescribe supplemental or
amendatory rules and regulations governing the offer­
ing, which will be communicated prom ptly to the
Federal Reserve Banks.
HENRY H. FOW LER,
S ecretary o f the Treasury.

3

UNITED STATES OF AMERICA
m

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 7 2

Dated and bearing interest from May 15, 1967

D ue May 15, 1972

DEPARTMENT CIRCULAR

TREASU RY DEPARTM ENT,
O f f ic e

Public Debt Series— No. 6-67

of t h e

S ecretary,

W ashington, A p ril 27,1967.
I.

OFFERING OF NOTES

are offered the privilege o f exchanging all or any part
o f such securities for 4*4 percent Treasury Notes o f
Series C-1968, which offering is set forth in D epart­
ment Circular, Public Debt Series — No. 5-67, issued
simultaneously with this circular.

1. The Secretary o f the Treasury, pursuant to
the authority o f the Second Liberty Bond A ct, as
amended, offers notes o f the United States, designated
4% percent Treasury Notes o f Series B-1972 at p a r:
(1) in exchange fo r 4*4 percent Treasury Notes of
Series D-1967, dated November 15, 1965, due
M ay 15, 1967;
(2) with a cash payment o f $1.00 per
United States in exchange for
Treasury Bonds o f 1962-67, dated
due June 15, 1967, in amounts
multiples thereof;

II.

$1,000 to the
21 percent
/2
M ay 5, 1942,
o f $1,000 or

(3) with a cash payment o f $3.00 per $1,000 to the
subscriber in exchange for 51/4 percent Treas­
ury Certificates o f Indebtedness o f Series A 1967, dated August 15, 1966, due August 15,
1967;

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.

(4) with a cash payment o f $1.50 per $1,000 to the
United States in exchange for 3 % percent
Treasury Notes o f Series A-1967, dated Sep­
tember 15, 1962, due August 15, 1967; or
(5) with a cash payment o f $2.00 per $1,000 to the
subscriber in exchange for 4 % percent Treas­
u ry Notes o f Series E-1967, dated February
15, 1966, due August 15, 1967.

3. The notes will be acceptable to secure deposits
o f public moneys. They will not be acceptable in
payment o f taxes.
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 regis­
tered notes, and fo r the transfer o f registered notes,
under rules and regulations prescribed b y the Secre­
tary o f the Treasury.

Interest will be adjusted as o f May 15, 1967, in the
case o f the securities due June 15 and August 15,
1967. Net payments on account o f accrued interest
due subscribers and cash adjustments due to and from
subscribers will be made as set forth in Section IV
hereof. The amount o f this offering will be limited
to the amount o f eligible securities tendered in ex­
change. The books will be open only on May 1
through May 3, 1967, for the receipt o f subscriptions.

5. The notes will be subject to the general regula­
tions o f the Treasury Department, now or hereafter
prescribed, governing United States notes.

2. In addition, holders o f the 4 % percent notes o f
Series D-1967, and the 2 % percent bonds o f 1962-67




D ESCRIPTION OF NOTES

1. The notes will be dated M ay 15, 1967, and will
bear interest from that date at the rate o f 4 % percent
per annum, payable semiannually on November 15,
1967, and thereafter on M ay 15 and November 15 in
each year until the principal amount becomes pay­
able. They will mature M ay 15, 1972, and will not be
subject to call fo r redemption prior to maturity.

4

III.

5. 5 % percen t notes o f Series A-1967. — Coupons
dated August 15, 1967, must be attached to the notes
in bearer form when surrendered. A ccrued interest
from February 15 to M ay 15, 1967 ($9.21961 per
$1,000), will be credited, the payment ($1.50 per
$1,000) due the United States will be charged, and
the difference ($7.71961 per $1,000) will be paid to
subscribers.

SUBSCRIPTION AND ALLOTMENT

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. Banking
institutions generally may submit subscriptions fo r
account o f customers, but only the Federal Reserve
Banks and the Treasury Department are authorized
to act as official agencies.

6. 4 % percen t notes o f Series E-1967. — Coupons
dated A ugust 15, 1967, must be attached to the notes
in bearer form when surrendered. A ccrued interest
from February 15 to M ay 15, 1967 ($11.98550 per
$1,000), plus the cash payment o f $2.00 per $1,000
will be paid to subscribers.

2. Under the Second Liberty B ond A ct, as
amended, the Secretary o f the Treasury has the
authority to reject or reduce any subscription, and
to allot less than the amount o f notes applied fo r
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, all
subscriptions will be allotted in full.
IV.

V.

