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FEDERAL RESERVE BANK OF N EW YORK Fiscal Agent of the United States r Circular No. 6 0 5 3 ~| O ctober 27, 1967 J I CASH OFFERING 5% Percent Treasury Notes of Series A-1969 5% Percent Treasury Notes of Series A-1974 To All Banking Institutions, and Others Concerned, in the Second Federal Reserve District: The subscription books will be open Monday, October 30, for one day only, for a Treasury offering, at par, of — 5% percent Treasury Notes of Series A-1969, dated November 15, 1967, maturing February 15, 1969; and 5% percent Treasury Notes of Series A-1974, dated November 15, 1967, maturing November 15, 1974, in the amount of $12.2 billion, or thereabouts. Subscriptions will be subject to allotment. Payment must be made by November 15, in cash, or in 4% percent Treasury Notes of Series F-1967, or 3% percent Treasury Bonds of 1967, both maturing November 15, 1967. Payment cannot be made by credit to Treasury Tax and Loan Accounts. The terms of the offering are set forth in Treasury Department Circulars No. 9-67 and No. 10-67, Public Debt Series; a copy of each is printed on the following pages. Subscriptions from all subscribers, except banking institutions for their own account and others as specified in Section III of the Treasury circulars, must be accompanied by payment of 2 percent (in cash or in maturing securities) of the amount of securities applied for. If subscribers required to make deposits desire to deposit the maturing securities but do not have the denominations to meet exactly the minimum deposit requirement, they are urged to leave any excess on deposit to avoid denominational exchanges and unnecessary movement of securities. Only commercial banks may submit subscriptions for account of customers, provided the names of the customers are set forth in such subscriptions. On subscriptions for account of customers of correspondent banks, the names of such customers, and if not individuals, their locations, must be furnished. Others than commercial banks may submit subscriptions onlv for their own account. Commercial banks are urged to retain the required deposits (cash or maturing securities) of their customers until after allotment of the new securities; if the maturing securities are retained, the risk and expense involved in forwarding them to this Bank will thus be avoided. Commercial banks are urged to enter subscriptions for their own account, and for account of their customers, with the Federal Reserve Bank or Branch in the District in which they are located. Subscriptions eligible for full allotment. — A subscription by or for account of any 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, foreign State, Government Investment Account, or Federal Reserve Bank will be allotted in full if accompanied by a certification that at 4 p.m., Eastern Daylight Saving time, October 25,1967, it owned or had contracted to purchase for value the maturing securities in an amount equal to or greater than the amount of its subscription, and that such securities will be sub mitted in payment for its subscription. Any such subscriber may enter an additional subscrip tion, which will be subject to a percentage allotment. Copies of a certification form are enclosed for all commercial banks and public institutions of the types listed above. Subscriptions will be received by this Bank as fiscal agent of the United States. Sub scriptions should be submitted immediately on the enclosed Form A -l for the 5% percent notes or Form B -l for the 5% percent notes; if maturing securities accompany a subscription, the enclosed Form A-2 or B-2 should be submitted with Form A -l or B-l, respectively. 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 one day only, Monday, October 30. Any subscription addressed to a Federal Reserve Bank or Branch or to the Treasury Depart ment and placed in the mail before midnight, Monday, will be considered timely. A lfred H ayes, President. UNITED STATES OF AMERICA 5 % PERCENT TREASURY NOTES OF SERIES A -1969 Dated and bearing interest from November 15, 1967 j) ue February 15 1969 D EPAR TM EN T CIRCULAR TREASURY DEPARTMENT, Public Debt Series — No. 9 -67 O f f ic e of the Secretary, Washington, October 26, 1967. I. OFFERING OF NOTES II. 1. The Secretary of the Treasury, pursuant to the authority of the Second Liberty Bond Act, as amend ed, offers $10,700,000,000, or thereabouts, of notes of the United States, designated 5% percent Treasury Notes of Series A-1969, at par and accrued interest. The following securities, maturing November 15, 1967, will be accepted at par in payment or exchange, in whole or in part, to the extent subscriptions are allot ted by the Treasury: 4% percent Treasury Notes of Series F-1967;or 3% percent Treasury Bonds of 1967. The books will be open only on October 30, 1967, for the receipt of subscriptions. 2 DESCRIPTION OF NOTES 1. The notes will be dated November 15, 1967, and will bear interest from that date at the rate of 5% percent per annum, payable on a semiannual basis on February 15 and August 15, 1968, and February 15, 1969. They will mature February 15, 1969, and will not be subject to call for redemption prior to matu rity. 2. The 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. any notes of this issue at a specific rate or price, until after midnight October 30, 1967. 3. The notes will be acceptable to secure deposits of public moneys. They will not be acceptable in pay ment of taxes. 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. 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. 4. Under the Second Liberty Bond Act, as amend ed, 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, politi cal 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 Re serve Bank, or Government Investment Ac count and such subscriber certifies in writing that at 4 p.m., Eastern daylight saving time, October 25, 1967, it owned or had contracted to purchase for value securities of the 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 sub scription subject to a percentage allotment) ; and (2) on a percentage basis, to be publicly an nounced. 5. The notes will be subject to the general regula tions 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. Subscrip tions from commercial banks for their own account will be restricted in each case to an amount not ex ceeding 50 percent of the combined capital (not in cluding capital notes or debentures), surplus and undivided profits of the subscribing bank. Subscrip tions will be received without deposit from banking institutions for their own account, Federally-insured savings and loan associations, States, political subdi visions or instrumentalities thereof, public pension and retirement and other public funds, international organizations in which the United States holds mem bership, 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 Gov ernment securities and borrowings thereon, Federal Reserve Banks and Government Investment Accounts. Subscriptions from all others must be accompanied by payment (in cash or in securities of the issues enumer ated 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. Allotment notices will be sent out promptly upon allotment. IV. 1. Payment at par and accrued interest, if any, for notes allotted hereunder must be made or com pleted on or before November 15, 1967, or on later allotment. 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 submitted to the Internal Revenue Service (an individual’s social security num ber 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. Pay ment may be made for any notes allotted hereunder in cash or by exchange of securities of the issues enumerated in Paragraph 1 of Section I hereof, which will be accepted at par. When payment is made with securities in bearer form, coupons dated November 15, 1967, should be detached and cashed when due. When 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 PAYMENT 3 Treasury Notes of Series A-1969 in the name of... .............if new notes in coupon form are desired, the assignment should be to “The Secretary of the Treasury for 5% percent Treasury Notes of Series A-1969 in coupon form to be delivered to payment is made with registered securities, the final interest due on November 15, 1967, will be paid by is sue of interest checks in regular course to holders of record on October 13, 1967, the date the transfer books closed. V. ASSIGNMENT OF REGISTERED NOTES V I. 1. Treasury securities in registered form tendered as deposits and in payment for notes allotted here under should be assigned by the registered payees or assignees thereof, in accordance with the general regu lations of the Treasury Department, in one of the forms hereafter set forth. Securities 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 securities must be delivered at the expense and risk of the holder. If the new notes are desired registered in the same name as the securities surren dered, the assignment should be to “The Secretary of the Treasury for 5% percent Treasury Notes of Series A-1969” ; if the new notes are desired regis tered in another name, the assignment should be to “The Secretary of the Treasury for 5% percent 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 subscrip tions 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 offer ing, which will be communicated promptly to the Federal Reserve Banks. HENRY H. FOWLER, Secretary of the Treasury. UNITED STATES OF AMERICA 5 % PERCENT TREASURY NOTES OF SERIES A-1974 Dated and bearing interest from November 15, 1967 Due November 15, 1974 D EPAR TM EN T CIRCULAR TREASURY DEPARTMENT, Public Debt Series — No. 10-67 O f f ic e of the Secretary, Washington, October 26, 1967. I. II. OFFERING OF NOTES 1. The Secretary of the Treasury, pursuant to the authority of the Second Liberty Bond Act, as amend ed, offers $1,500,000,000, or thereabouts, of notes of the United States, designated 5% percent Treasury Notes of Series A-1974, at par and accrued interest. The following securities, maturing November 15, 1967, will be accepted at par in payment or exchange, in whole or in part, to the extent subscriptions are al lotted by the Treasury: 4% percent Treasury Notes of Series F-1967;or 3% percent Treasury Bonds of 1967. The books will be open only on October 30, 1967, for the receipt of subscriptions. 