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FEDERAL RESERVE BANK OF NEW YORK Fiscal Agent of the United States /■Circular No. 5 9 7 6 1 L April 28, 1967 J Refunding of Treasury Notes, Bonds, and Certificates Maturing May 15, June 15, and August 15, 1967 To All Banking Institutions, and Others Concerned, in the Second Federal Reserve D istrict: The subscription books will be open Monday, May 1, through Wednesday, May 3, for an offering of— 414 percent Treasury Notes o f Series C-1968, dated M ay 15, 1967, maturing August 15, 1968, and 4 % percent Treasury Notes o f Series B-1972, dated M ay 15, 1967, maturing M ay 15, 1972, in exchange for the eligible series of Treasury notes, bonds, and certificates maturing May 15, June 15, and August 15, 1967, as set forth in Treasury Department Circulars Nos. 5-67 and 6-67, Public Debt Series, both dated April 27, 1967; a copy of each is printed on the following pages. Any gain or loss on this exchange will be fully recognized under the Internal Revenue Code. Holders of the securities maturing August 15 may exchange them only for the 4% per cent notes. Coupons dated May 15, 1967 on the securities maturing on that date should be detached and cashed when due. Coupons dated June 15 and August 15, 1967 on securities maturing on those dates must be attached. Tables 1 and 2 on page 6 show details of interest and other adjustments, and approximate investment yields. Only banking institutions may submit subscriptions for account of customers. On such subscriptions, the customers’ names must be furnished. On subscriptions for account of customers other than individuals, their locations must also be furnished. On subscriptions for account of customers of correspondent banks, the names of such customers and, if not individuals, their locations must be furnished. Subscribers are required to certify that at the time the subscription is entered the securities surrendered were owned and delivery was accepted by the subscriber, or that such securities were contracted for purchase for value by the subscriber for delivery to the sub scriber prior to the closing of the subscription books. Subscriptions will be received by this Bank as fiscal agent of the United States. Subscrip tions should be submitted in triplicate on official subscription forms, copies of whch are enclosed, and should be mailed immediately. If filed by telegram or letter, the subscriptions should be confirmed immediately by mail on the forms provided. The subscription books will remain open for three days, May 1 through May 3. Any subscription addressed to a Federal Reserve Bank or Branch or to the Treasury Department and placed in the mail before midnight Wednesday, May 3, will be considered timely. Cash subscriptions will not be received. A lfred H ayes, President. UNITED STATES OF AMERICA m P E R C E N T T R E A S U R Y N O T E S O F S E R IE S C - 1 9 6 8 Dated and bearing interest fro m May 15, 1967 D ue August 15, 1968 D EPAR T M EN T CIRCULAR TREASU RY DEPARTM ENT, O f f ic e Public Debt Series— No. 5 -67 of t h e S ecretary, W ashington, A p ril 27,1967. I. OFFERING OF NOTES 2. The income derived from the notes is subject to all taxes imposed under the Internal Revenue Code o f 1954. The notes are subject to estate, inheritance, g ift or other excise taxes, whether Federal or State, but are exempt from all taxation now or hereafter imposed on the principal or interest thereof by any State, or any of the possessions o f the United States, or by any local taxing authority. 1. The Secretary o f the Treasury, pursuant to the authority o f the Second Liberty Bond A ct, as amended, offers notes o f the United States, designated 4 1 4 percent Treasury Notes o f Series C -1968: (1 ) at 99.95 percent o f their face value in ex change for 4 % percent Treasury Notes o f Series D-1967, dated November 15, 1965, due M ay 15, 1967; or 3. The notes will be acceptable to secure deposits o f public moneys. They will not be acceptable in pay ment o f taxes. (2) at 99.95 percent o f their face value, plus a payment o f $1.00 per $1,000 to the United States, in exchange fo r 2 V2 percent Treasury Bonds o f 1962-67, dated May 5, 1942, due June 15, 1967, in amounts o f $1,000 or multiples thereof. 4. Bearer notes with interest coupons attached, and notes registered as to principal and interest, will be issued in denominations o f $1,000, $5,000, $10,000, $100,000, $1,000,000, $100,000,000 and $500,000,000. Provision will be made fo r the interchange o f notes o f different denominations and o f coupon and regis tered notes, and fo r the transfer o f registered notes, under rules and regulations prescribed by the Secre tary o f the Treasury. Interest will be adjusted on the bonds o f 1962-67 as o f M ay 15, 1967. Cash payments due to subscribers will be made as set forth in Section I V hereof. The amount o f this offering will be limited to the amount o f eligible securities tendered in exchange. The books will be open only on May 1 through M ay 3, 1967, for the receipt o f subscriptions. 5. The notes will be subject to the general regula tions o f the Treasury Department, now or hereafter prescribed, governing United States notes. 2. In addition, holders o f the securities enumer ated in Paragraph 1 o f this Section are offered the privilege o f exchanging all or any part o f them fo r 4 % percent Treasury Notes o f Series B-1972, which offering is set forth in Department Circular, Public Debt Series — No. 6-67, issued simultaneously with this circular. II. III. D ESCRIPTIO N OF NOTES 1. The notes will be dated M ay 15, 1967, and will bear interest from that date at the rate o f 4 1/4 per cent per annum, payable on a semiannual basis on A ugust 15, 1967, and on February 15 and August 15, 1968. They will mature A ugust 15, 1968, and will not be subject to call fo r redemption p rior to maturity. 2 SURSCRIPTION AND ALLOTM ENT 1. Subscriptions accepting the offer made b y this circular will be received at the Federal Reserve Banks and Branches and at the Office o f the Treasurer o f the United States, W ashington, D. C. 20220. Banking institutions generally may submit subscriptions for account o f customers, but only the Federal Reserve Banks and the Treasury Department are authorized to act as official agencies. 