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F ederal reserve Bank of Dallas FISCA L AGENT OF THE UNITED STATES DALLAS, TEX A S 75222 Circular No. 67-26 January 26, 1967 CASH OFFERING OF TREASURY NOTES To All Banking Institutions and Others Concerned in the Eleventh Federal Reserve District: There are enclosed Treasury Department Circulars, Public D ebt Series Nos. 1-67 and 2-67, relating to an offering of 4 3A % Treasury Notes of Series B-1968, maturing M ay 15, 1968, and 4% % Treasury Notes of Series A-1972, maturing February 15, 1972. Subscription forms for your use are also enclosed. PAYMENT Paym ent for the new notes may be made in cash or by the surrender of the following securities maturing February 15, 1967, at par: 3% % Treasury Notes of Series B-1967; or 4 % Treasury N otes of Series C-1967. T he notes may not be paid for by credit in Treasury Tax and Loan Accounts. Down payments in cash, or securities of the two maturing issues, are required of all subscribers except those specifically exempted in Section III, paragraph 1 of the official circulars and are not subject to withdrawal until after allotment. The down payments received by commercial banks from subscribers should b e held by commercial banks until after allotment is made. ALLOTMENT Each subscription is subject to allotment, but certain classes of subscribers named in paragraph 4 ( 1 ) of Section III of the official offering circulars m ay obtain full allotment up to the total amount of the two eligible securities maturing February 15 surrendered in payment if the eligible securities were owned or contracted for purchase by 4 p.m. Eastern Standard Time, January 25, 1967. These subscribers must com plete the certification on the reverse side of the subscription form. If the certification cannot be completed at the time the subscription is entered, a statement to that effect should accompany the subscription and the certification m ay be submitted separately. A form for furnishing delivery and payment instructions will accompany the notice of allotment. Provision will be made on the form for furnishing the taxpayer identifying number where registered notes are requested. CLOSING OF SUBSCRIPTION BOOKS The subscription books will be open only on M onday, January 30, 1967, and subscriptions postmarked before midnight on that date will be considered timely. Subscriptions will be received at this bank and its branches at El Paso, Houston and San Antonio. Additional circulars and forms will be furnished upon request. Yours very truly, W atrous H. Irons President Enclosures (4 ) This publication was digitized and made available by the Federal Reserve Bank of Dallas' Historical Library (FedHistory@dal.frb.org) UNITED STATES OF AMERICA 4% PERCENT TREASURY NOTES OF SERIES B-1968 Dated a n d bearing interest from February 15, 1967 Due May 15, 1968 TREASURY D EPA RTM EN T Office of the Secretary Washington, January 26, 1967 DEPARTMENT CIRCULAR Public D ebt Series — No. 1-67 I. OFFERING OF NOTES 1. The Secretary of the Treasury, pursuant to the authority of the Second Liberty Bond Act, as amended, offers $5,500,000,000, or thereabouts, of notes of the United States, designated 4% percent Treasury Notes of Series B-1968, at 99.875 percent of their face value and accrued interest. The following 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 Treasury: 3% percent Treasury N otes of Series B-1967; or 4 percent Treasury N otes of Series C-1967. T he books will be open only on January 30, 1967, for the receipt of subscriptions. II. DESCRIPTION OF NOTES 1. The notes will be dated February 15, 1967, and will bear interest from that date at the rate of 4 3A percent per annum, payable on a semiannual basis on M ay 15 and November 15, 1967, and on M ay 15, 1968. T hey will mature M ay 15, 1968, and will not be subject to call for redemption prior to maturity. 2. The income derived from the notes is subject to all taxes imposed under the Internal Revenue Code of 1954. T he 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 of the possessions of the United States, or by any local taxing authority. 3. The notes will be acceptable to secure deposits of public moneys. T hey will not be acceptable in payment of taxes. 4. Bearer notes with interest coupons attached, and notes registered as to principal and interest, will be issued in denominations of $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 of notes of different denominations and of coupon and registered notes, and for the transfer of registered notes, under rules and regulations prescribed by the Secretary of the Treasury. 