4 D ESCRIPTION OF NOTES 1. The notes will be dated November 15, 1967, and will bear interest from that date at the rate of 5% percent per annum, payable semiannually on May 15 and November 15 in each year until the principal amount becomes payable. They will mature Novem ber 15, 1974, and will not be subject to call for re demption prior to maturity. 2. The 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. any notes of this issue at a specific rate or price, until after midnight October 30, 1967. 3. The notes will be acceptable to secure deposits of public moneys. They will not be acceptable in pay ment 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. 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 amend ed, 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, politi cal 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 Re serve Bank, or Government Investment Ac count and such subscriber certifies in writing that at 4 p.m., Eastern daylight saving time, October 25, 1967, it owned or had contracted to purchase for value securities of the 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 sub scription subject to a percentage allotment) ; and (2) on a percentage basis, to be publicly an nounced. 5. The notes will be subject to the general regu lations 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. Subscrip tions from commercial banks for their own account will be restricted in each case to an amount not ex ceeding 50 percent of the combined capital (not in cluding capital notes or debentures), surplus and undivided profits of the subscribing bank. Subscrip tions will be received without deposit from banking institutions for their own account, Federally-insured savings and loan associations, States, political subdi visions or instrumentalities thereof, public pension and retirement and other public funds, international organizations in which the United States holds mem bership, 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 Gov ernment securities and borrowings thereon, Federal Reserve Banks and Government Investment Accounts. Subscriptions from all others must be accompanied by payment (in cash or in securities of the issues enumer ated 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. Allotment notices will be sent out promptly upon allotment. IV. 1. Payment at par and accrued interest, if any, for notes allotted hereunder must be made or com pleted on or before November 15, 1967, or on later allotment. 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 submitted to the Internal Revenue Service (an individual’s social security num ber 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. Pay ment may be made for any notes allotted hereunder in cash or by exchange of securities of the issues enumerated in Paragraph 1 of Section I hereof, which will be accepted at par. When payment is made with securities in bearer form, coupons dated November 15, 1967, should be detached and cashed when due. When 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 PAYMENT 5 payment is made with registered securities, the final interest due on November 15, 1967, will be paid by is sue of interest checks in regular course to holders of record on October 13, 1967, the date the transfer books closed. V. ASSIGNMENT OF REGISTERED SECURITIES 1. Treasury securities in registered form tendered as deposits and in payment for notes allotted here under should be assigned by the registered payees or assignees thereof, in accordance with the general regu lations of the Treasury Department, in one of the forms hereafter set forth. Securities 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 securities must be delivered at the expense and risk of the holder. If the new notes are desired registered in the same name as the securities surren dered, the assignment should be to “The Secretary of the Treasury for 5% percent Treasury Notes of Series A-1974” ; if the new notes are desired regis tered in another name, the assignment should be to ‘‘The Secretary of the Treasury for 5% percent Treasury Notes of Series A-1974 in the name of... .............if new notes in coupon form are desired, the assignment should be to “The Secretary of the Treasury for 5% percent Treasury Notes of Series A-1974 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 subscrip tions 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 offer ing, which will be communicated promptly to the Federal Reserve Banks. H E N R Y H. FOWLER, Secretary of the Treasury. Subscriber's Reference No. FORM A -2 (Subm it in triplicate) Subscription No. Securities Accompanying Subscription For United States of America 5% Percent Treasury Notes of Series A -1969 Dated November 15, 1967, Due February 15, 1969 F ederal R eserve B a n k of N ew Y Dated at..................... ork, Fiscal Agent of the United States, New York, N. Y. 10045 ......................... 1967 G entlem en : Referring to subscription entered in the amount of $................... for United States of America 5% percent Treasury Notes of Series A-1969, the undersigned delivers the following securities herewith, with coupons detached: Face am ount 3 % % Treasury Bonds of 1967 .............................. $........... 4 % % Treasury Notes of Series F-1967 ......................... Total......... (D o not fill in boxes b e lo w ) G o v e rn m e n t B ond D iv is io n Received Submitted by Checked Address .......... Cancelled CONTROL COPY $........... Subscriber’s Reference No. Subscription No. NONNEGOTIABLE RECEIPT To Subscriber: 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 Agent of the United States, hereby acknowledges receipt of securities deposited in the amount indicated below with subscription numbered as above in exchange for F 5% PERCENT TREASURY NOTES OF SERIES A-1969 Securities allottedon thissubscription willbe delivered on XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX November in accordance l\ovem.Der 15 10,1967 iybf, m accordance with witn vonr your instrnpfinns mstructions. XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Teller xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Government Bond Division— Issues & Redemption Section To F ederal R eserve B a n k op N ew Y ork, Face amount fiscal Agent of the United States 3 % % Bonds, 1967 .................. $ ............................ 4 % % Notes, F-1967 .............. ............................ Total .......................... $ ............................ (D ate) You are hereby authorized to deliver to (N am e o f representative) whose signature appears below, $...................................... par amount of securities issued pursuant to this subscription. Name ........................................... ....... .................... Submitted by ...-....................................................................................... Address .............................. ......................................................................... (Please print) (Official signature required) (Signature o f authorized representative) To Subscriber: I f 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. FORM Subscriber’s Reference No. B -2 (Subm it in triplicate) Subscription No. Securities Accompanying Subscription For United States of America 5% Percent Treasury Notes of Series A-1974 Dated November 15, 1967, Due November 15, 1974 F ederal R eserve B a n k op N ew Y Dated at..................... ork, Fiscal Agent of the United States, New York, N. Y. 10045 ......................... 1967 G entlem en : Referring to subscription entered in the amount of $................... for United States of America 5% percent Treasury Notes of Series A-1974, the undersigned delivers the following securities herewith, with coupons detached: Face amount 3 % % Treasury Bonds of 1967 .............................. $........... 4 % % Treasury Notes of Series F-1967 ......................... ........... Total......... $........... (D o not fill in boxes b e lo w ) G o ver n m en t B ond D Received Checked Cancelled CONTROL COPY iv is io n Submitted by Address ........ Subscriber’s Reference No. Subscription No. NONNEGOTIABLE RECEIPT To Subscriber: 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 Agent of the United States, hereby acknowledges receipt of securities deposited in the amount indicated below with subscription numbered as above in exchange for 5% PERCENT TREASURY NOTES OF SERIES A-1974 F Securities allottedon thissubscriptionwillbe delivered on xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx November 15, 1967, in accordance with your instructions. xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Teller xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Government Bond Division—Issues & Redemption Section To F ederal R eserve B a n k of N ew Y ork, Face amount Fiscal Agent of the United States 3 % % Bonds, 1967 .................. $ (Date) 4 % % Notes, F-1967 You are hereby authorized to deliver to Total .......................... (Name of representative) $ whose signature appears below, $........... ..... ....... par amount of securities issued pursuant to this subscription. Name ...................................