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FEDERAL RESERVE BANK
OF NEW YORK
Fiscal Agent of the United States
'Circular No. 2 2 5 2 T
. August 1, 1941 J

OFFERING OF TWO SERIES OF UNITED STATES TREASURY NOTES
Tax Series A-1943
Tax Series B-1943
Dated August 1, 1941
Due August 1, 1943
Issued at Par and Accrued Interest
Acceptable at Par and Accrued Interest in Payment of Federal Income Taxes

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

At the request of the Treasury Department, this bank transmits to you herewith a copy of Treasury
Department Circular No. 667, setting forth the terms of the offering of Treasury Notes of Tax Series A-1943
and Treasury Notes of Tax Series B-1943, together with a copy of a pamphlet issued by the Treasury
Department entitled "United States Treasury Tax Savings P l a n " and a supply of application forms.
The principal operations may be summarized as follows:
Issuing Agents
Notes of both series will be issued by the Federal Reserve Banks only, but banking institutions
generally may receive applications for notes of both series from their customers and forward such applications to the Federal Reserve Bank of New York.
Application Forms
Applications for notes of each series should be made on separate blanks which have been prepared for
this purpose in pad form. One pad of each of the application forms is enclosed for the use of banking institutions (Form GB-353 for Tax Series A and Form GB-354 for Tax Series B). Instructions for filling out
such applications will be found on the inside covers of such pads. A pad of Form G.B. 355 "Requisition
for Forms" is also enclosed for use in requisitioning additional forms.
Purchase Prices
The notes of both series will be sold at par during August 1941, and at par and accrued interest during
each subsequent month while they remain on sale, the purchase price advancing each month in the amount
of one month's interest. A table showing the purchase price for notes of each series issued in August,
September, October, November and December, 1941, will be found on page 5 of Treasury Department
Circular No. 667 and on the inside covers of the application form pads.
Each application must be accompanied by payment in full; and it should be noted that the month
in which payment (that is, immediately available funds) is received by the Federal Reserve Bank of New
York will determine the issue date and the purchase price of the notes applied for. Consequently, if payment in form other than cash, Federal funds, or advice of credit to War Loan Deposit Account is received
by the Federal Reserve Bank of New York near the end of one month and is not collected until the next
succeeding month, the purchase price for such notes will be that indicated for such next succeeding month.




Form of Payment
Any form of exchange, including personal checks, will be accepted subject to collection, and should be
drawn to the order of the Federal Eeserve Bank of New York or the Treasurer of the United States. Any
depositary, qualified pursuant to the provisions of Treasury Department Circular No. 92 (revised February
23, 1932, as supplemented) may make payment by advice of credit to the War Loan Deposit Account
for notes applied for on behalf of itself or its customers up to any amount for which it shall be qualified in
excess of existing deposits. In the latter case Form GB 352 should be attached to the application form
covered by such payment and adequate collateral should be provided in the usual manner. A pad of
Form G.B. 355 "Requisition for Forms" is enclosed for use in requisitioning such forms.
Presentation in Payment of Federal Income Taxes
After three months from the date of purchase (as shown by the issue date on each note), but not
before January 1, 1942, notes of both series may be presented in payment of Federal income taxes as outlined in section IV of Treasury Department Circular No. 667.
Taxation
Income derived from the notes shall be subject to all Federal taxes, now or hereafter imposed. The
notes 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.
Cash Redemption
A note of either series, if not presented in payment of taxes, will be (1) paid at maturity or (2) redeemed
prior to maturity, at the owner's option and request, as provided in section V of Treasury Department
Circular No. 667. Such payment or redemption will be made only by the Federal Reserve Bank that
issued the note, and will be made only at tlie price paid for such note, that is, at par and accrued interest
(if any) paid at the time of purchase. In other words, interest accrues on notes of both series after their
purchase only in case they are presented in payment of Federal income taxes.
Before any note will be accepted for redemption or payment the ' ' request for payment'' form on the
reverse side of such note must be completed in accordance with the instructions thereon.
Notes of Tax Series A-1943 may be redeemed at any time before maturity without advance notice, but
notes of Tax Series B-1943 will be redeemed before maturity only after 60 days from the issue date and on
30 days' advance notice to the issuing Federal Reserve Bank. The timely surrender of a note of Series B,
bearing a properly executed request for payment, will be accepted as constituting such advance notice.
Notes of either series may also be presented to the issuing Federal Reserve Bank for denominational
exchange to lower, but not to higher, denominations, or for partial cash redemption in amounts corresponding to an authorized denomination. In the event of a partial cash redemption a new note with the same
date of issue as the note surrendered will be issued in the face amount of the unredeemed portion of the old
note. The "request for payment" form on the reverse side of each note presented for partial redemption
or denominational exchange should be completed in accordance with the instructions thereon and an appropriate request for such redemption or exchange should be added thereto.
Payment of any note, or part thereof, either at maturity or on redemption prior to maturity will be
made by check drawn to the order of the owner and mailed to the address given in the request for payment.
This bank will be pleased to undertake to answer any inquiries relative to the new series of Treasury
tax notes. Additional copies of this circular, Treasury Circular No. 667 and the enclosed pamphlet will be
furnished upon request.