5. The notes will be subject to the general regulations of the Treasury Department, now or hereafter prescribed, governing United States notes. III. 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 of the Treasurer of the United States, Washington, 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 for account of customers provided the names of the customers are set forth in such subscriptions. Others than commercial banks will not be permitted to enter subscriptions except for their own account Subscriptions from commercial banks for their own account will be restricted in each case to an amount not exceeding 50 percent of the combined capital (not including capital notes or debentures), surplus and undivided profits of the subscribing bank. Subscriptions will be received without deposit from banking institutions for their own account, Federally-insured savings and loan associations, 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, dealers who make primary markets in Government securities and report daily to the Federal Reserve Bank of New York 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 of the two issues enumerated in para graph 1 of Section I hereof, which will be accepted at par) of 2 percent of the amount of notes applied for, not subject to withdrawal until after allotment. Registered securities submitted as deposits should be assigned as provided in Section V hereof. Following allotment, any portion of the 2 percent payment in excess of 2 percent of the amount of notes allotted may be released upon the request of the subscribers. 2. All 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 of any notes of this issue at a specific rate or price, until after midnight January 30, 1967. 3. Commercial banks in submitting subscriptions will be required to certify that they have no beneficial interest in any of the subscriptions they enter for the account of their customers, and that their customers have no beneficial interest in the banks’ subscriptions for their own account. 4. Under the Second Liberty Bond Act, as amended, the Secretary of the Treasury has the authority to reject or reduce any subscription, to allot less than the amount of notes applied for, and to make different percentage allotments to various classes of 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 of that authority, subscriptions will be allotted: ( 1 ) in full if the subscription is for a 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 and foreign State, Federal Reserve Bank, or Government Investment Account and such subscriber certifies in writing that at 4 p.m., Eastern standard time, January 25, 1967, it owned or had contracted to purchase for value notes of the two issues enumerated in paragraph 1 of Section I hereof, in an aggregate amount equal to or greater than the amount of such subscription (any such subscriber m ay enter an additional subscription subject to a percentage allotm ent); and ( 2 ) on a percentage basis, to be publicly announced. Allotment notices will be sent out promptly upon allotment. IV. PAYMENT 1. Payment at 99.875 percent of their face value and accrued interest, if any, for notes allotted hereunder must be made or completed on or before February 15, 1967, or on later allotm ent Paym ent 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 submitted to the Internal Revenue Service (an individual’s social security number or an employer identification number) is not furnished. In every case where full payment is not completed, the payment with application up to 2 percent of the amount of notes allotted shall, upon declaration made by the Secretary of the Treasury in his discretion, be forfeited to the United States. Payment may be made for any notes allotted hereunder in cash or by exchange of notes of the two issues enumerated in paragraph 1 of Section I hereof, which will be accepted at par. A cash adjustment will be made for the difference ($1.25 per $1,000) between the par value of maturing notes accepted in exchange and the issue price of the new notes. The payment will be made by check or by credit in any account maintained by a banking institution with the Federal Reserve Bank of its district, following acceptance of the maturing notes. In the case of registered notes, the payment will be made in accordance with the assignments on the notes surrendered. When payment is made with notes in bearer form, coupons dated February 15, 1967, should be