- ........... .............. Subm itted by Address (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. Subscriber ’ a Reference No. Subscription No. Securities Accompanying Subscription For United States of America 5% Percent Treasury Notes of Series A-1969 Dated November 15, 1967, Due February 15, 1969 F ederal R eserve B a n k op N e w Y ork , Fiscal Agent of the United States, New York, N. Y . 10045 Dated a t ............................................................. ......................................................................... 1957 G entlemen : Referring to subscription entered in the amount of $ ..................................................... for United States of America 5 % percent Treasury Notes of Series A-1969, the undersigned delivers the following securities herewith, with coupons detached: Face amount 3 % % Treasury Bonds of 1967 ....................................................................................... $ 4 % % Treasury Notes of Series F-1967 ....................................................................... T o t a l ........................... $ ............................ Submitted by ............................................... ....... Address .............................. .................... ............... SECURITY RECORDS “ IN T IC K E T ” Subscriber’ s Reference No. Subscription No. Securities Accompanying Subscription For United States of America 5% Percent Treasury Notes of Series A-1974 Dated November 15, 1967, Due November 15, 1974 F e d e r a l R ese rv e B a n k o f N e w Y o r k , Fiscal Agent of the United States, New York, N. Y. 10045 Dated at..................... ......................... 1907 Gentlem en : Referring to subscription entered in the amount of $................... for United States of America 5% percent Treasury Notes of Series A-1974, the undersigned delivers the following securities herewith, with coupons detached: Face am ount 3 % % Treasury Bonds of 1967 .............................. $ 4 % % Treasury Notes of Series F-1967 ......................... Total......... $............ Submitted by ................................................................... Address ............................................................ SECURITY RECORDS “ IN T IC K E T ” (Subm it with subscription) Certification by States, Political Subdivisions or Instrumentalities Thereof, Public Pension and Retirement and Other Public Funds, International Organi zations in Which the United States Holds Membership, Foreign Central Banks, Foreign States, Federal Reserve Banks, or Government Investment Accounts, Pursuant to Section III, Paragraph 4 (1) , Treasury Department Circu lars Nos. 9-67 and 10-67, Public Debt Series (This certificate may be executed by a subscriber in one of the classes listed above or by a commercial bank entering a subscription for account of such a subscriber.) .................................................., 1967 To the Federal Reserve Bank of New York: 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 Circu lar No. 9-67 or 10-67, Public Debt Series, subscription(s) in the amount of $..........................................; (2) That at 4 p.m., Eastern Daylight Saving time, October 25, 1967, it owned or had contracted to purchase for value 4 % % Treasury Notes of Series F-1967 or 3 % % Treasury Bonds of 1967, or both, in an amount equal to or greater than the amount of said subscription(s); and (3) That such securities will be submitted in payment for said subscription (s). (Nam e o f organization) .......................................................> ........................ (Official signature) (T itle) (A commercial bank executing this certificate should sign below) (Nam e o f bank) B y ........................................................................ , ....................... (Official signature) for above-named organization. (T itle) FORM A -l Subscriber’s Reference No. (P lease type or print legibly) Subscription No. SUBSCRIPTION— SUBJECT TO ALLOTMENT For United States of America 5% Percent Treasury Notes of Series A-1969 Dated November 15, 1967, Due February 15, 1969 IM PO R TAN T INSTRUCTIONS P a y m e n t. Payment at par fo r the notes to be allotted hereunder may be made in cash, or by exchange o f 3 % % Treasury Bonds o f 1967, or 4 % % Treasury Notes o f Serie* F -1967, both maturing N ovem ber 15, 1967. Coupons dated N ovem ber 15, 1967 should be d e ta c h e d from the maturing securities in bearer form and cashed when due. P a y m e n t f o r t h e n e w n o te s c a n n o t b e m a d e b y c r e d it th r o u g h T r e a s u r y T a x a n d L o a n A c c o u n t. D e p o s it. Subscriptions from banking institutions fo r their ow n account and from certain others as specified in Section III o f Treasury D epartm ent C ircular No. 9-67, Public D ebt Series, w ill be received without deposit. Sub scriptions from all others must b e accom panied by paym ent (in cash or in maturing secu rities) o f not less than 2 % o f the am ount o f notes applied for, except that com m ercial banks subscribing fo r account o f custom ers are urged to retain their custom ers' deposits until a fter allotm ent. Checks accom panying the subscriptions should be made payable to the Federal Reserve Bank o f New Y ork. S u b s c r ip tio n a m o u n ts . Am ount o f notes applied fo r must be in multiples o f $1,000. The subscription books will be open only on October 30 for the receipt of subscriptions. F R eserve B a n k of N e w Y o r k , Dated at..................... Fiscal Agent of the United States, New York, N. Y. 10045 ......................... 1967 Attention: Government Bond Division ederal Gentlem en : Pursuant to the provisions of Treasury Department Circular No. 9-67, Public Debt Series, dated October 26, 1967, the undersigned hereby subscribes at par for United States of America 5% percent Treasury Notes of Series A-1969 as follows: For own account ......................................... $ For our customers, shown on reverse side (for use of commercial banks) .... $_ Total subscription ...................... $ ( I f securities are subm itted with this subscription, the securities should be accom panied by Form A -2, which form shall be m ade a part o f your subscription .) (If the subscriber is, or is subscribing for account of, a member of one of the investor classes listed below, a check in the appropriate box should be indicated. A subscription from or for account of such member will receive full allotment only if accompanied by a written certification that at 4 p.m., Eastern Daylight Saving time, October 25, 1967, it owned or had contracted to purchase for value, an equal or greater amount of 3 % % Treasury Bonds of 1967, or 4 % % Treasury Notes of Series F-1967, both maturing November 15, 1967, and that such securities will be submitted in payment for its subscription. A form for the certification isenclosed. Subscriptions accompanied by such certifications should not be included on the same form with other subscriptions. If the investor classes listed below desire to enter an additional subscription, to be subject to allotment, a separate subscription form must be used.) □ □ □ □ 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 (If a commercial bank is subscribing for its own account or for account of customers, the following certifications are made a part of this subscription.) W e H e r e b y C e r t i f y 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. W e F u r t h e r C e r t i f y that all subscribers for whom subscriptions are hereby entered have agreed 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, October 30, 1967. W e F u r t h e r C e r t i f y 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. W e F u r t h e r C e r t i f y that applications received by us, if any, from other commercial banks for their own account and for the account of their customers have been entered with us under the same conditions, agreements, and certifications as set forth in this subscription form. http://fraser.stlouisfed.org/ Federal Reserve Bank of St. Louis The undersigned agrees not to purchase or to sell, or to make any agreements with respect to the pur chase or sale or other disposition of any notes of this issue at a specific rate or price until after midnight, October 30, 1967. TO SUBSCRIBER : (Fill in all required spaces before signing) Mark (X) in proper space to indicate if this is: ........ (N am e o f subscriber-— Please print or typewrite) Original subscription.... □ By (Official signature) Confirmation of a telegram . □ Confirmation of a letter .... □ (T itle) Address (D o not write in space b e lo w ) Deposit received by ........................ Allotment Figured ....................... Advised ( I f acknow ledgm ent o f this subscription is desired, com plete this stub) Receipt is acknowledged of your subscription for $............. Series A-1969, dated November 15, 1967, maturing February 15, 1969. of 5 % % Treasury Notes of For use of Federal Reserve Bank Time Stamp To. (Name) (Address) (For use of commercial bank subscribers only) Lists of Accounts Included in this Subscription (If space is insufficient in schedule below, attach separate listing) Leave blank Name and location (City and State) of ultimate “purchaser (Location of individuals not required) Amount Subscribed Leave blank • ^Note__ Do not include subscriptions entitled to full allotment on the same form as other subscriptions.) FORM B -l Subscriber’s Reference No. (P lease type or print legibly) Subscription No. SUBSCRIPTION— SUBJECT TO ALLOTMENT For United States of America 5% Percent Treasury Notes of Series A-1974 Dated November 15, 1967, Due November 15, 1974 IM PO R TAN T INSTRUCTIONS P a y m e n t. Payment at par fo r the note* to be allotted hereunder may be made in cash, or by exchange o f 3 % % Treasury Bonds o f 1967, or 4 % % Treasury Notes o f Series F-1967, both maturing Novem ber 15, 1967. Coupons dated N ovem ber 15, 1967 should be d e ta c h e d from the maturing securities in bearer form and cashed w hen due. P a y m e n t f o r t h e n e w n o te s c a n n o t b e m a d e b y c r e d it th r o u g h T r e a s u r y T a x a n d L o a n A c c o u n t. D e p o s it. Subscriptions from banking institutions fo r their ow n account and from certain others as specified in Section III o f Treasury D epartm ent Circular No. 10-67, Public D ebt Series, w ill be received w ithout deposit. Sub scriptions from all others must be accom panied by paym ent (in cash or in maturing secu rities) o f not less than 2 % o f the amount o f notes applied for, except that com m ercial banks subscribing fo r account o f custom ers are urged to retain their custom ers’ deposits until a fter allotm ent. Checks accom panying the subscriptions should be made payable to the Federal R eserve Bank o f New Y ork. S u b s c r ip tio n a m o u n ts . A m ount o f notes applied fo r must be in multiples o f $1,000. The subscription books will be open only on October 30 for the receipt of subscriptions. F R eserve B a n k of N e w Y o r k , Dated at..................... Fiscal Agent of the United States, New York, N. Y. 10045 ......................... 1967 Attention : Government Bond Division ederal G entlem en : Pursuant to the provisions of Treasury Department Circular No. 10-67, Public Debt Series, dated October 26, 1967, the undersigned hereby subscribes at par for United States of America 5% percent Treasury Notes of Series A-1974, as follows: For own account ......................................... .. $ For our customers, shown on reverse side (for use of commercial banks) .... $. Total subscription ...................... $ ( I f securities are subm itted with this subscription, the securities should be accom panied by Form B-2, which form shall be m ade a part o f your su bscription .) (If the subscriber is, or is subscribing for account of, a member of one of the investor classes listed below, a check in the appropriate box should be indicated. A subscription from or for account of such member will receive full allotment only if accompanied by a written certification that at 4 p.m., Eastern Daylight Saving time, October 25, 1967, it owned or had contracted to purchase for value, an equal or greater amount of 3 % % Treasury Bonds of 1967, or 4 % % Treasury Notes of Series F-1967, both maturing November 15, 1967, and that such securities will be submitted in payment for its subscription. A form for the certification isenclosed. Subscriptions accompanied by such certifications should not be included on the same form with other subscriptions. If the investor classes listed below desire to enter an additional subscription, to be subject to allotment, a separate subscription form must be used.) □ □ □ □ 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 (If a commercial bank is subscribing for its own account or for account of customers, the following certifications are made a part of this subscription.) W e H e r e b y C e r t i f y 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. W e F u r t h e r C e r t i f y that all subscribers for whom subscriptions are hereby entered have agreed 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, October 30, 1967. W e F u r t h e r C e r t i f y 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. W e F u r t h e r C e r t i f y that applications received by us, if any, from other commercial banks for their own account and for the account of their customers have been entered with us under the same conditions, ___ agreements, and certifications as set forth in this subscription form. http://fraser.stlouisfed.org/ Federal Reserve Bank of St. Louis The undersigned agrees not to purchase or to sell, or to make any agreements with respect to the pur chase or sale or other disposition of any notes of this issue at a specific rate or price until after midnight, October 30, 1967. (Fill in all required spaces before signing) TO SUBSCRIBER: Mark (X) in proper space to indicate if this is: (Nam e o f subscriber— Please print or typewrite) Original subscription.... □ By Confirmation of a telegram . □ Confirmation of a letter .... □ (Official signature) (T itle) Address (D o not w rite in space b e lo w ) Deposit received by ........................ Allotment $................. Figured ....................... Advised ( I f acknow ledgm ent o f this subscription is desired, com plete this stub) Receipt is acknowledged of your subscription for $............... of 5 % % Treasury Notes of Series A-1974, dated November 15, 1967, maturing November 15, 1974. For use of Federal Reserve Bank Time Stamp To..................... (Name) (Address) (For use of commercial bank subscribers only) Lists of Accounts Included in this Subscription ( I f space is insufficient in schedule below, attach separate listing) Leave blank Name and location (City and State) of ultimate purchaser (Location of individuals not required) Am ount Subscribed Leave blank ^Note__ Do not include subscription* entitled to full allotment on the same form as other subscriptions.) 1 Subscription Number FEDERAL RE SE R V E BANK OF N E W Y O R K f is c a l agent o f t h e u n it e d states NOTICE OF ALLOTMENT For United States of America 5 % Percent Treasury Notes of Series A-1969 To Subscriber: L J On your subscription, numbered as above, for $ (par amount) of— UNITED STATES OF AMERICA 5 % PERCENT TREASURY NOTES OF SERIES A -1969 DATED NOVEMBER 15, 1867, DUE FEBRUARY 15, 1969 which you filed pursuant to the provisions of Treasury Department Circular No. 9-67, Public Debt Series, dated October 26, 1967, the Secretary of the Treasury has allotted notes to you in the amount of— $ Important 1. To expedite delivery of the securities allotted to you and to facilitate prompt completion of this transaction, please fill in, sign and return immediately the attached Letter of Instructions to the Federal Reserve Bank of New York, Fiscal Agent of the United States, New York, N. Y. 10045. Payment 2. Payment at par for securities allotted must be made on or before November 15, 1967, as follows: B y Check — The check should be made payable to the order of the FEDERAL RESERVE BANK OF NEW YORK, FISCAL AGENT OF THE UNITED STATES. The securities will not be delivered by this Bank until the proceeds of a check have been collected. The proceeds of a check drawn on the Federal Reserve Bank of New York are immediately available. B y Cash— Payment may be made in cash. B y Charge — A member bank may make payment by requesting us to charge its reserve account, or a nonmember clearing bank may make payment by requesting us to charge its clearing account. B y Maturing Securities— Payment may be made by exchange of 3 % % Treasury Bonds of 1967, or 4 % % Treasury Notes of Series F-1967, both maturing November 15, 1967. The coupons due November 15, 1967 should be detached from the securities and cashed in regular course. Delivery 3. (a) Delivery of the securities allotted will be made by the Federal Reserve Bank of New York at its Head Office in New York City, and will not be made before November 15, 1967. (b) The securities allotted may be received over the counter by a representative of the subscriber, provided the representative presents a letter of authority identifying him and signed officially by the subscriber. Safekeeping 4. Securities allotted to member banks for their own account may be left with this Bank for safekeeping pursuant to the terms of our Operating Circular No. 14. F ederal R eserve B a n k of N e w Y Fiscal Agent of the United States. Checked by or k , Subscription Number (This letter of instructions, accompanied by attached three copies, shoyld be filled in and returned to Federal Reserve Bank of New York) LETTER OF INSTRUCTIONS To F R ederal eserve B ank of N e w Y ork, Fiscal Agent of the United States, Federal Reserve P. 0. Station, New York, N . Y. 10045 Attention: Government Bond Division— 2nd Floor From (Name and address of Subscriber) Dated at..................... ......................... 