ALLAN SPROUL,

President.

THE UNITED STATES OF AMERICA

TREASURY NOTES
Tax Series A-1943

Tax Series R-1943
Dated August 1,1941

Due August 1,1943

Issued at Par and Accrued Interest
Acceptable at Par and Accrued Interest in Payment of Federal Income Taxes
No. ui

TREASURY DEPARTMENT,
OFFICE OF THE SECRETARY,
J
WashingtOfl, July
22,

Bureau^fhfTubfic Debt

I. OFFERING OF NOTES

1. The Secretary of the Treasury, pursuant to the authority of the Second Liberty Bond Act,
as amended, offers for sale, to the people of the United States, through the Federal Reserve Banks, at
par and accrued interest, two issues of nontransferable notes of the United States, designated Treasury Notes of Tax Series A-1943, and Treasury Notes of Tax Series B-1943. As hereinafter provided, the notes of both series will be acceptable at par and accrued interest in payment of Federal
income taxes: Provided, however, that not exceeding $1,200 principal amount of notes of Tax Series
A-1943, and the accrued interest thereon, will be accepted from any one owner in any period of
twelve consecutive months in payment of taxes due from such owner. If not presented in payment
of taxes, the notes will be redeemable at the purchase price as hereinafter provided.
2. Descriptions of the notes of both series, and their terms are hereinafter fully set forth.
The notes will be placed on sale beginning August 1, 1941, and the sale will continue until December
31,1941, unless earlier terminated, as to either or both series, by the Secretary of the Treasury.
II. DESCRIPTION OF NOTES

1. General.—The notes of both series will be dated August 1, 1941, and will mature August
1, 1943. The owner's name and address, and the date of issue will be entered on each note at the
time of its issue by a Federal Reserve Bank. The month in which payment is received by a Federal
Reserve Bank or Branch, or by the Treasurer of the United States, will determine the purchase
price and issue date of each note. The notes may not be transferred. No hypothecation of the
notes on any account will be recognized by the Treasury Department, and they will not be accepted
to secure deposits of public money. Except as herein provided, the notes will be subject to the
general regulations of the Treasury Department, now or hereafter prescribed, governing bonds
and notes of the United States.
2. Denominations and interest.—The notes of Tax Series A-1943 will be issued in denominations of $25, $50, and $100, and interest thereon will accrue during each month after August 1941, in
the amount of 16 cents on each $100 principal amount, that is, 4 cents on each $25, 8 cents on each
$50, and 16 cents on each $100 denomination of note. The notes of Tax Series B-1943 will be
issued in denominations of $100, $500, $1,000, $10,000 and $100,000, and interest thereon will accrue
each month after August 1941, in the amount of 4 cents on each $100 principal amount, that is 4
cents on each $100, 20 cents on each $500, 40 cents on each $1,000, $4 on each $10,000, and $40
on each $100,000 denomination of note. In no case, however, shall interest accrue beyond the
month in which the note is presented in payment of taxes, or beyond its maturity. Exchanges of
authorized denominations of each series from higher to lower, but not from lower to higher, may
be arranged at the Federal Reserve Bank of issue.
3. Purchase price, and tax-payment value.—The notes of both series will be sold at par during
August 1941, and will be sold at par and accrued interest during each subsequent month while they
remain on sale, the purchase price for a note of any denomination of either series advancing each
month after August 1941, in the amount of one month's interest on that note. Tables, showing for



