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FEDERAL RESERVE BANK
OF N E W YORK
Fiscal Agent of the United States
24 0
[Circularl No.19420 9 T
Ai s
J
Aprils, 1942

J

Cash Offering of
Percent Treasury Certificates of Indebtedness of Series A-1942
Dated and bearing interest from April 15,1942

Due November 1,1942

To all Banking Institutions, and Others Concerned,
in the Second Federal Reserve District:

The following press statement was today made public:
Secretary of the Treasury Morgenthau today announced the offering, through the Federal Reserve
Banks, for cash subscription at par and accrued interest, of $1,500,000,000, or thereabouts, of
y% percent Treasury Certificates of Indebtedness of Series A-1942. In order to insure more extensive
participation for moderate amounts on the part of corporations, banks, and others interested in
a type of security carrying maturities somewhat longer than Treasury bills, subscriptions up to
$25,000 will be allotted in full. Subscriptions for larger amounts will be allotted on an equal
percentage basis, but not less than $25,000 on any one subscription.
The certificates will be dated April 15, 1942, will be payable on November 1, 1942, and will bear
interest at the rate of one-half of one percent per annum, payable at the maturity of the certificates.
They will be issued in bearer form only, with one interest coupon attached, in denominations of
$1,000, $5,000, $10,000 and $100,000.
Pursuant to the provisions of the Public Debt Act of 1941, interest upon the certificates now
offered shall not have any exemption, as such, under Federal tax Acts now or hereafter enacted. The
full provisions relating to taxability are set forth in the official circular released today.
Subscriptions will be received at the Federal Reserve Banks and Branches, and at the Treasury
Department, Washington. Banking institutions generally may submit subscriptions for account of
customers, but only the Federal Reserve Banks and the Treasury Department are authorized to act
as official agencies. Subscriptions for the certificates from banks and trust companies for their own
account will be received without deposit, but subscriptions from all others must be accompanied by
payment of 10 percent of the amount of certificates applied for. The bases on which, subscriptions
will be entertained from the various classes of subscribers will be the same as announced on December 3, 1941, for the December 15 cash offerings; they are set forth in the official circular governing
this offering.
The right is reserved to close the books as to any or all subscriptions or classes of subscriptions
at any time without notice. The basis of allotment of subscriptions will be publicly announced, and
payment for any certificates allotted must be made or completed on or before April 15, 1942, or on
later allotment.

The terms of this offering are set forth in Treasury Circular No. 683, dated April 6,1942,
a copy of which is printed on the following pages.
The subscription hooks are now open, and applications will be received by this bank as fiscal
agent of the United States. Subscriptions should be made on official subscription blanks and
mailed immediately or, if filed by telegram or letter, should be confirmed immediately by mail
on the blanks provided. Telegraphic or letter subscriptions to the cash offering entered by a
bank should state the amount subscribed for the bank's own account and the number of
subscriptions, at each amount, entered for the customers of the subscribing bank.




AT.T,ATT S P B O U L ,

President.

UNITED STATES OF AMERICA
PERCENT TREASURY CERTIFICATES OF INDEBTEDNESS OF SERIES A-1942
Dated and bearing interest from April 15, 1942

1942

Due November 1, 1942

TREASURY DEPARTMENT,

Department Circular No. 683

_

Bureau oTtheP^Wic Debt

Office of the Secretary,

Washington, April 6, 1942.