2. Under the Second Liberty B ond A ct, as amended, the Secretary o f the Treasury has the authority to reject or reduce any subscription, and to allot less than the amount o f notes applied fo r when he deems it to be in the public interest; and any action he may take in these respects shall be final. Subject to the exercise o f that authority, all sub scriptions will be allotted in full. difference ($9.87088 per $1,000) will be paid to sub scribers. V. IV. 1. Treasury securities in registered form tendered in paym ent fo r notes offered hereunder should be assigned by the registered payees or assignees thereof, in accordance with the general regulations o f the Treasury Department governing assignments for transfer or exchange, in one o f the form s hereafter set forth, and thereafter should be surrendered with the subscription to a Federal Reserve Bank or Branch or to the Office o f the Treasurer o f the United States, Washington, D. C. 20220. The securities must be de livered at the expense and risk o f the holder. I f the new notes are desired registered in the same name as the securities surrendered, the assignment should be to “ The Secretary o f the Treasury fo r exchange for 4 1 4 percent Treasury-Notes o f Series C-1968” ; if the new notes are desired registered in another name, the assignment should be to “ The Secretary o f the Treasury fo r exchange fo r 4 ^ percent Treasury Notes o f Series C-1968 in the name o f ........................ if new notes in coupon form are desired, the assign ment should be to “ The Secretary o f the Treasury for exchange fo r 4 ^ percent Treasury Notes o f Series C-1968 in coupon form to be delivered t o ................. PAYM ENT 1. Payment fo r the face amount o f notes allotted hereunder must be made on or before M ay 15, 1967, or on later allotment, and may be made only in a like face amount o f securities o f the two issues enu merated in Paragraph 1 o f Section I hereof, which should accom pany the subscription. Payment will not be deemed to have been completed where regis tered notes are requested if the appropriate iden tify ing number as required on tax returns and other documents submitted to the Internal Revenue Service (an individual’s social security number or an em ployer identification number) is not furnished. Cash payments due to subscribers will be made b y check or b y credit in any account maintained by a banking institution with the Federal Reserve Bank o f its Dis trict follow ing acceptance o f the securities surren dered. In the case o f registered securities, the payment w ill be made in accordance with the assignments thereon. 2. 4 1 4 percent notes o f Series B-1967. — W hen payment is made with notes in bearer form , coupons dated M ay 15, 1967, should be detached and cashed when due. W hen payment is made with registered notes, the final interest due on M ay 15, 1967, will be paid by issue o f interest checks in regular course to holders o f record on A p ril 14, 1967, the date the transfer books closed. A cash payment o f $0.50 per $1,000 on account o f the issue price o f the notes will be made to subscribers. V I. GENERAL PROVISIONS 1. As fiscal agents o f the United States, Federal Reserve Banks are authorized and requested to re ceive subscriptions, to make such allotments as may be prescribed by the Secretary o f the Treasury, to issue such notices as may be necessary, and to receive payment fo r and make delivery o f notes on full-paid subscriptions allotted, and they may issue interim receipts pending delivery o f the definitive notes. 3. 2^/2 p ercen t bonds o f 1962-67. — W hen pay ment is made with bonds in bearer form , coupons dated June 15, 1967, must be attached to the bonds in bearer form when surrendered. A ccrued interest from December 15, 1966, to May 15, 1967 ($10.37088 per $1,000), plus the payment ($0.50 per $1,000) due to the subscriber on account o f the issue price o f the new notes will be credited, the payment o f $1.00 per $1,000 due the United States will be charged, and the ASSIGNMENT OF REGISTERED SECURITIES 2. The Secretary o f the Treasury may at any time, or from time to time, prescribe supplemental or amendatory rules and regulations governing the offer ing, which will be communicated prom ptly to the Federal Reserve Banks. HENRY H. FOW LER, S ecretary o f the Treasury. 3 UNITED STATES OF AMERICA m P E R C E N T T R E A S U R Y N O T E S O F S E R IE S B - 1 9 7 2 Dated and bearing interest from May 15, 1967 D ue May 15, 1972 DEPARTMENT CIRCULAR TREASU RY DEPARTM ENT, O f f ic e Public Debt Series— No. 6-67 of t h e S ecretary, W ashington, A p ril 27,1967. I. OFFERING OF NOTES are offered the privilege o f exchanging all or any part o f such securities for 4*4 percent Treasury Notes o f Series C-1968, which offering is set forth in D epart ment Circular, Public Debt Series — No. 5-67, issued simultaneously with this circular. 1. The Secretary o f the Treasury, pursuant to the authority o f the Second Liberty Bond A ct, as amended, offers notes o f the United States, designated 4% percent Treasury Notes o f Series B-1972 at p a r: (1) in exchange fo r 4*4 percent Treasury Notes of Series D-1967, dated November 15, 1965, due M ay 15, 1967; (2) with a cash payment o f $1.00 per United States in exchange for Treasury Bonds o f 1962-67, dated due June 15, 1967, in amounts multiples thereof; II. $1,000 to the 21/2 percent M ay 5, 1942, o f $1,000 or (3) with a cash payment o f $3.00 per $1,000 to the subscriber in exchange for 51/4 percent Treas ury Certificates o f Indebtedness o f Series A 1967, dated August 15, 1966, due August 15, 1967; 2. The income derived from the notes is subject to all taxes imposed under the Internal Revenue Code o f 1954. The notes are subject to estate, inheritance, gift or other excise taxes, whether Federal or State, but are exempt from all taxation now or hereafter imposed on the principal or interest thereof by any State, or any o f the possessions o f the United States, or by any local taxing authority. (4) with a cash payment o f $1.50 per $1,000 to the United States in exchange for 3 % percent Treasury Notes o f Series A-1967, dated Sep tember 15, 1962, due August 15, 1967; or (5) with a cash payment o f $2.00 per $1,000 to the subscriber in exchange for 4 % percent Treas u ry Notes o f Series E-1967, dated February 15, 1966, due August 15, 1967. 3. The notes will be acceptable to secure deposits o f public moneys. They will not be acceptable in payment o f taxes. 4. Bearer notes with interest coupons attached, and notes registered as to principal and interest, will be issued in denominations o f $1,000, $5,000, $10,000, $100,000, $1,000,000, $100,000,000 and $500,000,000. Provision will be made for the interchange o f notes o f different denominations and o f coupon and regis tered notes, and fo r the transfer o f registered notes, under rules and regulations prescribed b y the Secre tary o f the Treasury. Interest will be adjusted as o f May 15, 1967, in the case o f the securities due June 15 and August 15, 1967. Net payments on account o f accrued interest due subscribers and cash adjustments due to and from subscribers will be made as set forth in Section IV hereof. The amount o f this offering will be limited to the amount o f eligible securities tendered in ex change. The books will be open only on May 1 through May 3, 1967, for the receipt o f subscriptions. 5. The notes will be subject to the general regula tions o f the Treasury Department, now or hereafter prescribed, governing United States notes. 