1987 On our subscription, numbered as above, for $ (par amount) of— UNITED STATES OF AMERICA 5% PERCENT TREASURY NOTES OF SERIES A-1969 DATED NOVEMBER 15, 1967, DUE FEBRUARY 15, 1969 which we filed pursuant to the provisions of Treasury Department Circular No. 9-67, Public Debt Series, dated October 26, 1967, we have received your notice of allotment stating that the Secretary of the Treasury has allotted securities to us in the amount of— and. as requested, we send you the following instructions: Deposit has been made— By check or cash..................................... By maturing 3 % % Treasury Bonds of 1967 .................. (par amount) By maturing 4 % % Treasury Notes of Series F-1967 ............. (par amount) Balance due, if any— □ By charge to our reserve account, which you are authorized to make □ By check □ By cash 3%% Treas. Bonds of 1967 By maturing securities— 47/s% Treas. Notes Series F-1967 Delivered to you herewith............ To be withdrawn from safekeeping with you To be delivered b y ........... ...... Total....................... $- If the amount of maturing securities delivered is in excess of the amount of new securities allotted, redeem excess indicated below in accordance with Form G.B.311 (Request for Redemption of Bearer Securities). amount Excess amount of maturing securities to be redeemed ............. (use Form G.B.311) B E ARE R SECURITIES DESIRED (For REGISTERED securities— use only reverse side) eces Denomi nation $ (Leave this apace blank) Face amount 1,000 □ □ □ □ □ $............. Dispose of securities issued, as follows: 1. Deliver over the counter to the undersigned 2. Hold in safekeeping (for member bank only)* 3. Hold as collateral for Treasury Tax and Loan Account* 4. Ship to the undersigned 5. Special instructions: 5,000 10,000 * If this item is checked, the undersigned certifies that the allotted securities w ill be ow ned solely by the undersigned. 100,000 1,000,000 (IM P O R T A N T ? ba a ccsp ta d .) TOTAL This letter of instructions must be signed officially in the space provided and re turned immediately to Federal Reserve Bank of New York. Fiscal Agent of the United States. Submitted by No changes in delivery instructions will (Please print) By By (A uthorized signature(s) required) ................... Title T itle ................. Address....................... ........................................................................ (S p aces below are fo r the use o f Federal Reserve Bank o f New Y o rk ) Governm ent B ond S a f e k e e p in g D iv is io n D iv is io n Received Cheeked Cancelled Deliver against payment of $............................................ DELIVERY RECEIPT Received from Federal Reserve Bank of New York, Fiscal Agent of the United States, the above-described securities allotted in the amount indicated above, £ ate.................................. Subscriber................................................................................... B y ......................................................................................... Schedule for Issue of Registered Securities (If registered securities, which are mailed directly by Treasury Department, Washington, D. C., are not to be sent to the registered owner, give mailing instructions below.) M ail registered securities to Subscription Number (D UPLICATE FOR USE OF F E D E R A L RESERVE BAN K OF N E W YORK) BLOTTER RECORD— GOVERNMENT BOND DIVISION To F ederal R eserve B ank of N ew Y ork , Fiscal Agent of the United States, Federal Reserve P. 0. Station, New York, N. Y. 10045 Attention: Government Bond Division— 2nd Floor Dated at..... From (Name and address of Subscriber) .1967 On our subscription, numbered as above, for $ (P ar amount) of— UNITED S T A T E S O F A M E R IC A 5 % PERCEN T T R E A S U R Y N OTES OF SERIES A -1 96 9 D A T E D N O VEM BER 15, 1967, DUE FEB RU A RY 15, 1969 which we filed pursuant to the provisions of Treasury Department Circular No. 9-67, Public Debt Series, dated October 26, 1967, we have received your notice of allotment stating that the Secretary of the Treasury has allotted securities to us in the amount of— and, as requested, we send you the following instructions: Deposit has been made— By check or cash..................................... By maturing 3% % Treasury Bonds of 1967 .................. (par amount) By maturing 4 % % Treasury Notes of Series F-1967 ............. (par amount) Balance due, if any— □ By charge to our reserve account, which you are authorized to make □ By check Q By cash 3 % % Treas. B onds 4 % % Treas. N o tes of 1967 Series F-1967 By maturing securities— Delivered to you herewith ............. To be withdrawn from safekeeping with you To be delivered b y ................. Total....... ..... ........ — If the amount of maturing securities delivered is in excess of the amount of new securities allotted, redeem excess amount indicated below in accordance with Form G.B.311 (Request for Redemption of Bearer Securities). Excess amount of maturing securities to be redeemed (use Form G.B.311) B E A R E R SECURITIES DESIRED ( F o r REGISTERED securities— use only reverse sid e ) Denomi nation $ (Leave this space blank) Face amount 1,000 Dispose of securities issued, as follows: □ 1. Deliver over the counter to the undersigned □ 2. Hold in safekeeping (for member bank only)* □ 3. Hold as collateralfor Treasury Tax and Loan Account4 □ 4. Ship to the undersigned □ 5. Special instructions: 5,000 10,000 * I f this item is checked, the undersigned certifies that the allotted securities w ill be ow ned solely by the undersigned. 100,000 1,000,000 (IM P O R T A N T : be a cce p te d .) TOTAL This letter of instructions must be signed officially in the space provided and re turned immediately to Federal Reserve Bank of New York, Fiscal Agent of the United State*. Submitted by No changes in delivery instructions will (Please print) By By (A uthorized signature(s) required) ................... Titl# T itle ................. Address ................................................................................................ (S p aces below are fo r the use o f Federal Reserve Bank o f New Y o rk ) Governm ent B ond S a t k k e b p in q D iv is io n D iv is io n Received Cheeked Cancelled DELIVERY RECEIPT Received from Federal Reserve Bank of New York, Fiscal Agent of the United States, the above-described securities allotted in the amount indicated above. Date. Subscriber. By. TsdiJui A aox 3L5I JA51EC<15£r? %o 2 Hm .1 . i JX loiaiYia moa T^aic^iHar/oo—(iHODaa \ Schedule for Issue of Registered Securities (Indicate under appropriate denominations, number of securities desired.) Name in which securities shall be registered, taxpayer identifying number (S ocial Security A ccoun t Number or Em ployer Identification N um ber), and post-office address for interest checks and other mail. ( Pleast prtnt or typewrite) ' i& vs. ■ J. r *. 12 ■ l O *' Am ount 11,000 $5,000 910,000 $100,000 $1,000,000 • 1 ..... " ■ • • ............................. ............... i r0 X •" ..................... ...................... ‘j t j c q i n g s b 1) ! b&ttoHs 8$ i-ii'iD 9s ? tto ii lo tixi/< ujxfc ‘) f l ! io (If registered securities, 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 securities to .. ‘S lU .'tt& b tllf ;itiO ;:n u ‘tit OS IVlIiiOO iora 10. » *1 70 ) xii bf 9if f o * qi ; UtlQlifMJ’lZ'dtll h i » b^n^t*t»b<su * iil /-•- ' oria »s bm» T* yl-ilo* beawo »d *"w *»»5; ».ndMtti ▼wriS ■>!» »>-. on *T r lit bsshotbu *; -s j - v r- rode >(tt <?j . J .J 4 Subscription Number (T R IP L IC A T E FOR USE OF F E D E R A L RESERVE BANK OF NEW YO RK ) RELOCATION OFFICE— OUT To F ederal R eserve B ank of New Y ork, Fiscal Agent of the United States, Federal Reserve P. 0. Station, New York, N. Y. 10045 Attention: Government Bond Division— 2nd Floor From (Name and address of Subscriber) Dated at..... .1967 On our subscription, numbered as above, for $ (par amount) of— UNITED STATES OF AMERICA 5 % PERCENT T R E A S U R Y N OTES OF SERIES A -1 96 9 DATED NOVEMBER 15, 1967, DUE FEB RU A RY 15, 1969 which we filed pursuant to the provisions of Treasury Department Circular No. 9-67, Public Debt Series, dated October 26, 1967, we have received your notice of allotment stating that the Secretary of the Treasury has allotted securities to us in the amount of— $ and, as requested, we send you the following instructions: Deposit has been made— By check or cash......... ............................. By maturing S% % Treasury Bonds of 1967 .................. By maturing 4 % % Treasury Notes of Series F-1967 ............. Balance due, if any— $............ (par amount) (par amount) □ By check Q By cash 3 % % Treas. Bonds of 1967 By maturing securities— 4 7/s % Treas. Notes Series F-1967 Delivered to you herewith............ To be withdrawn from safekeeping with you To be delivered b y ................. Total....................... $- If the amount of maturing securities delivered is in excess of the amount of new securities allotted, redeem excess amount indicated below in accordance with Form G.B.311 (Request for Redemption of Bearer Securities). Excess amount of maturing securities to be redeemed............. (use Form G.B.311) B E ARE R SECURITIES DESIRED (For REGISTERED securities— use only reverse side) Denomi nation (Leave this space blank) Face amount 1,000 $............. Dispose of securities issued, as follows: 1. Deliver over the counter to the undersigned 2. Hold in safekeeping (for member bank only) * 3. Hold as collateral for Treasury Tax and Loan Account* 4. Ship to the undersigned 5. Special instructions: □ □ □ □ □ 5,000 10,000 * I f this item is check ed, the undersigned certifies that the allotted securities w ill be ow ned solely by the undersigned. 