I. OFFERING OF CERTIFICATES
1. The Secretary of the Treasury, pursuant to the authority of the Second Liberty Bond Act, as
amended, invites subscriptions, at par and accrued interest, from the people of the United States for y%
percent certificates of indebtedness of the United States, designated Treasury Certificates of Indebtedness of
Series A-1942. The amount of the offering is $1,500,003,000, or thereabouts.
II. DESCRIPTION OF CERTIFICATES
1. The certificates will be dated April 15, 1942, and will bear interest from that date at the rate of %
percent per annum, payable on an annual basis at the maturity of the certificates. They will mature November 1, 1942, and will not be subject to call for redemption prior to maturity.
2. The income derived from the certificates shall be subject to all Federal taxes, now or hereafter
imposed. The certificates shall be subject to estate, inheritance, gift or other excise taxes, whether Federal
or State, but shall be exempt from all taxation now or hereafter imposed on the principal or interest thereof
by any State, or any of the possessions of the United States, or by any local taxing authority.
3. The certificates will be acceptable to secure deposits of public moneys. They will not be acceptable
in payment of taxes and will not bear the circulation privilege.
4. Bearer certificates with one interest coupon attached will be issued in denominations of $1,000,
$5,000, $10,000 and $100,000. The certificates will not be issued in registered form.
5. The certificates will be subject to the general regulations of the Treasury Department, now or
hereafter prescribed, governing United States certificates.
III. SUBSCRIPTION AND ALLOTMENT
1. Subscriptions will be received at the Federal Reserve Banks and Branches and at the Treasury
Department, Washington. Subscribers must agree not to sell or otherwise dispose of their subscriptions,
or of the securities which may be allotted thereon, prior to the closing of the subscription books. Banking
institutions generally may submit subscriptions for account of customers, but only the Federal Reserve
Banks and the Treasury Department are authorized to act as official agencies. Others than banking institutions will not be permitted to enter subscriptions except for their own account. Subscriptions from banks
and trust companies for their own account will be received without deposit. Subscriptions from all others
must be accompanied by payment of 10 percent of the amount of certificates applied for. Subscriptions will
be entertained from the various classes of subscribers on the following bases:
1. Banks and trust companies for their own account—not to exceed 50 percent of capital and
surplus.
2. Mutual savings and cooperative banks, Federal Savings and Loan Associations, trust accounts
and investment corporations, pension funds, insurance companies, and similar institutions and
f unds—not to exceed 10 percent of total resources.
3. Corporations organized for profit, and dealers and brokers—not to exceed 50 percent of net
worth.




4. Individuals—not to exceed 50 percent of net worth or 100 percent of cash deposited with
subscription.
2. The Secretary of the Treasury reserves the right to reject any subscription, in whole or in part, to
allot less than the amount of certificates applied for, and to close the books as to any or all subscriptions at
any time without notice; and any action he may take in these respects shall be final. Subject to these
reservations, subscriptions for amounts up to and including $25,000 will be allotted in full, and subscriptions for amounts over $25,000 will be allotted on an equal percentage basis, but not less than $25,000 on any
one subscription. The basis of the allotment will be publicly announced, and allotment notices will be sent
out promptly upon allotment.
IV. PAYMENT
1. Payment at par and accrued interest, if any, for certificates allotted hereunder must be made or
completed on or before April 15, 1942, or on later allotment. In every case where payment is not so completed, the payment with application up to 10 percent of the amount of certificates applied for shall, upon
declaration made by the Secretary of the Treasury in his discretion, be forfeited to the United States. Any
qualified depositary will be permitted to make payment by credit for certificates allotted to it for itself and
its customers up to any amount for which it shall be qualified in excess of existing deposits, when so notified by the Federal Eeserve Bank of its District.
V. GENERAL PROVISIONS
1. As fiscal agents of the United States, Federal Reserve Banks are authorized and requested to receive
subscriptions, to make allotments on the basis and up to the amounts indicated by the Secretary of the
Treasury to the Federal Reserve Banks of the respective districts, to issue allotment notices, to receive
payment for certificates allotted, to make delivery of certificates on full-paid subscriptions allotted, and
they may issue interim receipts pending delivery of the definitive certificates.
2. The Secretary of the Treasury may at any time, or from time to time, prescribe supplemental or
amendatory rules and regulations governing the offering, which will be communicated promptly to the
Federal Reserve Banks.




HENRY MORGENTHAU, J R . ,
Secretary of the Treasury.

B-BC
FEDERAL RESERVE BANK
OF NEW YORK

APPLICATION NO.

IN ACCORDANCE WITH YOUR CERTIFICATION WE HAVE THIS DAY CREDITED YOUR
WAR LOAN DEPOSIT ACCOUNT" WITH THE AMOUNT INDICATED ABOVE.
ACCOUNT OF ALLOTMENT OF

y2% Treasury Certificates of Indebtedness Series A-1942
Dated April 15, 1942
Due November 1, 1942



FEDERAL RESERVE BANK OF NEW YORK
FISCAL AGENT OF THE UNITED STATES
GOVERNMENT BOND DEPARTMENT.

B-BC
FEDERAL RESERVE BANK
OF NEW YORK

APPLICATION NO.