2. In addition, holders o f the 4 % percent notes o f Series D-1967, and the 2 % percent bonds o f 1962-67 D ESCRIPTION OF NOTES 1. The notes will be dated M ay 15, 1967, and will bear interest from that date at the rate o f 4 % percent per annum, payable semiannually on November 15, 1967, and thereafter on M ay 15 and November 15 in each year until the principal amount becomes pay able. They will mature M ay 15, 1972, and will not be subject to call fo r redemption prior to maturity. 4 III. 5. 5 % percen t notes o f Series A-1967. — Coupons dated August 15, 1967, must be attached to the notes in bearer form when surrendered. A ccrued interest from February 15 to M ay 15, 1967 ($9.21961 per $1,000), will be credited, the payment ($1.50 per $1,000) due the United States will be charged, and the difference ($7.71961 per $1,000) will be paid to subscribers. SUBSCRIPTION AND ALLOTMENT 1. Subscriptions accepting the offer made by this circular will be received at the Federal Reserve Banks and Branches and at the Office o f the Treasurer o f the United States, W ashington, D. C. 20220. Banking institutions generally may submit subscriptions fo r account o f customers, but only the Federal Reserve Banks and the Treasury Department are authorized to act as official agencies. 6. 4 % percen t notes o f Series E-1967. — Coupons dated A ugust 15, 1967, must be attached to the notes in bearer form when surrendered. A ccrued interest from February 15 to M ay 15, 1967 ($11.98550 per $1,000), plus the cash payment o f $2.00 per $1,000 will be paid to subscribers. 2. Under the Second Liberty B ond A ct, as amended, the Secretary o f the Treasury has the authority to reject or reduce any subscription, and to allot less than the amount o f notes applied fo r when he deems it to be in the public interest; and any action he may take in these respects shall be final. Subject to the exercise o f that authority, all subscriptions will be allotted in full. IV. V. PAYM ENT 1. Payment for the face amount o f notes allotted hereunder must be made on or before May 15, 1967, or on later allotment, and may be made only in a like face amount o f securities o f the five issues enumerated in Paragraph 1 o f Section I hereof, which should accom pany the subscription. Payment will not be deemed to have been completed where registered notes are requested if the appropriate identifying number as required on tax returns and other documents sub mitted to the Internal Revenue Service (an individ ual’s social security number or an employer identi fication number) is not furnished. Cash payments due to subscribers will be made by check or by credit in any account maintained by a banking institution with the Federal Reserve Bank o f its District fo l lowing acceptance o f the securities surrendered. In the case o f registered securities, the payment will be made in accordance with the assignments thereon. 2. 4x/± percent notes o f Series B-1967. — Coupons dated M ay 15, 1967, should be detached and cashed when due.1 3. 2 1/ 2 p ercen t bonds o f 1962-67. — Coupons dated June 15, 1967, must be attached to bonds in bearer form when surrendered. A ccrued interest from December 15, 1966, to M ay 15, 1967 ($10.37088 per $1,000) will be credited, the payment ($1.00 per $1,000) due the United States will be charged, and the difference ($9.37088 per $1,000) will be paid to subscribers. VI. GENERAL PROVISIONS 1. As fiscal agents o f the United States, Federal Reserve Banks are authorized and requested to re ceive subscriptions, to make such allotments as may be prescribed by the Secretary o f the Treasury, to issue such notices as may be necessary, and to receive payment for and make delivery o f notes on full-paid subscriptions allotted, and they may issue interim receipts pending delivery o f the definitive notes. 4. 5!/4 p ercen t certificates o f Series A-1967. — Coupons dated August 15, 1967, must be attached to the certificates when surrendered. A ccrued interest from February 15 to M ay 15, 1967 ($12.90746 per $1,000), plus the cash payment o f $3.00 per $1,000 will be paid to subscribers. 2. The Secretary o f the Treasury may at any time, or from time to time, prescribe supplemental or amendatory rules and regulations governing the offer ing, which will be communicated prom ptly to the Federal Reserve Banks. 1 Interest due on May 15, 1967, on registered securities will be paid by issue of interest checks in regular course to holders of record on April 14, 1967, the date the transfer books closed. ASSIGNMENT OF REGISTERED SECURITIES 1. Treasury securities in registered form tendered in payment fo r notes offered hereunder should be assigned by the registered payees or assignees thereof, in accordance with the general regulations o f the Treasury Department governing assignments for transfer or exchange, in one o f the form s hereafter set forth, and thereafter should be surrendered with the subscription to a Federal Reserve Bank or Branch or to the Office o f the Treasurer o f the United States, W ashington, D. C. 20220. The securities must be- de livered at the expense and risk o f the holder. I f the new notes are desired registered in the same name as the securities surrendered, the assignment should be to “ The Secretary o f the Treasury for exchange for 4 % percent Treasury Notes o f Series B-1972” ; if the new notes are desired registered in another name, the assignment should be to “ The Secretary of the Treas u ry fo r exchange fo r 4 % percent Treasury Notes of Series B-1972 in the name o f ........................................... .............................. ” ; if new notes in coupon form are desired, the assignment should be to “ The Secretary of the Treasury for exchange for 4 % percent Treas ury Notes o f Series B-1972 in coupon form to be de livered to ........................................................................... HENRY H. FOW LER, Secretary of the Treasury. 5 TABLE NO. 1 P a y m e n t s due to S u b s c r ib e r s in the M ay 1967 R e f u n d i n g (In dollars per $100 face value) Payment to (-{-) or by (—) subscribers on account of issue price of offered securities Securities to be exchanged F o r t h e 4 14 % N ote o f Accrued interest to May 15,1967 on securities exchanged to be paid to subscribers 8 /1 5 /6 8 +0.050000 — 0.050000 4 ^ % Note, 5 /1 5 /6 7 2i/2% Bond, 6 /1 5 /6 7 F or t h e 4 % % N ote of Net amount to be paid to subscribers 1.037088 0.050000 0.987088 1.037088 1.290746 0.921961 1.198550 0.937088 1.590746 0.771961 1.398550 5 /1 5 /7 2 414% Note, 5 / 1 5 / 6 7 ................. — Bond, 6 /1 5 /6 7 ............... ................. — 0.100000 51/4% Cert., 8 /1 5 /6 7 ................. ................. +0.300000 33/4% Note, 8 /1 5 /6 7 ................. ................. — 0.150000 4 % % Note, 8 /1 5 /6 7 ................. ................. +0.200000 21/ 2 % a Interest will be paid in regular course. T A B L E NO. 2 I nvestm ent R eturns in the M ay 1967 P r e r e f u n d i n g Securities eligible for exchange Approximate investment yield from 5/15/67 to maturity1 Approximate reinvestment rate for the extension period2 51/4% Cert., 8 /1 5 /6 7 33/4% Note, 8 /1 5 /6 7 4 % % Note, 8 /1 5 /6 7 4.72% 4.72 4.72 4.79% 4.77 4.79 1 Yields to nontaxable holders (or before tax) on issues offered in exchange based on prices of eligible issues (adjusted for payments on account of issue price). Prices are the mean of bid and ask quotations at noon on April 25, 1967. 