2
each month from August 1941, to August 1943, for each denomination of each series, the principal
amount of the notes with accrued interest added, are appended to this circular. The total shown
for any denomination for any month—August through December 1941—while the notes remain on
sale, is the purchase price, or cost, of the note during that month. Also, the total shown for any
denomination for any month thereafter is the tax-payment value, or the amount at which the note
will be acceptable during that month in payment of Federal income taxes as herein provided.
4. Acceptability in payment of taxes.—The notes of both series (but not more than $1,200 principal amount of notes of Tax Series A-1943 from any one owner in any period of twelve consecutive
months) will be acceptable, at par and accrued interest, in payment of Federal income taxes (current and back personal and corporation taxes, and excess-profits taxes). The conditions of presentation, surrender and acceptance of the notes in payment of such taxes are set forth in Section IV of
this circular.
5. Payment or redemption for cash.—The notes of either series may not be called by the Secretary of the Treasury for redemption prior to maturity. If such notes are not presented in payment
of taxes: (1) they will be payable at maturity, or (2) they will be redeemable prior to maturity,
at the owner's option and request, as hereinafter provided in Section V and in either case payment
will be made only at the price paid for the notes.
6. Taxation.—Income derived from the notes shall be subject to all Federal taxes, now or hereafter imposed. The notes 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.
III. PURCHASE OF NOTES

1. Applications and payment—Applications will be received by the Federal Reserve Banks and
Branches, and by the Treasurer of the United States, Washington, D. C. Banking institutions generally may submit applications for account of customers, but only the Federal Reserve Banks and
the Treasurer of the United States are authorized to act as official agencies. Every application must
be accompanied by payment in full, at par and accrued interest to the month in which payment is
received by a Federal Reserve Bank or Branch, or the Treasurer of the United States. Any form
of exchange, including personal checks, will be accepted subject to collection, and should be drawn
to the order of the Federal Reserve Bank or of the Treasurer of the United States, as the case may
be. Any depositary, qualified pursuant to the provisions of Treasury Department Circular No. 92
(revised February 23,1932, as supplemented) will be permitted to make payment by credit for notes
applied for on behalf of itself or its customers up to any amount for which it shall be qualified in
excess of existing deposits.
2. Reservations.—The Secretary of the Treasury reserves the right to reject any application in
whole or in part, and to refuse to issue or permit to be issued hereunder any notes in any case or in
any class or classes of cases if he deems such action to be in the public interest, and his action in any
such respect shall be final. If an application is rejected, in whole or in part, any payment received
therefor will be refunded. The Secretary of the Treasury, in his discretion, may designate agencies other than those herein provided for the sale of, or for the handling of applications for, Treasury
notes to be issued hereunder.
3. Delivery of notes.—Upon acceptance of full-paid applications, notes will be duly issued and,
unless delivered in person, will be delivered by registered mail within the Continental United States,
the Territories and Insular Possessions of the United States, the Canal Zone and the Philippine
Islands. No deliveries elsewhere will be made.
4. Form of application.—In applying for notes under this circular, care should be exercised to
specify whether those of Tax Series A-1943, or Tax Series B-1943 are desired, and there must be
furnished the name and address of the individual, corporation or other entity in which the notes are
to be issued; and if address for the delivery of the notes is different, appropriate instructions should



3
be given. The name should be in the same form as that used in the Federal income tax return of
the purchaser. The use of an official application form is desirable, but not necessary. Appropriate
forms may be obtained on application to any Federal Reserve Bank or Branch, and banking institutions generally will supply such forms.
IV. PRESENTATION IN PAYMENT OF TAXES

1. After three months from month of purchase (as shown by the date of issue on each note),
but not before January 1, 1942, during such time, and under such rules and regulations as the Commissioner of Internal Revenue, with the approval of the Secretary of the Treasury, shall prescribe,
notes issued hereunder in the name of a taxpayer (individual, corporation, or other entity) may be
presented and surrendered by such taxpayer, his agent, or his estate, to the Collector of Internal
Revenue, to whom the tax return is made, and will be receivable by the Collector at par and accrued
interest from August 1941, to the month, inclusive (but no accrual beyond August 1943), in which
presented in payment of any Federal income taxes (current and back personal and corporation taxes,
and excess-profit taxes) assessed against the original purchaser or his estate, but not more than
$1,200 principal amount of notes of Tax Series A-1943, and the accrued interest thereon, may be
accepted by the Collector in any period of twelve consecutive months in payment of Federal income
taxes due from such owner. The notes must be forwarded to the Collector at the risk and expense of
the owner, and, for his protection, should be forwarded by registered mail, if not presented in person.
V. CASH REDEMPTION AT OR PRIOR TO MATURITY