IN ACCORDANCE WITH YOUR CERTIFICATION WE HAVE THIS DAY CREDITED YOUR
"WAR LOAN DEPOSIT ACCOUNT" WITH THE AMOUNT INDICATED ABOVE.
ACCOUNT OF ALLOTMENT OF

Yz% Treasury Certificates of Indebtedness Series A-1942
Dated April 15, 1942
Due November 1, 1942



"OFNEWYORK

ADVICE TO SUBSCRIBER
Acknowledging Receipt of Cash Subscription
For United States Government Obligations Mentioned Below

To

Application No.
Date

r
L

J
Your cash subscription for $

United States of America ^ Percent Treasury Certificates of Indebtedness, Series A-1942, Dated April 15, 1942, Due November 1, 1942
has been received by this bank, as fiscal agent of the United States, and, pursuant to the provisions of the Treasury
Department's circular offering the above-mentioned obligations of the United States, allotment notices will be
sent out promptly upon allotment and allotments will be made on the basis and up to the amounts indicated by
the Secretary of the Treasury to this bank.
FEDERAL RESERVE BANK OF NEW YORK,

Fiscal Agent of the United States.

Checked by.



.KHL.

nc.aL.nvo o » n n

OF NEW YORK

To

SEC-AT5-2.C

CARD

RECORD

SECURITIES DEPARTMENT

Application No.
Date

Cash subscription received
from above subscriber for $
United States of America Vz Percent Treasury Certificates of Indebtedness, Series A-1942, Dated April 15, 1942, Due November 1, 1942




AMOUNT AIXOTTED $.

OF NEW YORK

SEC-ATS-3. C
SECURITIES DEPARTMENT

PAYMENT AND DISPOSITION RECORD

Application No.

To

Date

Cash subscription received
from above subscriber for $
United States of America % Percent Treasury Certificates of Indebtedness, Series A-1942, Dated April 15, 1942, Due November 1, 1942
DATE

BOOK CREDIT

CHARGE

CASH

DELIVERY TELLER

GOV. DEPOSIT

SHIP

ALLOTMENT
PREMIUM AND/OR
INTEREST
PURCHASE PRICE
DEPOSIT
PRINCIPAL DUE
REFUND
BALANCE
ACCRUED INT.

Digitized for DUE
AMOUNT FRASER


DISPOSITION
OVER COUNTER

SAFEKEEPING

1
SPECIAL DELIVERY INSTRUCTIONS

i

IB-C

Application Number

CASH SUBSCRIPTION
BY OTHER THAN A BANKING INSTITUTION
To United States Government Obligations
Described Below
Dated at.

.1942

Important
Subject to the reservations set forth in Treasury Department Circular No. 683, subscriptions for amounts up to
and including $25,000 will be allotted in full, and subscriptions for amounts over $25,000 will be allotted on an equal
percentage basis, but not less than $25,000 on any one subscription.
This application must be accompanied by payment of 10 percent of the amount applied for.
Subscriptions can be made only for $1,000 or in multiples of $1,000.
Interest decimal on coupon payable November 1,1942 (200 days in 365 day period) one day's interest on $1,000. is $0.013698630
FEDERAL BESERVE BANK OF NEW YORK,

Fiscal Agent of the United States,
New York, N. Y.
DEAR SIRS :

Pursuant to the provisions of Treasury Department Circular No. 683, dated April 6, 1942, please enter our (my)
subscription for $

(par value)

UNITED STATES OF AMERICA % PERCENT TREASURY CERTIFICATES
OF INDEBTEDNESS, SERIES A-1942, DATED APRIL 15, 1942,
DUE NOVEMBER 1, 1942
The undersigned subscriber
(a) certifies that this subscription is solely for subscriber's legitimate investment requirement and is within the limitation in amount prescribed by the Treasury; that no arrangements have been or will be made for the sale or other
disposition of this subscription, or of the securities which may be allotted thereon, prior to the closing of the subscription books; and
(b) agrees, in consideration of the receipt by you of this subscription, to make payment in full for the entire amount
which may be allotted on this subscription, at par on or before the date of issue, or at par and accrued interest if
on later allotment. If such payment is in excess of the amount deposited with this application the balance of the
payment due you will be made by the undersigned or (name)
in the manner indicated below.

By check

•

By cash

Q

Subscriber . . .
(Print name)

TO SUBSCRIBES:
Mark (X) in proper space
to indicate if this ia:

Sign here
(Official Signature Required)

Original subscription

Street address.