2 Rate for nontaxable holder (or before tax). Office of the Secretary o f the Treasury Office o f Debt Analysis 6 Subscription No. DELIVERY INSTRUCTIONS— EXCHANGE SUBSCRIPTION For United States of America 4lA Percent Treasury Notes of Series C-1968 Dated May 15, 1967, Due August 15, 1968 B E A R E R N O TE S D E S IR E D IN E X C H A N G E (U se schedule on reverse side for R E G IS T E R E D notes) Dispose o f securities issued as fo llo w s : Denomi nation Pieces $ (Leave this space blank) Face amount 1,000 5,000 10,000 □ 1. Deliver over the counter to the undersigned □ 2. H old in safekeeping member bank o n ly )* □ 3. H old as collateral fo r Treas* ury Tax and Loan A ccount* (fo r O 4. Ship to the undersigned □ 100,000 5. Special instructions: 1,000,000 TO TAL *If this item is checked, the subscriber certi fies that the allotted securities will be owned solely by the subscriber. The subscription books will open on May 1, and close at the close of business May 3, 1967. (IM PO R TA N T: No changes in delivery instructions will be accepted. A separate subscription form must be submitted for each group o f securities for which different delivery instruc tions are given .) Submitted by (Please print) By ................. • .................... , B y ...................... Title . . . ....................... , T itle .................. (Authorized signature(s) required) Address (Spaces below are for the use o f the Federal Reserve Bank o f New Y ork ) S a f e k e e p in g R ecord Received Received from F e d e r a l R e s e r v e B a n k o f N e w Y o r k the above described United States obngations m the amount subscribed for. Subscriber ................... Checked and delivered Schedule for Issue of Registered Notes Name in which notes shall be registered identifying number (Social Security Account Number or Employer Identification Number) and p^tTffice address for interest checks and other mail _______ ______ f rlease print or typewrite) (Indicate under appropriate denominations, number of notes Amount Name Ident. No. Address Name...... Ident. No. Address Name...... Ident. No, Address Name...... Ident. No. Address ( I f registered notes, which are mailed direct]v h v Tmoo,,™ registered owner, give mailing instructions below.) Department, Washington, D . C., are not to be sent to the Mail registered notes to Subscriber’s Keference No. (Please type or print legibly and submit in triplicate) Subscription No. A -l EXCHANGE SUBSCRIPTION For United States of America 4lA Percent Treasury Notes of Series C-1968 Dated May 15, 1967, Due August 15, 1968 I m p o r ta n t In s tr u c tio n s . 1. Securities of different issues surrendered in exchange may be listed together on the same subscription form , except that a separate subscription form should be used ( a ) for listing bearer securities surrendered, ( b ) for listing registered securities surrendered, and ( c ) for each group o f new securities for which different delivery instructions are given. 2. Separate subscription forms should be used for bearer securities and registered securities desired in exchange. 3. Social Security account numbers or Em ployer Identification numbers of all subscribers fo r r e g is te r e d notes must be furnished on the reverse side hereof. 4. Signatures are required on original on ly; all other filled-in matter should appear in triplicate. Dated at ......................................................... F ed eral R eserve B a n k of N e w Y o r k , Fiscal Agent o f the United States, New York, N. Y . 10045 A tten tion : ........................................................................ 1967 Government Bond Division Gentlem en : Subject to the provisions o f Treasury Department Circular No. 5-67, Public Debt Series, dated -il 27, 1967, the undersigned hereby subscribes for United States of America 41/4 percent Treasury es o f Series C-1968, in the amount o f $ ................................................. * and tenders in payment therefor notes desi“ e Par amount o f the securities — ~ " Delivered to you herewith .................................................................................................... $ $1,000; J ^ To be withdrawn from securities held by y o u ................................................................ $ To be delivered by ................................................................................................................. $ * (Please fill in on the reverse side the schedule “ List of Accounts Included in this Subscription.” ) S E C U R IT IE S S U R R E N D E R E D Total Am ount % Notes, D -1967 (detach cou pon s) (D o not fill in this colum n) T o Subscriber ............................... % Bonds, 1962-67 (w ith 6 /1 5 /6 7 coupons attached) Total ........................................................ net amount due subscriber on price and interest adjustments:* □ By check □ By credit to reserve account * See Section IV of T. D. Circular No. 5-67, Public Debt Series, for method of computing net adjustment. W e H e r e b y C e r t i f y that at the time this subscription was entered the above-described securities rendered or to be surrendered in connection with this exchange were owned and delivery was accepted •the subscriber, 01: such securities were contracted for purchase fo r value by the subscriber fo r delivery the subscriber prior to-the closing of the subscription books. (Signature(s) required also on Delivery Instructions below) (D o not fill in boxes below ) .. G overnm ent B ond D Received Checked iv is io n Submitted by .............................................. (Please print) Canceled By .......... ; ••, B y ............................ (Authorized signature(s) required) Title ...................................................... . Title Address ................................................ (I f space is insufficient in schedules below, attach separate listing) List of Accounts Included in this Subscription (Indicate total amount of each issue surrendered by each customer and by yourself) ( Leave this space blank) Name and location (C ity and State) o f ultimate purchaser ( Location o f individuals not required ) 4*4% Notes D-1967 $ ...................... 2 % % Bonds 1962-67 $ ...................... Total $ ................... Our own a c c o u n t ............................................. Totals ........................................................ $ ................................. $ ................................. $ ............................... I I ( I f registered notes, which are mailed directly by Treasury Department, Washington, D. C., are not to be sent to the registered owner, give mailing instructions below.) Mail registered notes t o ..................................................................................................................................... V Schedule for Issue of Registered Notes Mail registered notes to Subscriber’s Reference No. DUPLICATE— SECURITY RECORDS “ IN TICKET” Subscription No. A-2 EXCHANGE SUBSCRIPTION For United States of America 4J A Percent Treasury Notes of Series C-1968 Dated May 15, 1967, Due August 15, 1968 Dated at ......................................................... F ed er al R eser v e B a n k of N e w Y o rk , Fiscal Agent o f the United States, New York, N. Y . 10045 A tten tion : ........................................................................ 1967 Government Bond Division Gen tl em en : Subject to the provisions o f Treasury Department Circular No. 5-67, Public Debt Series, dated April 27, 1967, the undersigned hereby subscribes for United States o f America 4 1/4 percent Treasury Notes o f Series C-1968, in the amount of $ ................................................. * and tenders in payment therefor a like par amount o f the securities—• Delivered to you h e r e w ith ............................................................................................ $ To be withdrawn from securities held by y o u ....................................................... $.................................. To be delivered by ......................................................................................................... $.................................. * (Please fill in on the reverse side the schedule “ List of Accounts Included in this Subscription.” ) S E C U R IT IE S SU R R E N D E R E D Total Am ount 4 V i % Notes, D -1967 (detach coupon s) ................................................ 2 / 4 % Bonds, 1962-67 (w ith 6 /1 5 /6 7 coupons attached) ............... Total ......................................................................... (D o not fill in this colum n) T o Subscriber $ .......................... ........ .................................. $ ................................... .................................. $................................ . ...................... ........... Pay net amount due subscriber on price and interest adjustments:* □ By check □ By credit to reserve account * See Section IV of T. D. Circular No. 5-67, Public Debt Series, for method of computing net adjustment. W e H e r e b y C e r t i f y that at the time this subscription was entered the above-described securities surrendered or to be surrendered in connection with this exchange were owned and delivery was accepted by the subscriber, 01; such securities were contracted for purchase for value by the subscriber fo r delivery to the subscriber prior to-the closing of the subscription books. Submitted by ( I f space is insufficient in schedules below, attach separate listing) List of Accounts Included in this Subscription (Indicate total amount of each issue surrendered by each customer and by yourself) (Leave this space blank) Name and location (C ity and State) o f ultimate purchaser ( Location o f individuals not required) ---------- ----4*4% Notes D-1967 2 % % Bonds 1962-67 Total $ ...................... $ Our own account . . . Totals ..................... $ ................................. $ .................................. . $ ............................... NONNEGOTIABLE RECEIPT To Subscriber: Subscription No. F e d e r a l R e s e r v e B a n k o f N e w Y o r k , Fiscal A gent o f the United States, hereby acknowledges receipt o f securities tendered with subscription numbered as above in exchange fo r 41/4 P E R C E N T T R E A S U R Y N O TE S O F S E R IE S C-1968 Securities allotted on this subscription will be delivered on May 15, 1967, in accordance with your instructions. ...................................................................................... _ Teller Uovemment Bond Division — Issues & Redemption Section B E A R E R N O TE S D E S IR E D IN E X C H A N G E (U se schedule on reverse side for REGISTERED notes) Dispose o f securities issued as fo llo w s : Denomi nation Pieces f □ 1. Deliver over the counter to the undersigned 1,000 0 2. H old in safekeeping member bank on ly) * 5,000 □ 3. H old as collateral fo r Treasury Tax and Loan A ccount* □ 4. Ship to the undersigned □ 5. Special instructions: (Leave this space blanlc) Face amount 10,000 100,000 (fo r 1,000,000 TOTAL To F e d e r a l R e s e r v e B a n k or N e w Y o r k Fiscal Agent of the United States (Date) You are hereby authorized to deliver to Submitted by ......................... (Name of representative) whose signature appears below, I ................................................par amount of securities issued pursuant to this subscription. N a m e............................... (Please print) (Official signature required) (Signature of authorized representative) To Subscriber : If securities are to be delivered over the counter at this Bank to your representative, the authority in the box to the left should be executed on the date of delivery. Schedule for Issue of Registered Notes Mail registered notes to Subscriber’ s Reference No. TRIPLICATE— TREASURY REPORTS COPY Subscription No. A-3 EXCHANGE SUBSCRIPTION For United States of America 4% Percent Treasury Notes of Series C-1968 Dated May 15, 1967, Due August 15, 1968 Dated at ......................................................... F e d er al R ese r v e B a n k of N e w Y o r k , Fiscal A gent o f the United States, New Y ork, N. Y . 10045 A tten tion : ........................................................................ 1967 Government B ond Division Ge n t l e m e n : Subject to the provisions o f Treasury Department Circular No. 5-67, Public Debt Series, dated A p ril 27, 1967, the undersigned hereby subscribes for United States o f Am erica 4*4 percent Treasury Notes o f Series C-1968, in the amount of $ ................................................. * and tenders in payment therefor a like par amount o f the securities— Delivered to you h e r e w ith ............................................................................................ $.................................. To be withdrawn from securities held by y o u ....................................................... $.................................. To be delivered by ......................................................................................................... $ .................................. * (Please fill in on the reverse side the schedule “ List of Accounts Included in this Subscription.” ) S E C U R IT IE S SU R R E N D E R E D Total Am ount 4 % % Notes, D -1967 (detach coupon s) ................................................ 