PAYM ENT

1. Payment for the face amount o f notes allotted
hereunder must be made on or before May 15, 1967, or
on later allotment, and may be made only in a like
face amount o f securities o f the five issues enumerated
in Paragraph 1 o f Section I hereof, which should
accom pany the subscription. Payment will not be
deemed to have been completed where registered notes
are requested if the appropriate identifying number
as required on tax returns and other documents sub­
mitted to the Internal Revenue Service (an individ­
ual’s social security number or an employer identi­
fication number) is not furnished. Cash payments
due to subscribers will be made by check or by credit
in any account maintained by a banking institution
with the Federal Reserve Bank o f its District fo l­
lowing acceptance o f the securities surrendered. In
the case o f registered securities, the payment will be
made in accordance with the assignments thereon.
2. 4x percent notes o f Series B-1967. — Coupons
/±
dated M ay 15, 1967, should be detached and cashed
when due.1
3. 2 1 2 p ercen t bonds o f 1962-67. — Coupons dated
/
June 15, 1967, must be attached to bonds in bearer
form when surrendered. A ccrued interest from
December 15, 1966, to M ay 15, 1967 ($10.37088 per
$1,000) will be credited, the payment ($1.00 per
$1,000) due the United States will be charged, and
the difference ($9.37088 per $1,000) will be paid to
subscribers.

VI.

GENERAL PROVISIONS

1. As fiscal agents o f the United States, Federal
Reserve Banks are authorized and requested to re­
ceive subscriptions, to make such allotments as may
be prescribed by the Secretary o f the Treasury, to
issue such notices as may be necessary, and to receive
payment for and make delivery o f notes on full-paid
subscriptions allotted, and they may issue interim
receipts pending delivery o f the definitive notes.

4. 5!/4 p ercen t certificates o f Series A-1967. —
Coupons dated August 15, 1967, must be attached to
the certificates when surrendered. A ccrued interest
from February 15 to M ay 15, 1967 ($12.90746 per
$1,000), plus the cash payment o f $3.00 per $1,000
will be paid to subscribers.

2. The Secretary o f the Treasury may at any time,
or from time to time, prescribe supplemental or
amendatory rules and regulations governing the offer­
ing, which will be communicated prom ptly to the
Federal Reserve Banks.

1 Interest due on May 15, 1967, on registered securities will
be paid by issue of interest checks in regular course to holders
of record on April 14, 1967, the date the transfer books closed.




ASSIGNMENT OF REGISTERED SECURITIES

1.
Treasury securities in registered form tendered
in payment fo r notes offered hereunder should be
assigned by the registered payees or assignees thereof,
in accordance with the general regulations o f the
Treasury Department governing assignments for
transfer or exchange, in one o f the form s hereafter
set forth, and thereafter should be surrendered with
the subscription 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 securities must be- de­
livered at the expense and risk o f the holder. I f the
new notes are desired registered in the same name
as the securities surrendered, the assignment should
be to “ The Secretary o f the Treasury for exchange for
4 % percent Treasury Notes o f Series B-1972” ; if the
new notes are desired registered in another name, the
assignment should be to “ The Secretary of the Treas­
u ry fo r exchange fo r 4 % percent Treasury Notes of
Series B-1972 in the name o f ...........................................
.............................. ” ; if new notes in coupon form are
desired, the assignment should be to “ The Secretary
of the Treasury for exchange for 4 % percent Treas­
ury Notes o f Series B-1972 in coupon form to be de­
livered to ...........................................................................

HENRY H. FOW LER,
Secretary of the Treasury.

5

TABLE NO. 1

P

a y m e n t s due to

S u b s c r ib e r s

in

the

M ay

1967 R e f u n d i n g

(In dollars per $100 face value)

Payment to (-{-)
or by (—) subscribers
on account of
issue price of
offered securities

Securities to
be exchanged

F o r t h e 4 14 %

N ote o f

Accrued interest to
May 15,1967
on securities
exchanged
to be paid
to subscribers

8 /1 5 /6 8

+0.050000
— 0.050000

4 ^ % Note, 5 /1 5 /6 7
2i/2% Bond, 6 /1 5 /6 7

F

or t h e

4 % % N ote

Net am
ount
to be paid
to subscribers

1.037088

1.037088
1.290746
0.921961
1.198550

of

0.050000
0.987088

0.937088
1.590746
0.771961
1.398550

5 /1 5 /7 2

414%

Note, 5 / 1 5 / 6 7 .................
—
Bond, 6 /1 5 /6 7 ............... ................. — 0.100000
51/4% Cert., 8 /1 5 /6 7 ................. ................. +0.300000
33/4% Note, 8 /1 5 /6 7 ................. ................. — 0.150000
4 % % Note, 8 /1 5 /6 7 ................. ................. +0.200000
21/ 2 %

a Interest will be paid in regular course.