Confirmation of a telegram
Confirmation of a letter

p]

(City, Town or Village, and State)

SPACES BELOW ABB FOB THE USE OV THE FEDEBAL EESEBVE BANK OP NEW TOBK
SUBSCRIPTION RECORD

ALLOTMENT AND PAYMENT

BLOTTER

EXAMINED FOB
CLASSIFICATION

ALLOTMENT

OWN ACCOUNT
CHECKED

CHECKED

DEPOSIT

EXAMINED

CARDED

REFUNDED

ACKNOWLEDGED




BALANCE
DISPOSITION

FIGURED CHECKED ADVISED
DATE
DATE
DATE PAID

BY

BTC-C

Cash Subscription by Banking Institution

Application Number

To United States Government Obligations
Described Below
Dated at

Important

.1942

Subject to the reservations set forth in Treasury Department Circular No. 683, subscriptions for amounts up to
and including $25,000 will be allotted in full, and subscriptions for amounts over $25,000 will be allotted on an equal
percentage basis, but not less than $25,000 on any one subscription.
Subscriptions can be made only for $1,000 or in multiples of $1,000.
Interest decitnal on coupon payable November 1,1942 (200 days in 365 day period) one day's interest on $1,000, is $0.013698630
FEDERAL RESERVE BANK OF NEW YORK,

Fiscal Agent of the United States,
New York, N. Y.
DEAR SIRS :

Pursuant to the provisions of Treasury Department Circular No. 683, dated April 6,1942, please enter subscription
as follows for

UNITED STATES OF AMERICA % PERCENT TREASURY CERTIFICATES
OF INDEBTEDNESS, SERIES A-1942, DATED APRIL 15, 1942,
DUE NOVEMBER 1, 1942
*For our own account (not classified below).. $
*For our customers (classified below)

________

Total Subscription

(To

SUBSCRIBER: DO

(Not to exceed one-half of combined capital
and surplus aa certified in (c) below).

$

CLASSIFICATION OF CUSTOMERS' SUBSCRIPTIONS
(For example: Class A — 10 at $1,000)
not show on this form denominations oj securities of this issue to be desired on allotment.)

CLASS A
Subscriptions of $1,000
Number of]
Amount
Leave Blank
Subscript's!
of Each

CLASS B
Subacniitione over $1,000 to $10,000 Inol.
Number of
Amount
Leava Blank
Subscript's
of Eauh

CLASS C2
CLASS Cl
Stibaenntinns over S10,000 to 825,000 Inol. Subscriptions over $25,000 tu S50.000 Inel.
Number of
Amount
Number of
Amount
Leave Blank
Leave Blank Subscript's
^ubacript'e
of Each
oi Each

at

at

at

at,

at

at

at

at

at

at

at

at

at

at

at

at

at

at

al

at

at

at

at

at

at

at

at

at

CLASS D
CLASS E
CLASS G
CLASS F
Subscriptions of over £1,000,000
Subscriptions over 550,000 to f 100,000 Inel. Sub's over $100,000 to 8500,000 Inclusive Sub's over $500,000 to 81,000,000 Inclusive
Number of
Number of
Amount
Number oi
Amount
Number of
Amount
Amount
Leava Blank Subscript's
Leave B!ank
Leave Blank Subscript'3
Leave Ulank Subscript's
Subscript's
of Each
of Each
of Each
of Each
at

at

at

at

nt

at

at

at

at

at

at

at

at

at

at

at

at

at

at

at

at

at

at

at
—

I

We hereby certify:
(a) that we have received applications from our customers in the amounts set opposite the customers' names listed on
the reverse side of this form which is made a part of this subscription; that there has been paid to us by each such
customer, not subject to withdrawal until after allotment and payment in full for securities allotted, ten percent
of the amount applied for, or in the case of individuals so electing, 100 percent of the amount applied for; that
each such application, to the best of our knowledge and belief, is made in good faith for the customer's legitimate
investment requirements, and is within the limitation in amount prescribed by the Treasury; and that we have no
beneficial interest therein.
(b) that this subscription is solely for our own account or for the account of the customers specified herein; that no
arrangements have been or will be made for the sale or other disposition of our subscription, or of the securities
which may be allotted thereon, prior to the closing of the subscription books; and that our customers whose subscriptions are included herein will be requested to confirm to us their agreement to the same conditions with respect
to their subscriptions; and
(c) that our capital and surplus (not including undivided profits, reserves, etc.) is $
"We agree:
in consideration of the receipt by you of this subscription, to make payment in full for the entire amount which
may be allotted on this subscription, at par on or before the date of issue, or at par and accrued interest if on later
allotment. Such payment will be made by the method indicated hereon.
By charge to our reserve account, which you are
authorized to make
By cheek
TO SUBSCRIBER:
Mark (X) in proper apace
to indicate if this is:
Original subscription
Confirmation of a telegram....
Confirmation of a letter

rn
r~j

By credit to War Loan Deposit Account
•*~Fill in all required spaces before signing.