2 V z % Bonds, 1962-67 (with 6 /1 5 /6 7 coupons attached) Total (D o not (ill in this colum n) T o Subscriber $ .............. $. ......................................................................... $ Pay net amount due subscriber on price and interest adjustments:* □ By check □ By credit to reserve account * See Section IV of T. D. Circular No. 5-67, Public Debt Series, for method of computing: net adjustment. W e H er eb y C e r t if y that at the time this subscription was entered the above-described securities surrendered or to be surrendered in connection with this exchange were owned and delivery was accepted by the subscriber, oi; such securities were contracted for purchase fo r value by the subscriber fo r delivery to the subscriber prior to-the closing o f the subscription books. Submitted by Address ( I f space is insufficient in schedules below, attach separate listing) List of Accounts Included in this Subscription (Indicate total amount of each issue surrendered by each customer and by yourself) (Leave this space blank) Name and location (C ity and State) o f ultimate purchaser ( Location o f individuals not required ) 4 *4% Notes D-1967 2 % % Bonds 1962-67 $ ...................... $ ................ Total $ .... ' ’ Our own account............................................. Totals ....................................................... $ ................................. $ ................................... $ .............................. Subscription No. DELIVERY INSTRUCTIONS— EXCHANGE SUBSCRIPTION For United States of America 4% Percent Treasury Notes of Series B-1972 Dated May 15, 1967, Due May 15, 1972 B E A R E R N O TE S D E S IR E D IN E X C H A N G E (U se schedule on reverse side for REGISTERED notes) Pieces Denomi nation $ Dispose of securities issued as follows: □ 1. Deliver over the counter to the undersigned 1,000 □ 2. Hold in safekeeping member bank o n ly )* 5,000 □ 3. Hold as collateral for Treas u ry Tax and Loan A ccount* 10,000 □ 4. Ship to the undersigned □ 5. Special instructions: (Leave this space blank) Face amount 100,000 (for 1,000,000 TOTAL *If this item is checked, the subscriber certi fies that the allotted securities will be owned solely by the subscriber. (IM PO R TA N T: No changes in delivery instructions will be accepted. A separate subscription form must be submitted for each group o f securities fo r which different delivery instruc tions are given.) Submitted by The subscription books will open on May 1, and close at the close of business May 3, 1967. By ................. (Please print) ..................... By ...... .................... (Authorized signature(s) required) T it le ................................................... T i t l e ................. Address (Spaces below are for the use o f the Federal Reserve Bank o f New Y o rk ) S afek eeping R ecord Received Received from F e d e ra l R eserve B a n k o f N e w Y o r k the above described United States obligations in the amount subscribed for. Subscriber ................................................................................................................................. Checked and delivered D a te ...................................... B y ............................................................................................................. Schedule for Issue of Registered Notes Name in which notes shall be registered, taxpayer identifying number (Social Security Account Number or Employer Identification Number), and post-office address for interest checks and other mail. ( Please print or typewrite ) (Indicate under appropriate denominations, number of notes desired.) Amount $1,000 $5,000 $10,000 $100,000 $1,000,000 Name................................................... Ident. N o.......................................... A ddress.............................................. as’ '•*51* Name.............................................. Ident. N o.................................................... Address................................................ Name................................................................ Ident. No.............................................. Address........................................ Name.............................................. Ident. N o................................................... A ddress.................................... ?.............................. *- -■ . -if *• ( I f registered notes, which are mailed directly by Treasury Department, Washington, D. C., are not to be sent to the registered owner, give mailing instructions below.) Mail registered notes to (Please type or print legibly and submit in triplicate) Subscriber’s Beference No. Subscription No. B-l EXCHANGE SUBSCRIPTION For United States of America 4% Percent Treasury Notes of Series B-1972 Dated May 15,1967, Due May 15, 1972 I m p o r ta n t I n s tr u c tio n s . 1. Securities of different issues surrendered in exchange may be listed together on the same subscription form , except that a separate subscription form should be used ( a ) for listing bearer securities surrendered, ( b ) fo r listing registered securities surrendered, and ( c ) for each group o f new securities for^ which different delivery instructions are given. 2. Separate subscription form s should be used for bearer securities and registered securities desired in exchange. 3. Social Security account numbers or Em ployer Identification numbers of all subscribers fo r r e g is te r e d notes must be furnished on the reverse side hereof. 4. Signatures are required on original on ly; all other filled-in matter should appear in triplicate. F ederal R eserve Bank of N ew Y Dated at ......................................................... ork, Fiscal Agent o f the United States, New York, N. Y . 10045 A tten tion : ....... ,............................................................. 1967 Government B ond Division Gentlem en : Subject to the provisions o f Treasury Department Circular No. 6-67, Public Debt Series, dated A pril 27, 1967, the undersigned hereby subscribes fo r United States o f Am erica 4 % percent Treasury Notes o f Series B-1972, in the amount of $ ................................................. * and tenders in payment therefor a like par amount o f the securities— Delivered to you h e r e w ith ............................................................................................ $ To be withdrawn from securities held by y o u ........................................................ $ To be delivered by ......................................................................................................... $ * (Please fill in on the reverse side the schedule “ List of Accounts Included in this Subscription.” ) SE C U R IT IE S SU R R E N D E R E D (D o not fill in this colum n) T o Subscriber Total Am ount 4% % Notes, D -1967 (detach cou p on s) ................................................. ( 1 ) $ ................................... XXXXXXXXXXX 2 % % Bonds, 1962-67 (w ith 6 /1 5 /6 7 coupons attached) ............... ( 2 ) $ ................................... .................................. 5 l A% c o f I, A -1 9 6 7 (w ith 8 /1 5 /6 7 coupons attached) ................. ( 3 ) $ ................................... ................................... 