T A B L E NO. 2

I nvestm ent R eturns

in

the

M

ay

1967 P r e r e f u n d i n g

Securities eligible
for exchange

Approximate investment yield
from 5/15/67 to maturity1

Approximate reinvestment rate
for the extension period2

51/4% Cert., 8 /1 5 /6 7
33/4% Note, 8 /1 5 /6 7
4 % % Note, 8 /1 5 /6 7

4.72%
4.72
4.72

4.79%
4.77
4.79

1 Yields to nontaxable holders (or before tax) on issues offered in exchange based on prices of eligible issues (adjusted for payments on account
of issue price). Prices are the mean of bid and ask quotations at noon on April 25, 1967.

2 Rate for nontaxable holder (or before tax).

Office of the Secretary o f the Treasury
Office o f Debt Analysis




6

Subscription No.

DELIVERY INSTRUCTIONS— EXCHANGE SUBSCRIPTION
For United States of America 4l Percent Treasury Notes of Series C-1968
A
Dated May 15, 1967, Due August 15, 1968
B E A R E R N O TE S D E S IR E D IN E X C H A N G E
(U se schedule on reverse side for R E G IS T E R E D notes)

Dispose o f securities issued as fo llo w s :
Denomi­
nation

Pieces
$

5,000

10,000

1. Deliver over the counter to
the undersigned
2. H old in safekeeping
member bank o n ly )*

□

1,000

□
□

(Leave this space blank)

Face amount

3. H old as collateral fo r Treas*
ury Tax and Loan A ccount*

(fo r

O 4. Ship to the undersigned
□

100,000

5. Special instructions:

1,000,000
TO TAL

*If this item is checked, the subscriber certi­
fies that the allotted securities will be owned
solely by the subscriber.

The subscription books will open on
May 1, and close at the close of
business May 3, 1967.

(IM PO R TA N T: No changes in delivery instructions will be
accepted. A separate subscription form must be submitted for
each group o f securities for which different delivery instruc­
tions are given .)
Submitted by
(Please print)

By .................

• .................... , B y ......................

Title . . .

....................... , T itle ..................

(Authorized signature(s) required)

Address
(Spaces below are for the use o f the Federal Reserve Bank o f New Y ork )
S a f e k e e p in g R ecord

Received

Received from 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 the above described United
States obngations m the amount subscribed for.
Subscriber ...................

Checked
and

delivered



Schedule for Issue of Registered Notes
Name in which notes shall be registered
identifying number (Social Security Account Number
or Employer Identification Number) and p^tTffice
address for interest checks and other mail
_______ ______ f rlease print or typewrite)

(Indicate under appropriate denominations, number of notes
Amount

Name
Ident. No.
Address

Name......
Ident. No.
Address

Name......
Ident. No,
Address

Name......
Ident. No.
Address

( I f registered notes, which are mailed direct]v h v Tmoo,,™
registered owner, give mailing instructions below.)
Department, Washington, D . C., are not to be sent to the

Mail registered notes to




Subscriber’s Keference No.

(Please type or print legibly

and submit in

triplicate)

Subscription No.

A -l

EXCHANGE SUBSCRIPTION
For United States of America 4l Percent Treasury Notes of Series C-1968
A
Dated May 15, 1967, Due August 15, 1968
I m p o r ta n t In s tr u c tio n s .
1. Securities of different issues surrendered in exchange may be listed together on the
same subscription form , except that a separate subscription form should be used ( a ) for listing bearer securities
surrendered, ( b ) for listing registered securities surrendered, and ( c ) for each group o f new securities for which
different delivery instructions are given.
2. Separate subscription forms should be used for bearer securities and
registered securities desired in exchange.
3. Social Security account numbers or Em ployer Identification numbers of
all subscribers fo r r e g is te r e d notes must be furnished on the reverse side hereof.
4. Signatures are required on
original on ly; all other filled-in matter should appear in triplicate.

Dated at .........................................................

F ed eral R eserve B a n k of N e w Y o r k ,

Fiscal Agent o f the United States,
New York, N. Y . 10045
A tten tion :

........................................................................ 1967
Government Bond Division

Gentlem en :

Subject to the provisions o f Treasury Department Circular No. 5-67, Public Debt Series, dated
-il 27, 1967, the undersigned hereby subscribes for United States of America 41 percent Treasury
/4
es o f Series C-1968, in the amount o f $ ................................................. * and tenders in payment therefor
notes desi“ e Par amount o f the securities —
~ " Delivered to you herewith .................................................................................................... $
$1,000;
J
^
To be withdrawn from securities held by y o u ................................................................ $
To be delivered by ................................................................................................................. $
* (Please fill in on the reverse side the schedule “ List of Accounts Included in this Subscription.” )

S E C U R IT IE S S U R R E N D E R E D

Total Am ount
% Notes, D -1967 (detach cou pon s)

(D o not fill in this
colum n)
T o Subscriber

...............................