100,000 1,000,000 (IM P O R T A N T : be a cce p te d .) TOTAli This letter of instructions must be signed officially in the space provided and returned immediately to Federal Reserve Bank o f N ew York, Submitted by No change* in delivery instructions* w ill ( Please print) ^ By (Authorized iignature(») required) T itle ......................................................................... Title Fiscal Agent of the United States. Address ................................................................................................ (S p aces below are fo r the use o f Federal Reserve Bank o f New Y o rk ) G o v h &n m e n t B o n d S a x z k e b p in q D i v i s i o n Division Received Checked Cancelled Checked............................................ DELIVERY RECEIPT Received from Federal Reserve Bank of New York, Fiscal Agent of the United States, the above-described securities allotted in the amount indicated above. Date. Subscriber. By. Schedule for Issue of Registered Securities Nam e in which securities shall be registered, taxpayer identifying number (S ocial Security A ccoun t Num ber or E m ployer Identification N um ber), and post-office address for interest checks and other maiL (Please print mr typewrite) (Indicate under appropriate denominations, number o f securities desired.) Amount 91.000 $5,ooe $10,000 $100,000 $1,000,000 Name, Ident, No. Address,,.. Name. Idect No. Name,..... Ident. No, Address.... Name....... Ident, No. Address.... ( I f registered securities, which are mailed directly by Treasury Department, Washington, D. C., are not to be sent to the registered owner, give mailing instructions below.) t Mail registered securities to ......................................................................................................................... oJ i9>tiiiiOi) 9 ifi i9 v o i s v i l s f l .1 “ b 8 ft^ ia i9 fm u exit o ............................................................................................... & > [ j :anoitouitacri Is >oq8 .8 - . .......... .... — _ 1 5 (Q U A D R U P L IC A T E F O R USE OF F E D E R A L R E S E R V E B A N K OF N E W Y O R K ) Subscription Number DELIVERY TICKET— SAFEKEEPING DIVISION T o F e d er a l R eserv e B a n k of N e w Y o r k , Fiscal A gent of the U nited States, F ed eral Reserve P. 0 . Station, New York, N. Y. 10045 A tten tio n : Governm ent Bond Division—2nd Floor D ated a t ......................................................... F rom (N am e and address of Subscriber) .1967 On our subscription, num bered as above, fo r $ U N IT E D STATES OF A M E R IC A D ATED 5 (p a r am ount) of— PERCENT % NOVEM BER 15, 1967, TR EASU R Y DUE NOTES FEBRUARY 15, OF S E R IE S A -1 9 6 9 1969 which we filed p u rsu a n t to the provisions of T reasury D epartm ent C ircular No. 9-67, Public D ebt Series, dated October 26, 1967, we have received your notice of allotm ent statin g th a t the S ecretary of the T reasury has allotted securities to us in the am ount of— and, as requested, we send you the following instructions: Deposit has been made— By check or c a s h ......................................................................................................... ......$........................ By m aturing 3% % Treasury Bonds of 1967 ............................................................$........................ (p a r amount) By m aturing 4% % T reasury Notes of Series F-1967 .............................................$........................ (p a r amount) Balance due, if any— □ By charge to our reserve account, which you are authorized to make I □ By check S % % Treas. Bonds of 1967 By m aturing securities— □ By cash 4 7/h% Treas. Notes Series F-1967 Delivered to you h e r e w ith .............................................................. To be w ithdraw n from safekeeping w ith y o u ............................ $- To be delivered b y ............................................................................. T o t a l ............................................................................................. ................................................................. $.......................... $.......................... I f the am ount of m aturing securities delivered is in excess of the am ount of new securities allotted, redeem excess am ount indicated below in accordance with F orm G.B.311 (Request for Redem ption of B earer Securities). Excess am ount of m aturing securities to be redeemed .................................. (use Form G.B.311) BEARER SECURITIES DESIRED Dispose of securities issued, as follows: (For REGISTERED securities— use only reverse side) D e n o m i n a tio n ece s Pace (L e a v e th is sp a ce b la n k ) am ount $................................... 1,000 □ □ □ □ □ 1. 2. 3. 4. 5. D eliver over the counter to the undersigned H old in safekeeping (for member bank only)* H old as collateral for T reasury Tax and Loan Account* Ship to the undereigned Special instructions: 5 ,0 0 0 10,000 100,000 * I f th is it e m is c h e c k e d , th e u n d e r s ig n e d c e r tifie s th a t th e a llo t t e d s e c u r it ie s w ill b e o w n e d s o l e l y b y th e u n d e r s ig n e d . 1, 000,000 (IMPORTANT: No changes in delivery instructions will b« accepted.) TOTAL This letter of instructions must be signed officially in the space provided and returned immediately to Submitted by (Please print) ^ By (A uthorized signature(s) required) Federal Reserve Bank of New York, ................... T i t l e ............. T i t l e .................. Fiscal Agent of the United States. A d d ress (S p a c e s b e lo w Governm ent B ................................................................................................................................... a r e f o r th e u se o f F e d e r a l R e s e r v e ond Bank of Y ork) S a f e k e e p in g D iv i s io n D iv is io n Received N ew Checked Cancelled DELIVERY RECEIPT Received from Federal Reserve Bank of New York, Fiscal Agent of the United States, the above-described securities allotted in the amount indicated above. D a te . S u b sc r ib e r . By. Schedule for Issue of Registered Securities (Indicate under appropriate denominations, number of securities desired.) Name in which securities shall be registered, taxpayer identifying number (S ocial Security A ccoun t Num ber or Em ployer Identification N um ber), and post-office address for interest checks and other mail. (Please print or typewrite) Amount $1,000 $5,000 $10,000 $100,000 $1,000,000 Name...... Ident. No. Address.... Nmao., I d e a t No.,, Name,,....... Ident. No. Address.... Nam e....... I d e n t No. Address,... (I f registered securities, which are mailed directly by Treasury Department, Washington, D. O., are not to be sent to the registered owner, give mailing instructions below.) Mail registered securities to 6 ALLOTMENT NOTICE FOR GOVERNMENT BOND DIVISION Subscription ........................$ U N IT E D STATES OF D ATED A M E R IC A 5 (p a r am ount) ofPERCENT % NOVEM BER 15, 1967, TREASU R Y DUE NOTES FEBRUARY 15, OF S E R IE S A -1 9 6 9 1969 Allotm ent D IS P O S I T I O N DEPOSIT Over Counter Check or C a s h ............................................................................. Safekeeping 3%% Treasury Bonds of 1967 ..................................................... 4%% Treasury Notes Series F-1967 ........................................... T. T .& L . Excess amount Treasury Bonds of 1967 to be redeemed Excess amount Treasury Notes Series F-1967 to be redeemed Ship Excess cash payment to be refunded ............................................. Balance due Treasury ...................................................................... Special Instructions PAYMENT Check or Cash .............................................................................................. Treasury Bonds of 1967 Treasury Notes Series F-1967 Reserve Account ......................................................................................... Balance $. 7" ALLOTMENT NOTICE FOR SECURITIES DEPARTMENT Subscription U N IT E D STATES ........................$ OF D ATED Allotment, A M E R IC A 5 (p a r am ount) of— % NOVEM BER $ PERCENT 15, 1967, TR EASU RY DUE NOTES FEBRUARY 15, OF 1969 S E R IE S A -1 9 6 9 8 ALLOTMENT NOTICE FOR SECURITY FILES Subscription U N IT E D STATES ........................