1. General.—Any Treasury note of Tax Series A-1943 or Tax Series B-1943 will be redeemed
for cash at the purchase price at or before maturity. Notes of Tax Series A-1943 may be redeemed
before maturity without advance notice, but notes of Tax Series B-1943 may be redeemed before
maturity only after 60 days from date of issue and on 30 days' advance notice. The timely surrender of a note of Tax Series B-1943, bearing a properly executed request for payment, will be accepted as constituting the advance notice required hereunder.
2. Execution of request for payment.—The owner in whose name the note is inscribed must appear before one of the officers authorized by the Secretary of the Treasury to witness and certify requests for payment, establish his identity, and in the presence of such officer sign the request for
payment appearing on the back of the note, adding the address to which check is to be mailed.
After the request for payment has been so signed, the witnessing officer should complete and sign
the certificate provided for his use.
3. Officers authorized to witness and certify requests for payment.—Any officers authorized to
witness and certify requests for payment of United States Savings Bonds, as set forth in Treasury
Department Circular No. 530, Fourth Revision, as amended, are hereby authorized to witness and
certify requests for cash redemption of Treasury notes issued under this circular. Such officers
include United States postmasters, certain other post office officials, and the executive officers of all
banks and trust companies incorporated in the United States or its organized territories, including
officers at branches thereof who are certified to the Treasury Department as executive officers.
4. Presentation and surrender.—Notes bearing properly executed requests for payment must
be presented and surrendered to the Federal Reserve Bank of issue, at the expense and risk of the
owner. For the owner's protection, notes should be forwarded by registered mail, if not presented
in person.
5. Disability or death.—In case of the disability or death of the owner, and the notes are not to
be presented in payment of Federal income taxes due from his estate, instructions should be obtained
from the Federal Reserve Bank of issue before the request for payment is executed, or the notes
presented.
6. Partial redemption.—Partial cash redemption of notes of either series, corresponding to an
authorized denomination, may be made in the same manner, appropriate changes being made in the
request for payment. In case of partial redemption of a note, the remainder will be reissued with
the same date of issue as the note surrendered.
,„ „„



7. Payment.—Payment of any note, either at maturity or on redemption before maturity, will
be made only by the Federal Reserve Bank that issued the note, and will be made by check drawn
to the order of the owner, and mailed to the address given in his request for payment. In any case,
payment will be made at the purchase price of the note, that is, at par and accrued interest (if any)
paid at the time of purchase.
VI. GENERAL PROVISIONS

1. Federal Reserve Banks, as fiscal agents of the United States, are authorized to perform
such services or acts as may be appropriate and necessary under the provisions of this circular, and
under any instructions given by the Secretary of the Treasury.
2. The Secretary of the Treasury may at any time or from time to time supplement or amend
the terms of this circular, or of any amendments or supplements thereto, and may at any time or
from time to time prescribe amendatory rules and regulations governing the offering of the notes,
information as to which will promptly be furnished to the Federal Reserve Banks.




HENRY MORGENTHAU, Jr.,

Secretary of the Treasury.
(Piled with the Division of the Federal Register, July 31, 1941)

TREASURY NOTES—TAX SERIES A-1943
Purchase Price and Tax-Payment Value During Successive Months
Table, showing for each month from August 1941, to August 1943, for notes of each denomination, the principal
amount with accrued interest added. The total shown for any denomination, for any month—August through December
1941—while the notes remain on sale, is the Purchase Price, or Cost, of the note during that month. Also, the total shown
for any denomination for any month thereafter is the Tax-Payment Value, or the amount at which the note will be acceptable during that month in payment of Federal income taxes.
$100
PURCHASE PRICE
August, 1941
September, 1941.
October, 1941__November, 1941.
December, 1941_

$25.
25.
25.
25.
25.

00
04
08
12
16

$50. 00
50.08
50. 16
50. 24
50. 32

$100.
100.
100.
100.
100.