% Bonds, 1962-67 (w ith 6 /1 5 /6 7 coupons attached)
Total

........................................................

net amount due subscriber on price and interest adjustments:*
□ By check
□ By credit to reserve account
* See Section IV of T. D. Circular No. 5-67, Public Debt Series, for method of computing net adjustment.

W e H e r e b y C e r t i f y that at the time this subscription was entered the above-described securities
rendered or to be surrendered in connection with this exchange were owned and delivery was accepted
•
the subscriber, 01: such securities were contracted for purchase fo r value by the subscriber fo r delivery
the subscriber prior to-the closing of the subscription books.

(Signature(s) required also on Delivery Instructions below)

(D o not fill in boxes below )
..

G overnm ent B ond D

Received

Checked




iv is io n

Submitted by ..............................................
(Please print)

Canceled
By

.......... ; ••, B y ............................
(Authorized signature(s) required)

Title ...................................................... . Title
Address

................................................

(I f space is insufficient in schedules below, attach separate listing)

List of Accounts Included in this Subscription
(Indicate total amount of each issue surrendered by each customer and by yourself)

( Leave this
space blank)

Name and location (C ity and State)
o f ultimate purchaser
( Location o f individuals not required )

4*4% Notes
D-1967
$ ......................

2 % % Bonds
1962-67
$ ......................

Total
$ ...................

Our own a c c o u n t .............................................
Totals

........................................................

$ ................................. $ .................................

$ ...............................

I

I

( 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 t o .....................................................................................................................................




V

Schedule for Issue of Registered Notes

Mail registered notes to




Subscriber’s Reference No.

DUPLICATE— SECURITY RECORDS “ IN TICKET”

Subscription No.

A-2

EXCHANGE SUBSCRIPTION
For United States of America 4J Percent Treasury Notes of Series C-1968
A
Dated May 15, 1967, Due August 15, 1968

Dated at .........................................................

F ed er al R eser v e B a n k of N e w Y o rk ,

Fiscal Agent o f the United States,
New York, N. Y . 10045
A tten tion :

........................................................................ 1967
Government Bond Division

Gen tl em en :

Subject to the provisions o f Treasury Department Circular No. 5-67, Public Debt Series, dated
April 27, 1967, the undersigned hereby subscribes for United States o f America 4 1 percent Treasury
/4
Notes o f Series C-1968, in the amount of $ ................................................. * and tenders in payment therefor
a like par amount o f the securities—•
Delivered to you h e r e w ith ............................................................................................

$

To be withdrawn from securities held by y o u .......................................................

$..................................

To be delivered by .........................................................................................................

$..................................

* (Please fill in on the reverse side the schedule “ List of Accounts Included in this Subscription.” )

S E C U R IT IE S SU R R E N D E R E D

Total Am ount
4 V i % Notes, D -1967 (detach coupon s)

................................................

2 / 4 % Bonds, 1962-67 (w ith 6 /1 5 /6 7 coupons attached) ...............
Total

.........................................................................

(D o not fill in this
colum n)
T o Subscriber

$ .......................... ........

..................................

$ ...................................

..................................

$................................ .

...................... ...........

Pay net amount due subscriber on price and interest adjustments:*
□ By check
□ By credit to reserve account
* See Section IV of T. D. Circular No. 5-67, Public Debt Series, for method of computing net adjustment.

W e H e r e b y C e r t i f y that at the time this subscription was entered the above-described securities
surrendered or to be surrendered in connection with this exchange were owned and delivery was accepted
by the subscriber, 01; such securities were contracted for purchase for value by the subscriber fo r delivery
to the subscriber prior to-the closing of the subscription books.




Submitted by

( I f space is insufficient in schedules below, attach separate listing)

List of Accounts Included in this Subscription
(Indicate total amount of each issue surrendered by each customer and by yourself)

(Leave this
space blank)

Name and location (C ity and State)
o f ultimate purchaser
( Location o f individuals not required)

---------- ----4*4% Notes
D-1967

2 % % Bonds
1962-67

Total

$ ...................... $

Our own account . . .
Totals



.....................

$ ................................. $ .................................. . $ ...............................

NONNEGOTIABLE RECEIPT

To Subscriber:

Subscription No.