$ OF D ATED Allotment A M E R IC A 5 % NOVEM BER $ (p a r am ount) of— PERCENT 15, 1967, TR EASU R Y DUE NOTES FEBRUARY 15, OF 1969 S E R IE S A -1 9 6 9 I FEDERAL RESERVE BANK OF NEW YORK 1 Subscription Number FISCAL AGENT OF TH E U N ITED ST A T E S NOTICE OF ALLOTMENT For United States of America 5 % Percent Treasury Notes of Series A-1974 To Subscriber: On your subscription, num bered as above, for $ U N IT E D ST A T E S OF D ATED A M E R IC A 5 % NOVEM BER (p a r am ount) of— PERCENT 15, 1967, TREASU R Y DUE NOTES NOVEM BER 15, OF S E R IE S A -1 9 7 4 1974 which you filed p u rsu a n t to the provisions of T reasury D epartm ent C ircular No. 10-67, Public Debt Series, dated October 26, 1967, the Secretary of the T reasury has allotted notes to you in the am ount of— $ Important 1. To expedite delivery of the securities allotted to you and to facilitate prom pt completion of this transaction, please fill in, sign and return immediately the attached Letter of Instructions to the Federal Reserve Bank o f New York, Fiscal A gent of the United States, New York, N. Y. 10045. Payment 2. P aym ent a t p a r for securities allotted m ust be made on or before November 15, 1967, as follow s: B y C h e c k — The check should be made payable to the order of the 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 , F I S C A L A G E N T O F T H E U N I T E D S T A T E S . The securities will not be delivered by this Bank until the proceeds of a check have been collected. The proceeds of a check drawn on the Federal Reserve Bank of New York are immediately available. B y C a sh — Payment may be made in cash. B y Charge— A member bank may make payment by requesting us to charge its reserve account, or a nonmember clearing bank may make payment by requesting us to charge its clearing account. B y Maturing Securities— Payment may be made by exchange of 3%% Treasury Bonds of 1967, or 4%% Treasury Notes of Series F-1967 both maturing November 15, 1967. The coupons due November 15, 1967 should be detached from the securities and cashed in regular course! Delivery 3. (a) Delivery of the securities allotted will be made by the F ederal Reserve B ank of New York at its H ead Office in New York City, and will not be made before November 15, 1967. (b) The securities allotted may be received over the counter by a representative of the subscriber, provided the representative presents a letter of authority identifying him and signed officially by the subscriber. Safekeeping 4. Securities allotted to member banks for their own account may be left with this B ank for safekeei)in«- m irsnant to the term s of our O perating C ircular No. 14. m Checked b y ...................................................................... 1* 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 Agent of the United States. Subscription Number ( This letter of instructions, accompanied by attached three copies, should be filled in and returned to Federal Reserve Bank of New York) LETTER OF INSTRUCTIONS To F ederal R eserve B ank of New Y ork, Fiscal A gent of the U nited States, F ed eral Reserve P. 0 . Station, New York, N. Y. 10045 A ttention: Governm ent Bond Division— 2nd Floor D ated a t ............. F rom (Nam e and address of Subscriber) .1967 On our subscription, num bered as above, for $ U N IT E D STATES OF A M E R IC A D ATED 5 % NOVEM BER (p a r am ount) of— PERCENT 15, 1967, TREASU R Y DUE NOTES NOVEM BER OF 15, S E R IE S A -1 9 7 4 1974 which we filed p u rsu a n t to the provisions of T reasury D epartm ent C ircular No. 10-67, Public Debt Series, dated October 26, 1967, we have received your notice of allotm ent stating th a t the Secretary of the T reasury has allotted securities to us in the am ount of— $ and, as requested, we send you the following in stru ctio n s: Deposit has been made— By check or c a s h ......................................................................................................... $................................ By m atu rin g 3% % T reasury Bonds of 1967 ...................................................... $................................ (p a r am ount) By m atu rin g 4 % % T reasury Notes of Series F-1967 ....................................... $................................ (p a r am ount) B alance due, if any— □ By charge to our reserve account, which you are authorized to make □ By check □ By cash S % % Treas. Bonds of 1967 By m atu rin g securities— d7/s % Treas. Notes Series F-1967 Delivered to you h e r e w ith ................................ To be w ithdraw n from safekeeping w ith you To be delivered b y ............................................... $- T o t a l ............................................................... I f the am ount of m aturing securities delivered is in excess of the am ount of new securities allotted, redeem excess am ount indicated below in accordance w ith F orm G.B.311 (Request for Redem ption of B earer Securities). Excess am ount of m aturing securities to be redeemed (use Form G.B.311) BEARER Dispose of securities issued, as follow s: SECURITIES DESIRED ( For REGISTERED securities— use only reverse side) D e n o m i nation ecee $ (L e a v e th is sp a ce b la n k ) F a ce am ount 1,000 □ Q □ □ □ 1. 2. 3. 4. 5. Deliver over the counter to the undersigned H old in safekeeping (for member bank only)* H old as collateral for T reasury Tax and Loan Account* Ship to the undersigned Special instructions: 5 ,0 0 0 10,000 100,000 * I f th is ite m a llo tte d is c h e c k e d , t h e u n d e r s ig n e d s e c u r itie s w ill b e o w n e d s o le ly b y c e r tifie s th a t th e th e u n d e r s ig n e d . 1,000,000 (IM P O R T A N T : No ch anges in d e liv e r y in s tr u c tio n s w ill b e a c c e p t e d .) TOTAL. This letter of instructions must be signed officially in the space provided and returned immediately to Submitted by ( Please print) ^ By (Authorized signature(s) required) Federal Reserve Bank of New York, .................... T i t l e ............. T i t l e ................. Fiscal Agent of the United States. A d d r e s s ............................................................ .. .................................................................... (S p a c e s b e lo w G overnm ent B a r e fo r th e u se o f F e d e r a l R e s e r v e ond B ank o f Y ork) S a f e k e e p in g D iv is io n D iv is io n Received N ew Checked Cancelled DELIVERY RECEIPT Received from Federal Reserve Bank of New York, Fiscal Agent of the United States, the above-described securities allotted in the amount indicated above. D a te . Subscriber. By. Schedule for Issue of Registered Securities (Indicate under appropriate denominations, number o f securities desired.) Name in which securities shall be registered, taxpayer identifying number (S ocial Security A ccount N um ber or Em ployer Identification N um ber), and post-office address for interest checks and other mail. Amount (Please print or typewrite) $1,000 $5,000 $10,000 $100,000 $1,000,000 NfijriP!............................................................................. ....... Ident. No................... ............ ................................................ ............ Address......... ....................... ................................................ 1 <i i,-.: ; OK Namft................................. ........... ....................... ................ : 't-isqaG 7 n< Ident. No.......... .................................................................... Address.......................................................... ...................... . Ident No ............................ ................ .................... ( I f registered securities, 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 securities to ..................... is-" ' tom *10' <j.fllq9S.>ir9lBfi fix fol<» ’ I .2 ! ................. if^igiebmr arf. : anoitoxrataa a ii nu •OS z i d i ■ Y; (brtuipn ..............alJiT b»srn>d>irA) ................. >9 I m e b s t )o rnqt lo n e., s a d l ixi fle 9 9 itn u j» a bodlisaaJj-OToda a d i ;8 b-1 !•* j IVI oi 3 (D U P L IC A T E F O R U SE OF F E D E R A L R E S E R V E B A N K OF N E W Y O R K ) Subscription Number BLOTTER RECORD— GOVERNMENT BOND DIVISION LETTER OF INSTRUCTIONS To F e d e r a l R eser v e B a n k of N e w Y o r k , F iscal A gent of the U nited States, F ed eral Reserve P. 0 . Station, New York, N. Y. 10045 A tten tio n : Governm ent Bond Division—2nd Floor F rom (Nam e and address of Subscriber) D ated a t ......................................................... .1967 On our subscription, num bered as above, fo r $ U N IT E D STATES OF A M E R IC A D ATED (P ar am ount) of— 5 % NOVEM BER PERCENT 15, 1967, TREASU R Y DUE NOTES NOVEM BER 15, OF S E R IE S A -1 9 7 4 1974 which we filed p u rsu a n t to the provisions of T reasury D epartm ent C ircular No. 10-67, Public D ebt Series, dated October 26, 1967, we have received your notice of allotm ent statin g th a t the S ecretary of the T reasury has allotted securities to us in the am ount of— $ and, as requested, we send you the following in stru ctio n s: Deposit has been made— By cheek or c a s h ............................................... .......................................................... $................................ By m atu rin g 3% % T reasury Bonds of 1967 ...................................................... (p a r am ount) By m atu rin g 4 % % T reasury Notes of Series F-1967 ....................................... (p a r am ount) Balance due, if any— □ By check □ By charge to our reserve account, which you are authorized to make 4 % % Treas. Notes Series F-1967 3 % % Treas. Bonds of 1967 By m atu rin g securities— □ By cash Delivered to you h e r e w ith ................................ To be w ithdraw n from safekeeping w ith you To be delivered b y ............................................... T o t a l ............................................................... I f the am ount of m aturing securities delivered is in excess of the am ount of new securities allotted, redeem excess am ount indicated below in accordance w ith F orm G.B.311 (Request for R edem ption of B earer Securities). Excess am ount of m aturing securities to be re d e e m e d .................................. (use Form G.B.311) BEARER SECURITIES DESIRED Dispose of securities issued, as follow s: (For REGISTERED securities— use only reverse side) icm Denomi nation □ □ □ □ □ ( L e a v e th is sp a e e b la n k ) F a ce am ount $................................... 1,000 1. 2. 3. 4. 5. D eliver over the counter to the undersigned H old in safekeeping (for member bank only)* H old as collateral for T reasury Tax and Loan Account* Ship to the undersigned Special instructions: 5 ,0 0 0 10,000 100,000 * I f th is it e m a llo tte d , is c h e c k e d , t h e u n d e r s ig n e d c e r tifie s th a t th e s e c u r itie s w ill b e o w n e d s o le ly b y th e u n d e r s ig n e d . 