00
16
32
48
64

TAX-PAYMENT VALUE
January, 1942
February, 1942
MARCH, 1942
April, 1942
May, 1942
JUNE. 1942
July, 1942
August, 1942
SEPTEMBER, 1942.
October, 1942
November, 1942
DECEMBER, 1942..
January, 1943
February, 1943
MARCH, 1943
April, 1943
May, 1943
JUNE, 1943
July, 1943
August, 1943

$25. 20
25.24
25.28
25. 32
25. 36
25.40
25.44
25.48
25. 52
25. 56
25. 60
25.64
25. 68
25.72
25.76
25.80
25.84
25.88
25. 92
25.96

$50. 40
50.48
50. 56
50. 64
50. 72
50.80
50.88
50. 96
51.04
51. 12
51.20
51. 28
51.36
51.44
51.52
51.60
51.68
51.76
51.84
51.92

$100.
100.
101.
101.
101.
101.
101.
101.
102.
102.
102.
102.
102.
102.
103.
103.
103.
103.
103.
103.

80
96
12
28
44
60
76
92
08
24
40
56
72
88
04
20
36
52
68
84

TREASURY NOTES—TAX SERIES B-1943
Purchase Price and Tax-Payment Value During Successive Months
Table, showing for each month from August 1941, to August 1943, for notes of each denomination, the principal amount
with accrued interest added. The total shown for any denomination, for any month—August through December 1941—
while the notes remain on sale, is the Purchase Price, or Cost, of the note during that month. Also, the total shown for
any denomination for any month thereafter is the Tax-Payment Value, or the amount at which the note will be acceptable
during that month in payment of Federal income taxes.
$100

$500

$1,000

$10,000

$100,000

PURCHASE PRICE
August, 1941
September, 1941.
October, 1941.....
November, 1941.
December, 1941-

January, 1942
February, 1942
MARCH, 1942
April, 1942
May, 1942
JUNE, 1942
July, 1942.
August, 1942
SEPTEMBER, 1942.
October, 1942
November, 1942
DECEMBER, 1942..
January, 1943
February, 1943
M A R C H , 1943
April, 1943
May, 1943J U N E , 1943
July, 1943..—
—
August,
1943—-



$100.
100.
100.
100.
100.

00
04
08
12
16

$500. 00
500. 20
500. 40
500. 60
500. 80

$1,
1,
1,
1,
1,

000. 00
000. 40
000. 80
001. 20
001. 60

$10,
10,
10,
10,
10,

000
004
008
012
016

$100,
100,
100,
100,
100,

000
040
080
120
160

TAX-PAYMENT VALUE
$100. 20
100. 24
100. 28
100. 32
100. 36
100. 40
100. 44
100. 48
100. 52
100. 56
100. 60
100. 64
100. 68
100. 72
100. 76
100. 80
100. 84
100. 88
100. 92
100. 96
U. S. GOVERNMENT PRINTING OFFICE

$501. 00 $1, 002. 00
501. 20 1, 002. 40
501. 40 1, 002. 80
501. 60 1, 003. 20
501. 80 1, 003. 60
502. 00
004.00
502. 20
004. 40
502. 40
004. 80
502. 60
005. 20
502. 80
005. 60
503. 00
006.00
503. 20
006. 40
503. 40
006. 80
503. 60
007. 20
503. 80
007. 60
504. 00
008. 00
504. 20
008. 40
504. 40
008. 80
504. 60 1, 009. 20
504. 80 1, 009. 60

16—22497

$10, 020
10, 024
10, 028
10, 032
10, 036
10, 040
10, 044
10, 048
10, 052
10, 056
10, 060
10, 064
10, 068
10, 072
10, 076
10, 080
10, 084
10, 088
10, 092
10. 096

$100, 200
100, 240
100, 280
100, 320
100, 360
100, 400
100, 440
100, 480
100, 520
100, 560
100,600
100, 640
100, 680
100,720
100, 760
100, 800
100, 840
100, 880
100, 920
100, 960

UB-3S4—350M—7-41

ORIGINAL

J3

To be forwarded to
Federal Reserve Bank

Application for

UNITED STATES TREASURY NOTES OF TAX SERIES B
To FEDERAL RESERVE BANK OP NEW YORK,

Fiscal Agent of the United States.
The undersigned hereby applies for United
States Treasury Notes of Tax Series B issued
pursuant to appropriate Treasury Department Circular, as follows:

T h e r e is no limit on
amount of Series B Notes
that may be used in payment of Federal income
taxes.