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, hereby acknowledges receipt o f
securities tendered with subscription numbered as above in exchange fo r
41/4 P E R C E N T T R E A S U R Y N O TE S O F S E R IE S C-1968
Securities allotted on this subscription will be delivered on
May 15, 1967, in accordance with your instructions.
......................................................................................
_
Teller
Uovemment Bond Division — Issues & Redemption Section

B E A R E R N O TE S D E S IR E D IN E X C H A N G E
(U se schedule on reverse side for REGISTERED notes)

Dispose o f securities issued as fo llo w s :
Denomi­
nation
f

□

1. Deliver over the counter to
the undersigned

1,000

0

2. H old in safekeeping
member bank on ly) *

5,000

Pieces

□

3. H old as collateral fo r Treasury Tax and Loan A ccount*

□

4. Ship to the undersigned

□

5. Special instructions:

(Leave this space blanlc)

Face amount

10,000
100,000

(fo r

1,000,000
TOTAL

To F e d e r a l R e s e r v e B a n k or N e w Y o r k
Fiscal Agent of the United States
(Date)

You are hereby authorized to deliver to

Submitted by .........................

(Name of representative)

whose signature appears below,
I ................................................par amount
of securities issued pursuant to this subscription.
N a m e...............................
(Please print)
(Official signature required)
(Signature of authorized representative)




To Subscriber : If 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.

Schedule for Issue of Registered Notes

Mail registered notes to




Subscriber’ s Reference No.

TRIPLICATE— TREASURY REPORTS COPY

Subscription No.

A-3

EXCHANGE SUBSCRIPTION
For United States of America 4% Percent Treasury Notes of Series C-1968
Dated May 15, 1967, Due August 15, 1968

Dated at .........................................................

F e d er al R ese r v e B a n k of N e w Y o r k ,

Fiscal A gent o f the United States,
New Y ork, N. Y . 10045
A tten tion :

........................................................................ 1967
Government B ond Division

Ge n t l e m e n :

Subject to the provisions o f Treasury Department Circular No. 5-67, Public Debt Series, dated
A p ril 27, 1967, the undersigned hereby subscribes for United States o f Am erica 4*4 percent Treasury
Notes o f Series C-1968, in the amount of $ ................................................. * and tenders in payment therefor
a like par amount o f the securities—
Delivered to you h e r e w ith ............................................................................................

$..................................

To be withdrawn from securities held by y o u .......................................................

$..................................

To be delivered by .........................................................................................................

$ ..................................

* (Please fill in on the reverse side the schedule “ List of Accounts Included in this Subscription.” )

S E C U R IT IE S SU R R E N D E R E D

Total Am ount
4 % % Notes, D -1967 (detach coupon s)

................................................

2 V z % Bonds, 1962-67 (with 6 /1 5 /6 7 coupons attached)
Total

(D o not (ill in this
colum n)
T o Subscriber

$

..............

$.

.........................................................................

$

Pay net amount due subscriber on price and interest adjustments:*
□ By check
□ By credit to reserve account
* See Section IV of T. D. Circular No. 5-67, Public Debt Series, for method of computing: net adjustment.

W e H er eb y C e r t if y that at the time this subscription was entered the above-described securities
surrendered or to be surrendered in connection with this exchange were owned and delivery was accepted
by the subscriber, oi; such securities were contracted for purchase fo r value by the subscriber fo r delivery
to the subscriber prior to-the closing o f the subscription books.




Submitted by

Address

( I f space is insufficient in schedules below, attach separate listing)

List of Accounts Included in this Subscription
(Indicate total amount of each issue surrendered by each customer and by yourself)

(Leave this

space blank)

Name and location (C ity and State)
o f ultimate purchaser
( Location o f individuals not required )

4 *4% Notes
D-1967

2 % % Bonds
1962-67

$ ...................... $ ................

Total

$ ....

'
’

Our own account.............................................
Totals



.......................................................

$ ................................. $ ................................... $ ..............................

Subscription No.

DELIVERY INSTRUCTIONS— EXCHANGE SUBSCRIPTION
For United States of America 4% Percent Treasury Notes of Series B-1972
Dated May 15, 1967, Due May 15, 1972
B E A R E R N O TE S D E S IR E D IN E X C H A N G E
(U se schedule on reverse side for REGISTERED notes)

Denomi­
nation

Dispose of securities issued as follows:
1. Deliver over the counter to
the undersigned

1,000

□

2. Hold in safekeeping
member bank o n ly )*

□

3. Hold as collateral for Treas­
u ry Tax and Loan A ccount*

10,000

$

□

5,000

Pieces

□

4. Ship to the undersigned

□

5. Special instructions:

(Leave this space blank)

Face amount

100,000

(for

1,000,000
TOTAL
*If this item is checked, the subscriber certi­
fies that the allotted securities will be owned
solely by the subscriber.

(IM PO R TA N T: No changes in delivery instructions will be
accepted. A separate subscription form must be submitted for
each group o f securities fo r which different delivery instruc­
tions are given.)
Submitted by

The subscription books will open on
May 1, and close at the close of
business May 3, 1967.

By .................