3 % % Notes, A -1 9 6 7 (w ith 8 /1 5 /6 7 coupons attached) ................. ( 4 ) $ .................................. ................................... 4% % ( 5 ) $ .............................. . ................................... Notes, E-1967 (w ith 8 /1 5 /6 7 coupons attached) Total ................. ......................................................................... $ .................. -...... -------------------- ------------------------- Pay net amount due subscriber on price and interest adjustm ents:* □ By check □ By credit to reserve account * See Section IV of T. D. Circular No. 6-67, Public Debt Series, for method of computing net adjustment. W e H e r e b y C e r t i f y that at the time this subscription was entered the above-described securities surrendered or to be surrendered in connection with this exchange were owned and delivery was accepted by the subscriber, or such securities were contracted for purchase fo r value by the subscriber fo r delivery to the subscriber prior to the closing of the subscription books. (Signature(s) required also on Delivery Instructions below) (D o not fill in boxes below ) G o v e r n m e n t B o n d D iv is io n Beceived Checked Submitted by ........................................................................................... (Please print) Canceled By .......................................................... . B y ............................................ (Authorized signature (s) required) Title ...................................................... . T itle ........................................ Address ...................................................................................................... (If Space is insufficient in schedules below, attach separate listing) List of Accounts Included in this Subscription (Indicate amount of each issue surrendered by each customer and by yourself) (Leave thii space blankJ Name and location (C ity and State) o f ultimate purchaser (3) (2) (i) sy4% 414% Notes 2y2% Bonds ■ D-1967 (Location of individuals not required) $ C o f I ’s A-1967 1962-67 $ & Total $ Our own a c c o u n t................................................... T o t a ls ....................... $ .............. $ .............. $ .............. (4) (5) 3 % % Notes 4 % % Notes A-1967 E-1967 $ $ ■*1 VOur own a c c o u n t ................................ Totals ............................................... $ .............. * ...;............. $ ............. Subscription No. SECURITY RECORDS “OUT TICKET’ DELIVERY INSTRUCTIONS— EXCHANGE SUBSCRIPTION For United States of America 4% Percent Treasury Notes of Series B-1972 Dated May 15,1967, Due May 15, 1972 B E A R E R N O TE S D E S IR E D IN E X C H A N G E (U se schedule on reverse side for REGISTERED notes) Pieces Denomi nation % Dispose of securities issued as follows: □ 1. Deliver over the counter to the undersigned □ 2. Hold in safekeeping member bank only) * 5,000 □ 3. Hold as collateral for Treasury Tax and Loan Account* 10,000 □ 4. Ship to the undersigned □ 5. Special instructions: Face amount (Leave this space blank) 1,000 100,000 1 ,000,000 TOTAL Submitted by Address (for Schedule for Issue of Registered Notes Name in which notes shall be registered, taxpayer identifying number (Social Security Account Number or Employer Identification Number), and post-office address for interest checks and other mail. (Please print or typewrite) (Indicate under appropriate denominations, number of notes desired.) Amount $1,000 $5,000 $10,000 $100,000 $1,000,000 Name....................................................................... Ident. No................................................................. Address.................................................................... Name........................................................................ Ident. N o................................................................. .V Address.................................................................... Name........................................................................ Ident. N o.............................................................. Address................................................... Name............................................. Ident. N o................................................. Address.................................................................... ---------------------- ( I f registered notes, which are mailed directly by Treasury Department, Washington, D. C., are not to be sent to the registered owner, give mailing instructions below.) Mail registered notes to Subscriber's Reference No. DUPLICATE— SECURITY RECORDS “IN TICKET” Subscription No. B-2 EXCHANGE SUBSCRIPTION For United States of America 4% Percent Treasury Notes of Series B-1972 Dated May 15, 1967, Due May 15,1972 Dated at ......................................................... F ed er al R eser v e B a n k of N e w Y o r k , Fiscal A gen t o f the United States, New York, N. Y . 10045 A tten tion : .......... ,.......................... ..................... ............. 1967 Government Bond Division Gen tlem en : Subject to the provisions of Treasury Department Circular No. 6-67, Public Debt Series, dated A pril 27, 1967, the undersigned hereby subscribes for United States o f Am erica 4 % percent Treasury Notes o f Series B-1972, in the amount o f $ ................................................. * and tenders in payment therefor a like par amount o f the securities— Delivered to you herewith ............................................................................................ $.................................. To be withdrawn from securities held by y o u ........................................................ $.................................. To be delivered by ......................................................................................................... $ .................................. * (Please fill in on the reverse side the schedule “ List of Accounts Included in this Subscription.” ) S E C U R IT IE S SU R R E N D E R E D Total Am ount 4^% Notes, D -1967 (detach coupon s) ................................................. ( 1 ) $ ............. .......... ( 2 ) $ ............ C o f I, A -1 9 6 7 (w ith 8 /1 5 /6 7 coupons attached) ................. ( 3 ) $ ............. 3 % % Notes, A -1 96 7 (w ith 8 /1 5 /6 7 coupons attached) ................. ( 4 ) $ ............. 4 / „ % Notes, E-1967 (w ith 8 /1 5 /6 7 coupons attached) ................. ( 5 ) $ ............ ......................................................................... $............. 