detached and cashed when due. When payment is made with registered notes, the final interest due on February 15, 1967, will be paid by issue of interest checks in regular course to holders of record on January 13, 1967, the date the transfer books closed. V. ASSIGNMENT OF REGISTERED NOTES 1. Treasury notes in registered form tendered as deposits and in payment for 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 of the forms hereafter set forth. Notes tendered in payment should be surrendered to a Federal Reserve Bank or Branch or to the Office of the Treasurer of the United States, Washington, D. C. 20220. The maturing notes must be delivered at the expense and risk of the holder. If the new notes are desired registered in the same name as the notes surrendered, the assignment should be to “The Secretary of the Treasury for 4% percent Treasury Notes of Series B-1968”; if the new notes are desired registered in another name, the assignment should be to “The Secretary of the Treasury for 4 3A percent Treasury Notes of Series B-1968 in the name of ____________________”; if new notes in coupon form are desired, the assignment should be to “The Secretary of the Treasury for 4 2A percent Treasury Notes of Series B-1968 in coupon form to be delivered t o ___ ____ ____________ _____ __ VI. GENERAL PROVISHONS 1. As fiscal agents of the United States, Federal Reserve Banks are authorized and requested to receive subscriptions, to make such allotments as may be prescribed by the Secretary of the Treasury, to issue such notices as may be necessary, to receive payment for and make delivery of notes on full-paid subscriptions allotted, and they may issue interim receipts pending delivery of the definitive notes. 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. H E N R Y H. FOW LER, Secretary of 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 DEPARTMENT CIRCULAR TREASURY DEPARTMENT Public D ebt Series — No. 2-67 Office of the Secretary Washington, January 26, 1967 I. OFFERING OF NOTES 1. The Secretary of the Treasury, pursuant to the authority of the Second Liberty Bond Act, as amended, offers $2,000,000,000, or thereabouts, of notes of the United States, designated 4 3A percent Treasury Notes of Series A-1972, at 99.625 percent of their face value and accrued interest. The following 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 Treasury: 3% percent Treasury Notes of Series B-1967; or 4 percent Treasury N otes of Series C-1967. The books will be open only on January 30, 1967, for the receipt of subscriptions. II. DESCRIPTION OF NOTES 1. The notes will be dated February 15, 1967, and will bear interest from that date at the rate of 4 3A 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. T hey will mature February 15, 1972, and will not be subject to call for redemption prior to maturity. 2. T he income derived from the notes is subject to all taxes imposed under the Internal Revenue Code of 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 of the possessions of the United States, or by any local taxing authority. 3. T he notes will be acceptable to secure deposits of public moneys. T hey will not be acceptable in payment of taxes. 4. Bearer notes with interest coupons attached, and notes registered as to principal and interest, will be issued in denominations of $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 of notes of different denominations and of coupon and registered notes, and for the transfer of registered notes, under rules and regulations prescribed by the Secretary of the Treasury. 5. T he notes will be subject to the general regulations of the Treasury Department, now or hereafter prescribed, governing United States notes. III. 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 of the Treasurer of the United States, Washington, 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 for account of customers provided the names of the customers are set forth in such subscriptions. Others than commercial banks will not be permitted to enter subscriptions except for their own account. Subscriptions from commercial banks for their own account will be restricted in each case to an amount not exceeding 50 percent of the combined capital (not including capital notes or debentures), surplus and undivided profits of the subscribing bank. Subscriptions will be received without deposit from banking institutions for their own account, Federally-insured savings and loan associations, 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, dealers who make primary markets in Government securities and report daily to the Federal Reserve Bank of N ew York 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 of the two issues enumerated in paragraph 1 of Section I hereof, which will be accepted at par) of 2 percent of the amount of notes applied for, not subject to withdrawal until after allotment. Registered securities submitted as deposits should be assigned as provided in Section V hereof. Following allotment, any portion of the 2 percent payment in excess of 2 percent of the amount of notes allotted may be released upon the request of the subscribers. 