(Please print)

..................... By ...... ....................
(Authorized signature(s) required)

T it le ................................................... T i t l e .................
Address

(Spaces below are for the use o f the Federal Reserve Bank o f New Y o rk )
S afek eeping R ecord

Received

Received from F e d e ra l R eserve B a n k o f N e w Y o r k the above described United
States obligations in the amount subscribed for.

Subscriber .................................................................................................................................
Checked
and
delivered




D a te ......................................

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

Name...................................................
Ident. N o..........................................
A ddress..............................................
as’ '•5*
*1
Name..............................................
Ident. N o....................................................
Address................................................

Name................................................................
Ident. No..............................................
Address........................................

Name..............................................
Ident. N o...................................................
A ddress.................................... ?
..............................
*-

-■ .

-if

*
•
( 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




(Please type or print legibly and submit in triplicate)

Subscriber’s Beference No.

Subscription No.

B-l

EXCHANGE SUBSCRIPTION
For United States of America 4% Percent Treasury Notes of Series B-1972
Dated May 15,1967, Due May 15, 1972
I m p o r ta n t I n s tr u c tio n s .
1. Securities of different issues surrendered in exchange may be listed together on the
same subscription form , except that a separate subscription form should be used ( a ) for listing bearer securities
surrendered, ( b ) fo r listing registered securities surrendered, and ( c ) for each group o f new securities for^ which
different delivery instructions are given.
2. Separate subscription form s should be used for bearer securities and
registered securities desired in exchange.
3. Social Security account numbers or Em ployer Identification numbers of
all subscribers fo r r e g is te r e d notes must be furnished on the reverse side hereof.
4. Signatures are required on
original on ly; all other filled-in matter should appear in triplicate.
F

ederal

R

eserve

Bank

of

N ew Y

Dated at .........................................................

ork,

Fiscal Agent o f the United States,
New York, N. Y . 10045
A tten tion :

....... ,............................................................. 1967
Government B ond Division

Gentlem en :

Subject to the provisions o f Treasury Department Circular No. 6-67, Public Debt Series, dated
A pril 27, 1967, the undersigned hereby subscribes fo r United States o f Am erica 4 % percent Treasury
Notes o f Series B-1972, in the amount of $ ................................................. * and tenders in payment therefor
a like par amount o f the securities—
Delivered to you h e r e w ith ............................................................................................

$

To be withdrawn from securities held by y o u ........................................................

$

To be delivered by .........................................................................................................

$

* (Please fill in on the reverse side the schedule “ List of Accounts Included in this Subscription.” )

SE C U R IT IE S SU R R E N D E R E D
(D o not fill in this
colum n)
T o Subscriber

Total Am ount
4% %

Notes, D -1967 (detach cou p on s) .................................................

( 1 ) $ ...................................

XXXXXXXXXXX

2 % % Bonds, 1962-67 (w ith 6 /1 5 /6 7 coupons attached) ...............

( 2 ) $ ...................................

..................................

5

l%
A

c o f I, A -1 9 6 7 (w ith 8 /1 5 /6 7 coupons attached) .................

( 3 ) $ ...................................

...................................

3 % % Notes, A -1 9 6 7 (w ith 8 /1 5 /6 7 coupons attached) .................

( 4 ) $ ..................................

...................................

4% %

( 5 ) $ .............................. .

...................................

Notes, E-1967 (w ith 8 /1 5 /6 7 coupons attached)
Total

.................

.........................................................................

$ .................. -...... -------------------- -------------------------

Pay net amount due subscriber on price and interest adjustm ents:*
□ By check
□ By credit to reserve account
* See Section IV of T. D. Circular No. 6-67, Public Debt Series, for method of computing net adjustment.
W e H e r e b y C e r t i f y that at the time this subscription was entered the above-described securities
surrendered or to be surrendered in connection with this exchange were owned and delivery was accepted
by the subscriber, or such securities were contracted for purchase fo r value by the subscriber fo r delivery
to the subscriber prior to the closing of the subscription books.

(Signature(s) required also on Delivery Instructions below)

(D o not fill in boxes below )
G o v e r n m e n t B o n d D iv is io n

Beceived

Checked




Submitted by ...........................................................................................
(Please print)

Canceled

By .......................................................... . B y ............................................
(Authorized signature (s) required)

Title ...................................................... . T itle ........................................
Address

......................................................................................................

(If Space is insufficient in schedules below, attach separate listing)

List of Accounts Included in this Subscription
(Indicate amount of each issue surrendered by each customer and by yourself)
(Leave thii
space blankJ

Name and location (C ity and State)
o f ultimate purchaser

(3)

(2)

(i)

sy4%

414% Notes 2y2% Bonds
■ D-1967

(Location of individuals not required)

$

C o f I ’s
A-1967

1962-67

$

&

Total

$

Our own a c c o u n t...................................................
T o t a ls .......................