Q

(Name of Banking Institution)

By

D

•

Address

D

(Title)

(Official signature)
(City, Town or Village, and State)

*N0TE:

Securities of this issue allotted to a qualified depositary for its own account may be paid for by credit to War Loan Deposit Account
and may also be deposited with Federal Reserve Bank of New York aa collateral security for such Account.
Securities of this issue allotted to a qualified depositary for account of its customers may be paid for by credit to War Loan Deposit
Account, but may not be deposited with Federal Reserve Bank of New York as collateral security for such Account without the written consent
of the owners of euch securities.
SPACES BELOW ABE FOE THE USE OF THE FEDERAL RESERVE BANK
SUBSCRIPTION RECORD
BLOTTER
OWN ACCOUNT
CHECKED
EXAMINED

Digitized ACKNOWLEDGED
for FRASER


EXAMINED FOR
CLASSIFICATION
CHECKED
CARDED

PAYMENT

ALLOTMENT
Figured
DISPOSITION

Checked Advised

R/A

B/C

List of customers' applications included in the foregoing subscription
entered and certified by
(Name of banking institution)

PoJt office address

Name of Customer
(.Pleat e print or use typewriter)




Address

State.

Amount Subscribed

FEDEEAL RESERVE B A N K OF N E W YORK

Application Number

Fiscal Agent of the United States

NOTICE OF ALLOTMENT
On Cash Subscription to United States Government Obligations
Applied for by Subscriber as Described Below
To Subscriber;
1942

Referring to your subscription, numbered as above indicated, for $

(pap value)

UNITED STATES OF AMERICA U PERCENT TREASURY CERTIFICATES OF INDEBTEDNESS, SERIES A-1942
DATED APRIL 15, 1942, DUE NOVEMBER 1, 1942

for which you have applied under the provisions of the Treasury Department's circular containing the offering of such
securities for subscription, you have been allotted by the Secretary of the Treasury
$

of the amount applied for.

IMPORTANT INFORMATION FOR SUBSCRIBER
1. To expedite delivery of the securities of this issue allotted to subscriber and to facilitate prompt completion of
this transaction, please observe the following directions, and fill in, sign and return immediately the attached letter of
instructions to the Federal Reserve Bank of New York, Fiscal Agent of the United States, New York, N. Y.
Payment by Check, Cash, Charge or Credit
2. On or before the date of this issue payment must be made or completed at par, or at par and accrued interest if
payment is to be made after the date of this issue, for the securities allotted to subscriber as stated above, and payment
therefor may be made by check, cash, charge, or credit, as follows:
By Check—A check tendered in payment Bhould be made payable to the order of the FEDERAL RESERVE BANK OF NEW YORK,
FISCAL AGENT OF THE UNITED STATES, and the proceeds thereof must be immediately available on the date that payment is due,
but such cheek need not necessarily accompany the attached letter of instructions. The proceeds of a cheek tendered in payment by
subscriber on the date of this issue, drawn on the Federal Reserve Bank of New York, will be immediately available on the date of this
issue. Should a subscriber wish to make payment by certified check on any other bank the securities can not be delivered until the
Federal Reserve Bank of New York, Fiscal Agent of the United States, receives the proceeds of such check, and, therefore, such subscriber
should tender such certified check at least 2 days prior to the date payment is due if he wishes delivery of the securities on the
date of this issue.
By Cash—Payment may be made in cash.
By 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 Credit—(a) If subscriber ia a depositary of public moneys qualified under the provisions of Treasury Department Circular No. 92, dated
February 23, 1932, aa nmended, with respect to special deposits of public moneys under the Act of Congress approved September 24, 1917,
as amended, subscriber will be permitted to make payment by credit in the War Loan Deposit Aceount for securities of this issue allotted
to it for itself and its customers up to any amount for which it shall be qualified in excess of existing deposits.
(b) Securities of this issue allotted to a qualified depositary for its own account may be pledged with Federal Reserve Bank of New York
as collateral security for deposits in the War Loan Deposit Account. Securities of this issue allotted to a qualified depositary for account of
- its customers may not be pledged as such collateral security without the written consent of the owners of such securities.