2. All 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 of any notes of this issue at a specific rate or price, until after midnight January 30, 1967. 3. Commercial banks in submitting subscriptions will be required to certify that they have no beneficial interest in any of the subscriptions they enter for the account of their customers, and that their customers have no beneficial interest in the banks’ subscriptions for their own account. 4. Under the Second Liberty Bond Act, as amended, the Secretary of the Treasury has the authority to reject or reduce any subscription, to allot less than the amount of notes applied for, and to make different percentage allotments to various classes of 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 of that authority, subscriptions will be allotted: ( 1 ) in full if the subscription is for a 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 and foreign State, Federal Reserve Bank, or Government Investment Account and such subscriber certifies in writing that at 4 p.m., Eastern standard time, January 25, 1967, it owned or had contracted to purchase for value notes of the two issues enumerated in paragraph 1 of Section I hereof, in an aggregate amount equal to or greater than the amount of such subscription (any such subscriber may enter an additional subscription subject to a percentage allotm ent); and (2 ) on a percentage basis, to be publicly announced. Allotment notices will be sent out promptly upon allotment. IV. PAYMENT 1. Payment at 99.625 percent of their face value and accrued interest, if any, for notes allotted hereunder must be made or completed on or before February 15, 1967, or on later allotment. Paym ent 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 submitted to the Internal Revenue Service (an individual’s social security number or an employer identification number) is not furnished. In every case where full payment is not completed, the payment with application up to 2 percent of the amount of notes allotted shall, upon declaration made by the Secretary of the Treasury in his discretion, be forfeited to the United States. Paym ent may be made for any notes allotted hereunder in cash or by exchange of notes of the two issues enumerated in paragraph 1 of Section I hereof, which will be accepted at par. A cash adjustment will be made for the difference ($3.75 per $1,000) between the par value of maturing notes accepted in exchange and the issue price of the new notes. The payment will be made by check or by credit in any account maintained by a banking institution with the Federal Reserve Bank of its district, following acceptance of the maturing notes. In the case of registered notes, the payment will be made in accordance with the assignments on the notes surrendered. When payment is made with notes in bearer form, coupons dated February 15, 1967, should be detached and cashed when due. When payment is made with registered notes, the final interest due on February 15, 1967, will be paid by issue of interest checks in regular course to holders of record on January 13, 1967, the date the transfer books closed. V. ASSIGNMENT OF REGISTERED NOTES 1. Treasury notes in registered form tendered as deposits and in payment for 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 of the forms hereafter set forth. N otes tendered in payment should be surrendered to a Federal Reserve Bank or Branch or to the Office of the Treasurer of the United States, Washington, D. C. 20220. The maturing notes must be delivered at the expense and risk of the holder. If the new notes are desired registered in the same name as the notes surrendered, the assignment should be to “The Secretary of the Treasury for 4 3A percent Treasury Notes of Series A-1972”; if the new notes are desired registered in another name, the assignment should be to “The Secretary of the Treasury for 4 3A percent Treasury Notes of Series