2 V z % Bonds, 1962-67 (w ith 6 /1 5 /6 7 coupons attached) . S% % Total (D o not fill in this colu m n ) T o Subscriber xxxxxxxxxxx Pay net amount due subscriber on price and interest adjustm ents:* □ By check □ By credit to reserve account * See Section IV o f T. D. Circular No. 6-67, Public Debt Series, for method of computing net adjustment. W e Hereby C e r tify that at the time this subscription was entered the above-described securities surrendered or to be surrendered in connection with this exchange were owned and delivery was accepted by the subscriber, or such securities were contracted for purchase for value by the subscriber for delivery to the subscriber prior to the closing of the subscription books. Submitted by Address ( I f space is insufficient in schedules below, attach separate listing) List of Accounts Included in this Subscription (Indicate amount of each issue surrendered by each customer and by yourself) (Leave this space blank) Name and location (C ity and State) o f ultimate purchaser ( Location of individuals not required) (3) sy4% Cof I ’s (2) Notes 2%% Bonds (l) 414 % D-1967 $ 1962-67 $ Total A-1967 $ $ Our own a c c o u n t ................................................... T o t a ls ............................................... $ .............. $ .............. $ .............. (4) (5) 3%% Notes 4%% Notes A-1967 E-1967 $ Our own a c c o u n t ........................................................................... Totals ................................................................ $ .............. $ .............. $ ................ Subscription No. NONNEGOTIABLE RECEIPT To Subscriber: F ederal R eserve B a n k of N e w Y ork , Fiscal A gent o f the United States, hereby acknowledges receipt of securities tendered with subscription numbered as above in exchange for 43,4 P E R C E N T T R E A S U R Y N O TE S O F S E R IE S B-1972 Securities allotted on this subscription will be delivered on May 15, 1967, in accordance with your instructions. ...................................... Teiier................................................. Government Bond Division — Issues & Redemption Section B E A R E R N O TE S D E S IR E D IN E X C H A N G E (U se schedule on reverse side for R E G IS T E R E D notes) Denomi nation Pieces $ Dispose o f securities issued as fo llo w s : □ 1. Deliver over the counter to the undersigned 1,000 □ 2. H old in safekeeping member bank on ly) * 5,000 □ 3. H old as collateral fo r Treasu ry Tax and Loan A ccount* 10,000 □ 4. Ship to the undersigned □ 5. Special instructions: (Leave this space blank) Face amount 100,000 (fo r 1,000,000 TOTAL To F e d e r a l R e s e r v e B a n e or N e w Y o r k Fiscal Agent of the United States (Date) You are hereby authorized to deliver to Submitted by .................................................................................................... (Name of representative) whose signature appears below, I ................................................par amount of securities issued pursuant to this subscription. (Please print) To Subscriber: If (Official signature required) (Signature of authorized representative) securities are to be delivered over the counter at this Bank to your representative, the authority in the box to the left should be executed on the date of delivery. Mail registered notes to Subscriber’s Reference No. TRIPLICATE— TREASURY REPORTS COPY Subscription No. B-3 EXCHANGE SUBSCRIPTION For United States of America 4% Percent Treasury Notes of Series B-1972 Dated May 15, 1967, Due May 15, 1972 Dated at .................................................. ....... F ederal R eserve B a n k op N e w Y o r k , Fiscal A gent o f the United States, New Y ork, N. Y . 10045 A tten tion : .........................................................................1967 Government Bond Division G entlem en : abject to the provisions o f Treasury Department Circular No. 6-67, Public Debt Series, dated 27, 1967, the undersigned hereby subscribes for United States of Am erica 4 % percent Treasury '</ o f Series B-1972, in the amount o f $ ................................................. * and tenders in payment therefor -j par amount o f the securities— \ 3 delivered to you herewith ............................................................................................ $.................................. To be withdrawn from securities held by y o u ........................................................ $.................................. To be delivered by ......................................................................................................... $.................................. * (Please fill in on the reverse side the schedule “ List of Accounts Included in this Subscription.” ) S E C U R IT IE S S U R R E N D E R E D Total Am ount 4 % % Notes, D -1967 (detach coupon s) ........................ ........................ ( 1 ) $ .................................. (D o not fill in this colum n) T o Subscriber XXXXXXXXXXX 2 V 2 % Bonds, 1962-67 (w ith 6 /1 5 /6 7 coupons attached) ............... ( 2 ) $ ................................... .................................. 5 % % C o f I, A -1 96 7 (w ith 8 /1 5 /6 7 coupons attached) ................. ( 3 ) $ ................................... ................................... 3 % % Notes, A -1 96 7 (w ith 8 /1 5 /6 7 coupons attached) ................. ( 4 ) $ .......................... ........ ................................... 4% % ( 5 ) $ ................................... ................................... Notes, E-1967 (w ith 8 /1 5 /6 7 coupons attached) ................. Total ......................................................................... $ .................. ....................................................... ....... Pay net amount due subscriber on price and interest adjustments:* □ By check □ By credit to reserve account * See Section IV of T. D. Circular No. 6-67, Public Debt Series, for method of computing net adjustment. W e H e r e b y C e r t i f y that at the time this subscription was entered the above-described securities surrendered or to be surrendered in connection with this exchange were owned and delivery was accepted by the subscriber, or such securities were contracted fo r purchase fo r value by the subscriber fo r delivery to the subscriber prior to the closing o f the subscription books. Submitted by Address ( I f space is insufficient in schedules below, attach separate listing) List of Accounts Included in this Subscription (Indicate amount of each issue surrendered by each customer and by yourself) (Leave this pace blank) Name and location (C ity and State) of ultimate purchaser (i) 4 ^ % Notes (2 ) (Location of individuals not required) D-1967 1962-67 Bonds (3) 5*4% Cof I ’s Total A-1967 $ .............. $ .............. $ $ ........... ..... sj ' 1 Our own a ccou n t....................................................... T o t a ls .................................................................... $ ................. $ .............. $ .............. (4) (5) 3% % Notes 4% % Notes A-1967 E-1967 $ .............. $ .............. Our own a c c o u n t..................................................................... Totals ............................................................................ $ .............. $ .............. ji