Delivery
3. (a) Delivery of the securities of this issue will be made by the Federal Reserve Bank of New York at its
head office in New York, N. Y., and will not be made before the issue date.

1

(b) Securities of this issue allotted to subscriber will be delivered over the counter to a representative of the
subscriber only when a letter of authority signed officially by the subscriber identifying such representative is presented
by him.
(c) Securities of this issue allotted to subscriber will be delivered to others under special instructions from suberiber but only when such securities are either the sole property of the subscriber or are the property of its customers who
ave authorized the subscriber in writing to cause their said securities to be so delivered.
Further Instructions
4. (a) Securities of this issue will be held for safekeeping by, or delivered to the Discount Department of, the Federal
Reserve Bank of New York for the account of member banks only, provided such securities are the sole property of the
aember bank.
(b) It is requested that all blank spaces be typed in where neeessary on the attached letter of instructions to
his bank and that such letter be signed officially and returned to this bank without delay.
FEDERAL RESERVE BANK OF NEW YORK,

Fiscal Agent of the United States
Checked by
*!A-C




Application Number

LETTER OF INSTRUCTIONS
To FEDERAL RESERVE BANK OF NEW YORK,

Fiscal Agent of the United States,
Government Bond Department,
New York, N. Y.
From (Name and address of Subscriber)
1942

Referring to our subscription, numbered as above indicated, for $

(par value)

UNITED STATES OF AMERICA H PERCENT TREASURY CERTIFICATES OF INDEBTEDNESS, SERIES A-1942
DATED APRIL 15, 1942, DUE NOVEMBER 1, 1942

for which we applied under the provisions of the Treasury Department's circular containing the offering of such
securities for subscription, we have received your notice of allotment stating that we have been allotted by the Secretary
of the Treasury
$
of the amount applied for.
As requested we are sending you the following instructions:
Payment for such securities will be made or completed as indicated below.
By charge to our reserve account, which you are authorized to make $
By check

$

By cash

$

By credit to War Loan Deposit Account as shown in the following "Certificate of Advice":
CERTIFICATE OF ADVICE
A p r i l 15j 1 9 4 2
I HEREBY CERTIFY that there has been deposited this day with the above bank or trust company, to the credit of
the Federal Reserve Bank of New York, as fiscal agent of the United States, War Loan Deposit Account, to be held
subject to withdrawal on demand through the Federal Reserve Bank of New York, the
sum of

Dollars, $

To be executed only when subscriber is making
payment through War Loan Deposit Account.

Cashier or Vice President.

Issue and dispose of securities allotted on this subscription as indicated below:
DISPOSITION
DENOMINATIONS
Pieces

1. Deliver over the counter to the undersigned

Par Value

Leave Blank

2. Ship to the undersigned
3. Hold in safekeeping
bank only)

XXX

(For member

XXX

4. Hold as collateral for War Loan
deposits

xxx
SI ,000

5. Deliver as indicated below.

5,000

Deliver to:

Par Amount

10,000

Against
Payment of

xx xxx
100,000
Total

and credit proceeds to our Reserve account

•

or to our account with
The undersigned, if a bank or trust company, hereby certifies (a) that the securities which you are hereby or hereafter instructed
to dispose of in the manner indicated in item numbered 3 above are the sole property of the undersigned, and (b) that the securities
which you are hereby or hereafter instructed to dispose of in the manner indicated in items numbered 4 and 5 above are either the sole
property of the undersigned or the property of its customers who have authorized in writing such disposition.

: - T h i s letter of instructions must be signed
officially in the space provided here and
returned immediately to
Federal Reserve Bank of New York,

Name of Subscriber.
(Please print)
By(Official signature required)

(Title)

Street address

Fiscal Agent of the United States.
City, Town or Village, and State.
DO NOT USE SPACES BELOW

Delivery Receipt

PAYMENT RECORD

Received from FEDERAL RESERVE BANK OF NEW YORK the above described
PAYMENT RECEIVED

DELIVER AGAINST PAYMENT

United States Government obligations allotted in the amount indicated above.

or $

Subscriber
By.

Date.
Taken from Vault

NA-C




Counted

Checked

Delivered

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