$ .............. $ .............. $ ..............
(4)
(5)
3 % % Notes 4 % % Notes
A-1967
E-1967

$

$

■*
1

VOur own a c c o u n t ................................
Totals

...............................................




$ .............. * ...;.............

$ .............

Subscription No.

SECURITY RECORDS “OUT TICKET’
DELIVERY INSTRUCTIONS— EXCHANGE SUBSCRIPTION
For United States of America 4% Percent Treasury Notes of Series B-1972
Dated May 15,1967, Due May 15, 1972

B E A R E R N O TE S D E S IR E D IN E X C H A N G E
(U se schedule on reverse side for REGISTERED notes)

Pieces

Denomi­
nation

%

Dispose of securities issued as follows:
□

1. Deliver over the counter to
the undersigned

□

2. Hold in safekeeping
member bank only) *

5,000

□

3. Hold as collateral for Treasury Tax and Loan Account*

10,000

□

4. Ship to the undersigned

□

5. Special instructions:

Face amount

(Leave this space blank)

1,000

100,000

1 ,000,000
TOTAL




Submitted by

Address

(for

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. N o.................................................................
.V

Address....................................................................

Name........................................................................
Ident. N o..............................................................
Address...................................................

Name.............................................
Ident. 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




Subscriber's Reference No.

DUPLICATE— SECURITY RECORDS “IN TICKET”

Subscription No.

B-2

EXCHANGE SUBSCRIPTION
For United States of America 4% Percent Treasury Notes of Series B-1972
Dated May 15, 1967, Due May 15,1972

Dated at .........................................................

F ed er al R eser v e B a n k of N e w Y o r k ,

Fiscal A gen t o f the United States,
New York, N. Y . 10045
A tten tion :

.......... ,.......................... ..................... ............. 1967
Government Bond Division

Gen tlem en :

Subject to the provisions of Treasury Department Circular No. 6-67, Public Debt Series, dated
A pril 27, 1967, the undersigned hereby subscribes for United States o f Am erica 4 % percent Treasury
Notes o f Series B-1972, in the amount o f $ ................................................. * and tenders in payment therefor
a like par amount o f the securities—
Delivered to you herewith ............................................................................................

$..................................

To be withdrawn from securities held by y o u ........................................................

$..................................

To be delivered by .........................................................................................................

$ ..................................

* (Please fill in on the reverse side the schedule “ List of Accounts Included in this Subscription.” )

S E C U R IT IE S SU R R E N D E R E D
Total Am ount
4^%

Notes, D -1967 (detach coupon s) .................................................

( 1 ) $ .............

..........

( 3 ) $ .............

3 % % Notes, A -1 96 7 (w ith 8 /1 5 /6 7 coupons attached) .................

( 4 ) $ .............

4 / „ % Notes, E-1967 (w ith 8 /1 5 /6 7 coupons attached)

.................

( 5 ) $ ............

.........................................................................

xxxxxxxxxxx

( 2 ) $ ............

C o f I, A -1 9 6 7 (w ith 8 /1 5 /6 7 coupons attached) .................

(D o not fill in this
colu m n )
T o Subscriber

$.............

2 V z % Bonds, 1962-67 (w ith 6 /1 5 /6 7 coupons attached) .
S% %

Total

Pay net amount due subscriber on price and interest adjustm ents:*
□ By check
□ By credit to reserve account
* See Section

IV o f T. D. Circular No. 6-67, Public Debt Series, for method of computing net adjustment.

W e Hereby C e r tify that at the time this subscription was entered the above-described securities
surrendered or to be surrendered in connection with this exchange were owned and delivery was accepted
by the subscriber, or such securities were contracted for purchase for value by the subscriber for delivery
to the subscriber prior to the closing of the subscription books.




Submitted by

Address

( I f space is insufficient in schedules below, attach separate listing)

List of Accounts Included in this Subscription
(Indicate amount of each issue surrendered by each customer and by yourself)

(Leave this
space blank)

Name and location (C ity and State)
o f ultimate purchaser
( Location of individuals not required)

(3)
sy4%
Cof I ’s

(2)
Notes 2%% Bonds

(l)

414 %

D-1967

$

1962-67

$

Total

A-1967

$

$

Our own a c c o u n t ...................................................
T o t a ls ...............................................

$ .............. $ .............. $ ..............
(4)
(5)
3%% Notes 4%% Notes
A-1967

E-1967

$

Our own a c c o u n t ...........................................................................
Totals

................................................................




$ .............. $ ..............

$ ................

Subscription No.