Total Face Amount
(without interest)

No. of Pieces Denomination

Leave Blank

$100
500
l?000
10,000
100,000
Total Face Amount $_

at $.
(See purchase price table)

per $100 face amount, making a total purchase price of $
Please inscribe the notes with the following name and address:
(Name — Please type or print)
(Address — Please type or print)

and forward the notes by registered mail to the banking institution submitting this application, unless otherwise instructed.
Other instructions, if any
Date
(Signature of Purchaser or Agent)

FOR USE OF BANKING INSTITUTION
We submit the above application, payment in respect thereof to be made as
follows:
• By check enclosed.
• By charge to our reserve account, which is hereby authorized.
• By credit to War Loan Deposit Account, certificate of advice on
Form GB-352 being enclosed.
(Name of Banking Institution)

By-

,'Ofiicia'l signature unless check enclosed)


Address


(City, Town or Village, and State)

(Title)

GB-354—250M—7-41

Application for

DUPLICATE
To be retained by banking
institution accepting
application

UNITED STATES TREASURY NOTES OF TAX SERIES B
To FEDERAL RESERVE B A N K OF N E W YORK,

Fiscal Agent of the United States.
The undersigned hereby applies for United
States Treasury Notes of Tax Series B issued
pursuant to appropriate Treasury Department Circular, as follows:
No. of Pieces

T h e r e is no limit on
amount of Series B Notes
that may be used in payment of Federal income
taxes.

Total Face Amount
(without interest)

Denomination

Leave Blank

$100
500
1,000
10,000
100,000
Total Face Amount $.

at $_
(See purchase price table)

per $100 face amount, making a total purchase price of $
Please inscribe the notes with the following name and address:
(Name — Please type or print)
(Address — Please type or print)

ind forward the notes by registered mail to the banking institution submitting this application, unless otherwise instructed.
Other instructions, if any
Date
(Signature of Purchaser or Agent)

FOR USE OF BANKING INSTITUTION
We submit the above application, payment in respect thereof to be made as
follows:
• By check enclosed.
• By charge to our reserve account, which is hereby authorized.
• By credit to War Loan Deposit Account, certificate of advice on
Form GB-352 being enclosed.
(Name of Banking Institution)

By-

(Official signature unless check enclosed)


Addres s


(City, Town or Village, and State)

(Title)

TRIPLICATE
-D
To be retained by purchaser

GB-354—250M—7-41

Application for

UNITED STATES TREASURY NOTES OF TAX SERIES B
To FEDERAL RESERVE B A N K OF N E W YORK,

Fiscal Agent of the United States.
The undersigned hereby applies for United
States Treasury Notes of Tax Series B issued
pursuant to appropriate Treasury Department Circular, as follows:
No. of Pieces

Denomination

There is no limit on
amount of Series B Notes

that may be used in payment of Federal income
taxes.

Total Face Amount
(without interest)

Leave Blank

1

$100
500
1,000
10.000
100.000

Total Face Amount $_

at $.
(See purchase price table)

per $100 face amount, making a total purchase price of $
Please inscribe the notes with the following name and address:
(Name — Please type or print)
(Address — Please type or print)

and forward the notes by registered mail to the banking institution submitting this application, unless otherwise instructed.
Other instructions, if any
Date.

(Signature of Purchaser or Asrenti

(For use of banking institution receiving application)
MEMORANDUM RECEIPT
Received $_
from
the purchase price of a like face amount of United States Treasury Notes
of Tax Series B.

.1941.
Date.



GB352 I5M 7-41

Federal Reserve Bank
of New York

CERTIFICATE OF ADVICE
Date

I HEREBY CERTIFY that there has been deposited this day with the below named bank or trust company, to
Z

the credit of the FEDERAL RESERVE BANK OF NEW YORK, as fiscal agent of the UNITED STATES, "WAR

I
c

r for

E

c

LOAN DEPOSIT ACCOUNT" the sum of $

_in payment for UNITED STATES TREASURY

NOTES, designated TAX SERIES_

Jo be held subject to withdrawal on demand.

1
used onl

3

<J <
c
o
a-.-:

CO
LU

CQ

(Indicate only one series]

CO
LU

LU LU

co co

U



(Official Signature Required)

G. B. 3 5 5 5OM 7-41

REQUISITION FOR FORMS
U. S. TREASURY NOTES
TAX SERIES
Date

TO:

FEDERAL RESERVE BANK OF N E W YORK

FROM:
Please ship the following:
QUANTITY

FORM

No.