A-1972 in the name of __ _________________ ”; if new notes in coupon form are desired, the assignment should be to “The Secretary of the Treasury for 4% percent Treasury Notes of Series A-1972 in coupon form to be delivered to___________________________ ”. VI. GENERAL PROVISIONS 1. As fiscal agents of the United States, Federal Reserve Banks are authorized and requested to receive subscriptions, to make such allotments as may be prescribed by the Secretary of the Treasury, to issue such notices as may be necessary, to receive payment for and make delivery of notes on full-paid subscriptions allotted, and they may issue interim receipts pending delivery of the definitive notes. 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. H E N R Y H. FOWLER, Secretary of the Treasury. CASH 43A% Treasury Notes of Series B-1968 At 99.875% of Face Value D ue May 15,1968 To: Federal Reserve Bank, Station K, Dallas, Texas 75222 or — The.—____________ __ ____ __________________________ .Branch El Pmo 79989 H o n sto n 77001 S a n A n to n io 78206 L IST A LL SUB SC RIPTIO N S ON R EV ER SE SID E EACH SU B SC RIPTIO N TO T H IS ISS U E MUST BE IN A M U L T IPL E O F $1,000 P u rsu a n t to th e provisions of T reasury D epartm en t C ircular, Public D ebt Series No. 1-67 dated Ja n u a ry 26,1967, the undersigned hereby subscribes fo r $ — ----------------------- 4% % T reasu ry N otes of Series B-1968, dated F eb ru ary 15, 1967, m atu rin g M ay 15, 1968, and w ill m ake paym ent in accordance w ith th e provisions of Section IV of the offering circular. BY A ll subscriptions except those specifically exem pted in Section III, p a ra g ra p h 1 of the official circu lar, m u st be accompanied by a cash deposit of not less th an 2% of th e am ount of securities applied for. In th e cases of subscriptions entered through com m ercial banks the deposits should be retained by th e bank en terin g the subscriptions until allotm ent has been made and final paym ent is com pleted. All o th er required deposits m ust accom pany this subscription. PAY M EN T FO R N OTES ALLOTTED MAY NOT BE MADE BY CREDIT IN TREA SU RY TAX AND LOAN ACCOUNTS RETAINED THE COMMERCIAL BANKS D ated F eb ru ary 15,1967 SUBSCRIPTION Form for indicating METHOD OF PAYMENT, DELIVERY INSTRUCTIONS and DENOMI NATIONS of securities desired will accompany NOTICE OF ALLOTMENT. Amount CLASS OF SUBSCRIPTION Our own subscription . . Customers subscriptions . (List again on reverse) (Show in schedule on reverse) C ER TIFIC A TIO N BY COMMERCIAL BANKS We hereby certify th a t we have received applications from our custom ers in the am ounts set opposite the custom ers’ nam es on th e list which is made a p art of this subscription; th a t th ere has been paid to us by each such custom er as required by official offering circular, not subject to w ithdraw al until a fte r allotm ent, not less than 2 percent of the am ount applied fo r; th a t we have not made unsecured loans, or loans collateralized in who4e or in p a rt by the securities applied for, to supply th e am ounts of such paym ents to any of such custom ers; th a t we have no beneficial in terest in the applications of such custom ers, and th a t none of our custom ers has any beneficial in terest in th e am ount subscribed fo r our own account. We fu rth e r certify th a t the subscription fo r our own account does not exceed 50percent cap ital notes or debentures), surplus and undivided profits. of our combined cap ital (not including W e fu rth e r certify th a t applications received by us, if any, from other com m ercial banks fo r th e ir own account and fo r th e ac count of their custom ers have been entered w ith us under the sam e conditions, agreem ents and certifications as set fo rth in th is sub scription form . C ER TIFIC A TIO N BY ALL SUBSCRIBERS W e certify th a t all subscribers listed hereon have agreed not to purchase or to sell, or to m ake any agreem ents w ith respect to the purchase or sale or other disposition of any of the notes of this issue a t a specific ra te or price, until a fte r m idnight, Ja n u ary 30, 1967. C E R TIFIC A TIO N BY SPEC IA L CLA SSES O F SUBSCRIBERS ( If A pplicable) (See reverse side) THROUGH COMMERCIAL BANKS SHOULD BE TOTAL □ This is an original subscription □ This is a confirmation (N a m e of su b sc rib e r) (A u th o rized sig n a tu re ) D ated.................. -................................................................................- ............................ P L E A S E F IL L IN T H E FORM BELOW W H ICH W ILL BE R ETU RN ED TO YOU AS AN ACKNOW LEDGM ENT O F YOUR SUBSCRIPTION (O V E R ) 67-26 This acknowledges your subscription for $_ 4%% Treasury Notes of Series B-1968 DEPOSITS REQUIRED ON SUBSCRIPTIONS ENTERED (A dd ress) By....................... — ............................................................... .......................................... F.R.B. Subscription No. IM PORTANT — Please use th e above num ber in all m a tte rs — w hether paym ent o r correspondence — re la tin g to th is subscription. The F ed eral Reserve B ank or B ranch will acknowledge by stam p in g below. MAIL TO N am e A ddress Please list nam e and address of each subscriber, indicating by num ber in th e first column th e class ol investor, m accordance w ith th e follow ing schedule: INVESTOR CLASSES AND NUMBERS 1. 2. 3. 4. 5. Individuals, p artn ersh ip s and personal tr u s t accounts M utual savings banks Insurance com panies D ealers and brokers Pension and retirem en t funds of S tate and local governm ents 6. O ther pension and retirem en t funds 7. S tate and local governm ent funds o th er th a n pension and retirem en t 8. Commercial banks 9. C orporations oth er th a n banks and insurance com panies 10. Savings and building and loan associations 11. All o thers LIST OF SUBSCRIBERS Investor Clots NAM E O F SUBSCRIBER AMOUNT A DDRESS DO NOT U S E O ur own subscription TOTAL $ C ER TIFIC A TIO N BY STATES, POLITICAL SUBDIVISIONS OR IN ST R U M E N TA L IT IE S T H ER E O F, PU B LIC PEN SIO N AND R ETIR E M E N T AND OTHER PUBLIC FU N D S, IN TERN A TIO N A L ORGANIZATIONS IN W HICH T H E U N ITED STA TES HOLDS M EM BERSH IP, FO R EIG N CEN TRA L BANKS AND FO R EIG N STA TES, FED E R A L R E SE R V E BANKS AND GOVERNM ENT IN V ESTM EN T ACCOUNTS PU R SU A N T TO SECTION I II PARAG RAPH 4 (1 ), TREA SU RY D EPA RTM EN T CIRCULAR, PUBLIC DEBT SE R IE S — NO. 1-67. To th e F ed eral Reserve Bank of D allas The undersigned hereby certifies: (1) T h at it is one of the ty p es of subscribers designated above and has entered fo r p referred full allotm ent u nder th e provisions of section III, p ara g ra p h 4 (1 ), of T reasu ry D epartm ent Circular, Public D ebt Series — No. 1-67, subscription(s) in th e am ount o f ? ----------------------------------; (2) T h at a t 4 p.m., E astern S tandard Time, Ja n u a ry 25, 1967, it owned or had contracted to purchase fo r value 3% % T reasu ry N otes of Series B-1967 and 4% T reasu ry N otes of Series C-1967 in an am ount equal to or g re a te r th a n th e am ount of said subscrip ti o n ^ ) ; and (3) T h at such securities w ill be subm itted in paym ent fo r said subscrip tio n (s). (N a m e of S u bscriber) (A d dress) (S ig n a tu re o f P e rso n A u th orized to S ig n on B eh alf o f S u b scrib er) (T itle a n d A dd ress) D ated .. Note: If the above certification cannot be completed at the time the subscription is entered, a statement to that effect should accom pany the subscription, and the certification in the above form should be submitted separately as soon as possible. CASH SUBSCRIPTION 4%% Treasury Notes of Series A-1972 At 99.625% oi Face Value Due February 15, 1972 To: Federal Reserve Bank, Station K, Dallas, Texas 75222 or — The.......... ...... ..... —........... ................ ............... ...... ....... ........ ...... Branch E l P a s o 79999 H ousto n 77001 S an A n to n io 78206 LIST ALL SUBSCRIPTIONS ON REVERSE SIDE EACH SUBSCRIPTION TO THIS ISSUE MUST BE IN A MULTIPLE OF $1,000 Pursuant to the provisions of Treasury Department Circular, Public Debt Series No. 2-67 dated January 26,1967, the undersigned hereby subscribes for $__________________ 4%% Treasury Notes of Series A-1972, dated February 15, 1967, maturing February 15, 1972, and will make payment in accordance with the provisions of Section IV of the offering circular. All subscriptions except those specifically exempted in Section III, paragraph 1 of the official circular, must be accompanied by a cash deposit of not less than 2% of the amount of securities applied for. In the cases of subscriptions entered through com mercial banks the deposits should be retained by the bank entering the subscriptions until allotment has been made and final payment is completed. All other required deposits must accompany this subscription. PAYMENT FOR NOTES ALLOTTED MAY NOT BE MADE BY CREDIT IN TREASURY TAX AND LOAN ACCOUNTS. CLASS OF SUBSCRIPTION Form for indicating METHOD OF PAYMENT, DELIVERY INSTRUCTIONS and DENOMI NATIONS of securities