NONNEGOTIABLE RECEIPT

To Subscriber:

F ederal R eserve B a n k of N e w Y ork , Fiscal A gent o f the United States, hereby acknowledges receipt of
securities tendered with subscription numbered as above in exchange for
43,4 P E R C E N T T R E A S U R Y N O TE S O F S E R IE S B-1972
Securities allotted on this subscription will be delivered on
May 15, 1967, in accordance with your instructions.
...................................... Teiier.................................................
Government Bond Division — Issues & Redemption Section

B E A R E R N O TE S D E S IR E D IN E X C H A N G E
(U se schedule on reverse side for R E G IS T E R E D notes)

Denomi­
nation

Dispose o f securities issued as fo llo w s :
1. Deliver over the counter to
the undersigned

1,000

□

2. H old in safekeeping
member bank on ly) *

□

3. H old as collateral fo r Treasu ry Tax and Loan A ccount*

10,000

$

□

5,000

Pieces

□

4. Ship to the undersigned

□

5. Special instructions:

(Leave this space blank)

Face amount

100,000

(fo r

1,000,000
TOTAL

To F e d e r a l R e s e r v e B a n e or N e w Y o r k
Fiscal Agent of the United States
(Date)

You are hereby authorized to deliver to

Submitted by ....................................................................................................

(Name of representative)

whose signature appears below,
I ................................................par amount
of securities issued pursuant to this subscription.
(Please print)

To Subscriber: If
(Official signature required)
(Signature of authorized representative)




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.

Mail registered notes to




Subscriber’s Reference No.

TRIPLICATE— TREASURY REPORTS COPY

Subscription No.

B-3

EXCHANGE SUBSCRIPTION
For United States of America 4% Percent Treasury Notes of Series B-1972
Dated May 15, 1967, Due May 15, 1972

Dated at .................................................. .......

F ederal R eserve B a n k op N e w Y o r k ,

Fiscal A gent o f the United States,
New Y ork, N. Y . 10045
A tten tion :

.........................................................................1967
Government Bond Division

G entlem en :

abject to the provisions o f Treasury Department Circular No. 6-67, Public Debt Series, dated
27, 1967, the undersigned hereby subscribes for United States of Am erica 4 % percent Treasury
'/ o f Series B-1972, in the amount o f $ ................................................. * and tenders in payment therefor
<
-j par amount o f the securities—
\

delivered to you herewith ............................................................................................
To be withdrawn from securities held by y o u ........................................................
3

$..................................
$..................................

To be delivered by .........................................................................................................

$..................................

* (Please fill in on the reverse side the schedule “ List of Accounts Included in this Subscription.” )

S E C U R IT IE S S U R R E N D E R E D
Total Am ount
4 % % Notes, D -1967 (detach coupon s)

........................ ........................

( 1 ) $ ..................................

(D o not fill in this
colum n)
T o Subscriber
XXXXXXXXXXX

2 V 2 % Bonds, 1962-67 (w ith 6 /1 5 /6 7 coupons attached) ...............

( 2 ) $ ...................................

..................................

5 % % C o f I, A -1 96 7 (w ith 8 /1 5 /6 7 coupons attached) .................

( 3 ) $ ...................................

...................................

3 % % Notes, A -1 96 7 (w ith 8 /1 5 /6 7 coupons attached) .................

( 4 ) $ .......................... ........

...................................

4% %

( 5 ) $ ...................................

...................................

Notes, E-1967 (w ith 8 /1 5 /6 7 coupons attached) .................
Total

.........................................................................

$ .................. ....................................................... .......

Pay net amount due subscriber on price and interest adjustments:*
□ By check
□ By credit to reserve account
* See Section IV of T. D. Circular No. 6-67, Public Debt Series, for method of computing net adjustment.
W e H e r e b y C e r t i f y that at the time this subscription was entered the above-described securities
surrendered or to be surrendered in connection with this exchange were owned and delivery was accepted
by the subscriber, or such securities were contracted fo r purchase fo r value by the subscriber fo r delivery
to the subscriber prior to the closing o f the subscription books.




Submitted by

Address

( I f space is insufficient in schedules below, attach separate listing)

List of Accounts Included in this Subscription
(Indicate amount of each issue surrendered by each customer and by yourself)

(Leave this
pace blank)

Name and location (C ity and State)
of ultimate purchaser

(i)
4 ^ % Notes

(2 )

(Location of individuals not required)

D-1967

1962-67

Bonds

(3)

5*4%
Cof I ’s

Total

A-1967

$ .............. $ .............. $

$

........... ..... sj
' 1

Our own a ccou n t.......................................................
T o t a ls ....................................................................

$ ................. $ .............. $ ..............
(4)
(5)
3% % Notes 4% % Notes
A-1967

E-1967

$ .............. $ ..............

Our own a c c o u n t.....................................................................
 Totals ............................................................................


$ .............. $ ..............

ji


Federal Reserve Bank of St. Louis, One Federal Reserve Bank Plaza, St. Louis, MO 63102