DESCRIPTION

G. B. 352

Certification of War Loan Deposit

G. B. 353

Application Forms for Series A Notes

G. B. 354

Application Forms for Series B Notes




Booklets "Tax Savings Plan"

353-200M-7-41

ORIGINAL
A
To be forwarded to
Federal Reserve Bank

Application for

JMTED STATES TREASURY NOTES OF TAX SERIES A
To FEDERAL KESERVE BANK OF NEW YORK,

Fiscal Agent of the United States.
The undersigned hereby applies for United
States Treasury Notes of Tax Series A issued
pursuant to appropriate Treasury Department Circular, as follows:

Only $1,200 principal
amount of Series A notes
may be applied on payment of taxes in any
twelve consecutive months
by any one taxpayer.

Total face amount
(without interest)

No. of pieces Denomination

Leave blank

$25
50
100
Total Face Amount $_

at $(See purchase price table)

per $25 face amount, making a total purchase price of $
Please inscribe the notes with the following name and address:
(Name — Please type or print)

(Address — Please type or print)

and forward the notes by registered mail to the banking institution submitting this application, unless otherwise instructed.
Other instructions, if any
Date.
(Signature of Purchaser or Agent)

FOR USE OF BANKING INSTITUTION
We submit the above application, payment in respect thereof to be made as
follows:
• By check enclosed.
• By charge to our reserve account, which is hereby authorized.
• By credit to War Loan Deposit Account, certificate of advice on
Form GB-352 being enclosed.
(Name of Banking Institution)

By-

(Official signature unless check enclosed)


Address


(City, Town or Village, and State)

(Title)

GB-3S3—200M—7-41
•,.
A
c
Appbcation for

DUPLICATE
A
To be retained by banking
institution accepting
application

UNITED STATES TREASURY NOTES OF TAX SERIES A
To FEDERAL RESERVE BANK OP NEW YORK,

Fiscal Agent of the United States.
The undersigned hereby applies for United
States Treasury Notes of Tax Series A issued
pursuant to appropriate Treasury Department Circular, as follows:

Only $1,200 p r i n c i p a l
amount of Series A notes
may be applied on payment of taxes in any
twelve consecutive months
by any one taxpayer.

Total face amount
(without interest)

No. of pieces Denomination

Leave blank

$25
50
100
Total Face Amount $_

at $_
(See purchase price table)

per $25 face amount, making a total purchase price of $
Please inscribe the notes with the following name and address:
(Name — Please type or print)

(Address — Please type or print)

and forward the notes by registered mail to the banking institution submitting this application, unless otherwise instructed.
Other instructions, if any
Date-

(Signature of Purchaser or Agent)

FOR USE O F BANKING INSTITUTION
We submit the above application, payment in respect thereof to be made as
follows:
• By check enclosed.
• By charge to our reserve account, which is hereby authorized.
• By credit to War Loan Deposit Account, certificate of advice on
Form GB-352 being enclosed.
(Name of Banking Institution)

By-

(Official signature unless check enclosed)


Address


(City, Town or Village, and State)

(Title)

GB-353—200M—7-41

A

TRIPLICATE
A
To be retained by purchaser

Application for

UNITED STATES TREASURY NOTES OF TAX SERIES A
To FEDERAL RESERVE BANK OP NEW YORK,

Fiscal Agent of the United States.
The undersigned hereby applies for United
States Treasury Notes of Tax Series A issued
pursuant to appropriate Treasury Department Circular, as follows:
No. of pieces Denomination

Only $1,200 principal
amount of Series A notes
may be applied on payment of taxes in any
twelve consecutive months
by any one taxpayer.

Total face amount
(without interest)

Leave blank

$25
50
100
at $_

Total Face Amount $_

(See purchase price table)

per $25 face amount, making a total purchase price of $
Please inscribe the notes with the following name and address:
(Name — Please type or print)

(Address — Please type or print)

and forward the notes by registered mail to the banking institution submitting this application, unless otherwise instructed.
Other instructions, if any
Date-

(Signature of Purchaser or Agent)

(For use of banking institution receiving application)
MEMORANDUM RECEIPT
from_
Received $
the purchase price of a like face amount of United States Treasury Notes
of Tax Series A.

DigitizedDate.
for FRASER


.1941.