desired will accompany NOTICE OF ALLOTMENT. Amount Our own su b scrip tion .......................................... $ (List again on reverse) CnptoTneViS su b scrip tion (Show in schedule on reverse) $ , ...................... TOTAL . . . $ CERTIFICATION BY COMMERCIAL BANKS We hereby certify that we have received applications from our customers in the amounts set opposite the customers* names on the list which is made a part of 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 of the amount applied for; that we have not made unsecured loans, or loans collateralized in whole or in part by the securities applied for, to supply the amounts of such payments to any of such customers; that we have no beneficial interest in the applications of such customers, and that none of our customers has any beneficial interest in the amount subscribed for our own account. We further certify that the subscription for our own account does not exceed 50 percent of our combined capital (not including capital notes or debentures), surplus and undivided profits. We further certify that applications received by us, if any, from other commercial banks for their own account and for the ac count of their customers have been entered with us under the same conditions, agreements and certifications as set forth in this sub scription form. CERTIFICATION BY ALL SUBSCRIBERS We certify that all subscribers listed hereon have agreed not to purchase or to sell, or to make any agreements with respecc to the purchase or sale or other disposition of any of the notes of this issue at a specific rate or price, until after midnight, January 30, 1967. CERTIFICATION BY SPECIAL CLASSES OF SUBSCRIBERS (If Applicable) (See reverse side) THROUGH COMMERCIAL BANKS SHOULD BE RETAINED BY THE COMMERCIAL BANKS Dated February 15, 1967 □ This is an original subscription □ This is a confirmation DEPOSITS REQUIRED ON SUBSCRIPTIONS ENTERED (Name of subscriber) (A d d ress) By................................................................................................................... (A u th o rize d s ig n a tu re ) Dated.............................. ........................ .......................................................... PLEASE FILL IN THE FORM BELOW WHICH WILL BE RETURNED TO YOU AS AN ACKNOWLEDGMENT OF YOUR SUBSCRIPTION (OVKR) 67-26 This acknowledges your subscription for 4%% Treasury Notes of Series A-1972 F.R.B. Subscription No. IMPORTANT — Please use the above number in all matters — whether paym ent or correspondence — relating to this subscription. The Federal Reserve Bank or Branch will acknowledge by stamping below. MAIL TO Name Address Please list name and address of each subscriber, indicating by number in the first column the class ol investor, in accordance with the following schedule: INVESTOR CLASSES AND NUMBERS 1. 2. 3. 4. 5. 6. Individuals, partnerships and personal trust accounts Mutual savings banks Insurance companies Dealers and brokers Pension and retirement funds of State and local governments Other pension and retirement funds 7. State and local government funds other than pension and retirement 8. Commercial banks 9. Corporations other than banks and insurance companies 10. Savings and building and loan associations 11. All others LIST OF SUBSCRIBERS Invastor Class NAME OF SUBSCRIBER AMOUNT ADDRESS DO NOT USE Our own subscription TOTAL $ CERTIFICATION BY 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, FEDERAL RESERVE BANKS AND GOVERNMENT INVESTMENT ACCOUNTS PURSUANT TO SECTION III PARAGRAPH 4 (1), TREASURY DEPARTMENT CIRCULAR, PUBLIC DEBT SERIES — NO. 2-67. To the Federal Reserve Bank of Dallas 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 of section III, paragraph 4 (1), of Treasury Department Circular, Public Debt Series — No. 2-67, 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% % Treasury Notes of Series B-1967 and 4% Treasury Notes of Series C-1967 in an amount equal to or greater than the amount of said subscrip tion^) ; and (3) That such securities will be submitted in payment for said subscription(s). (N am e of Su b scrib er) (A d d ress) by---------- (S ig n a tu re o f P e rso n A u th o rized to S ig n on B ehalf o f S u b scrib er) (T itle a n d A ddress) Dated—____________________________ Note: If the above certification cannot be completed at the time the subscription is entered, a statement to that effect should accom pany the subscription, and the certification in the above form should be submitted separately as soon as possible.
@FedFRASER