1 000,000 (IM P O R T A N T : b e a c c e p t e d .) TOTAXi This letter of instructions must be signed officially in the space provided and returned immediately to Submitted b j No changes in d e liv e r y in s tr u c tio n s w ill (Please print) ^ By (Authorized signature(s) required) Federal Reserve Bank o f New York, .................... T i t l e ............. T i t l e ................. Fiscal Agent of the United States. Address .................................................................................................. (S p a c e s b e lo w a re fo r th e u se o f F e d e ra l R e se rv e Bank Received of N ew Y ork) S a x e k e e p in g D iv is io n G o v e r n m e n t B o n d D iv is io n Cheeked Cancelled DELIVERY RECEIPT Received from Federal Reserve Bank of New indicated above. Date Subscriber Y ork, Fiscal Agent of the United States, the a b o v e -described securities allotted in the amount odnui aoiJqixoadi/t (5LHGY W 3M r4 0 '/IVIAH iil’/ SBSSLH i rAii&LU2i'4 1U tKtSfU JiU'1 vioiaivia ciwoa m j atmmv** o - -ohod;m h s tto js Schedule for Issue of Registered Securities (Indicate under appropriate denominations, number of securities desired.) Name in which securities shall be registered, taxpayer identifying number (S ocial Security A ccoun t Number or Em ployer Identification N um ber), and post-office address for interest checks and other mail. (Please print or typewrite) Amount $1,000 $5,000 $10,000 $100,000 $1,000,000 Name. Ident. No. ,..f....7..„............................................. Address. • 55 ' 1 ---- ------------------- —------- ------------------ ----N am e. IS -------------- ----------------- -— „ . J 9iit £o •n:,.":., i09d -ii Zi>d I d e a l No. Address. Name. Ident. No. Address. Name. Ident. No. Address. (I f registered securities, 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 securities to .. bs ic.’i orft o i isJiiJJoa t>;!l <9vo i /i i y la o in f id i 3d a Min *ro!> S id q 9 8 ib l6 ? . r.t IjIoH .1 f arit o t qiriB □ : arioit,oinj8iii If*' oq£ .6 □ •t* b*»0''ei#fco# at'i „i>9>i39«3 *. m i ft I. a sdU T d vis!o > b o a w o s d iiiw io ith o 3 9 > b o /Jo d ia l u oH . iT K A T H O ’IM l) ( .b t if a s s a •« ■M ........................................ ^ 0 ............................................................................................ (tmiopai at JmuorfjuA) ....................... e l i i T .................................................................. (alT»Y w sK ) o >*0 «a >f»iT ^ fo Y 1 s r .a i s H i i j ib s l lo m u siti w l 9t a w o lsd •»->»q2 ) i.im u ownaouctfAa . . £l. $ iii dtCi w ie v i - . a . .jo £ •.••j lo iJ ibai 9tirtrw>do8 4 (T R IP L IC A T E F O R U SE O F F E D E R A L R E S E R V E B A N K OF N E W Y O R K ) Subscription Number RELOCATION O F F IC E -O U T T o F ed er a l R eserv e B a n k of N e w Y o r k , Fiscal A gent of the U nited States, F ed eral Reserve P. 0 . Station, ' New York, N. Y. 10045 A tten tio n : Governm ent Bond Division— 2nd Floor F rom (N am e and address of Subscriber) D ated a t ......................................................... ....................................................................1967 On our subscription, num bered as above, fo r $ UNITED ST A T E S OF A M E R IC A D ATED (p a r am ount) of— 5 94 NOVEM BER PERCENT 15, 1967, TREASU R Y DUE NOTES NOVEM BER 15, OF S E R IE S A -1 9 7 4 1974 which we filed p u rsu a n t to the provisions of T reasury D epartm ent C ircular No. 10-67, Public Debt Series, dated October 26, 1967, we have received your notice of allotm ent stating th a t the Secretary of the T reasury has allotted securities to us in the am ount of— $ and, as requested, we send you the following in stru ctio n s: Deposit has been made— By check or c a s h .......................................................................................................... $................................ By m atu rin g 3% % T reasury Bonds of 1967 ...................................................... $................................ (p a r am ount) By m atu rin g 4 % % T reasury Notes of Series F-1967 ....................................... $................................ (p a r am ount) ♦ B alance due, if any— □ By charge to our reserve account, which you are authorized to make □ By check □ By cash 5%% Treas. Bonds By m atu rin g securities— 4 % % Treas. Notes Series F-1967 o f 1967 Delivered to you h e r e w ith ................................ To be w ithdraw n from safekeeping w ith you To be delivered b y ................................................ $- T o t a l ....................................... ...................... I f the am ount of m aturing securities delivered is in excess of the am ount of new securities allotted, redeem excess am ount indicated below in accordance w ith F orm G.B.311 (Request for Redem ption of B earer Securities). Excess am ount of m aturing securities to be redeemed (use Form G.B.311) BEARER SECURITIES DESIRED Dispose of securities issued, as follow s: (For REGISTERED securities— use only reverse side) Denomi nation scee $ (Leave this spaee blank) Face amount 1,000 □ □ □ □ □ 1. 2. 3. 4. 5. D eliver over the counter to the undersigned H old in safekeeping (for member bank only)* H old as collateral for T reasury Tax and Loan Account* Ship to the undersigned Special instructions: 5 ,0 0 0 10,000 100,000 * I f th is ite m a llo tte d is c h e c k e d , t h e u n d e r s ig n e d s e c u r itie s w ill b e o w n e d c e r tifie s th a t the s o le ly b y th e u n d e r s ig n e d . 1, 000,000 (IM P O R T A N T : No ch anges in d e liv e r y in str u c tio n s w ill b e a c c e p t e d .) TOTAL This le tte r of instructions m ust b e signed officially in th e space p ro v id ed a n d retu rn ed im m ediately to Submitted by (Please print) ^ By (A uthorized *ignature(s) required) F ed eral R eserve B ank of New Y ork, T i t l e ........................................................................... Title Fiscal Agent of the United States. A d d r e s s ............ .. ...................................................................... .. .......................................... (S p a c e s b e lo w G overnm ent B a re fo r th e u se o f F e d e ra l R e s e rv e ond Bank of Y ork) S a f e k e e p in g D iv is io n D iv is io n Received N ew Cheeked Cancelled DELIVERY RECEIPT Received from Federal Reserve Bank of New York, Fiscal Agent of the United States, the above-described securities allotted in the amount indicated above. D a te. S u b sc r ib e r . By. Schedule for Issue of Registered Securities Name in which securities shall be registered, taxpayer identifying number (Social Security Account Number or Employer Identification Number), and post-office address for interest checks and other mail. ( P le a s e p r i n t o r t y p e w r ite ) (Indicate under appropriate denominations, number of securities desired.) Amount $1,000 $5,000 $10,000 $100,000 $1,000,000 I d e n t N o ..,..... .................................. ................................................................ x id d re s s ............ ........................................................ .............. ........................ - I d e n t N o .................................. .......................................................... ........... A d d r e s s ............. ..... ...................................................... .................. ................. 4} I d e n t N o ..... .................... .................................................................................. A ddress.... ............................. ................ ........................................... Ident. No.......................................................................................... . A ddress.... ............... .......................................................................... (I f registered securities, which are mailed directly by Treasury Department, Washington, D. C., are not to be sent to the registered owner, give mailing instructions below.) M a il r eg ister ed se c u r itie s to (Q U A D R U P L IC A T E F O R USE OF F E D E R A L R E S E R V E B A N K OF N E W Y O R K ) Subscription Number DELIVERY TICKET— SAFEKEEPING DIVISION T o F e d er a l R eser v e B a n k op N e w Y o r k , Fiscal A gent of the U nited States, F ederal Reserve P. 0 . Station, New York, N. Y. 10045 A tten tio n : Governm ent Bond Division—2nd Floor andaddress of Subscriber) F rom (N am e D ated a t .......................................................... .1967 On our subscription, num bered as above, for $ U N IT E D STATES OF D ATED A M E R IC A (p a r am ount) of— 5% NOVEM BER PERCENT 15, 1967, TR EASU R Y DUE NOTES NOVEM BER 15, OF S E R IE S A -1 9 7 4 1974 which we filed p u rsu a n t to the provisions of T reasury D epartm ent C ircular No. 10-67, Public Debt Series, dated October 26, 1967, we have received your notice of allotm ent statin g th a t the S ecretary of the T reasury has allotted securities to us in the am ount of— $ and, as requested, we send you the following in stru ctio n s: Deposit has been made— By check or c a s h ................................................................................................................$................................. By m atu rin g 3% % T reasury Bonds of 1967 ...................................................... ......$................................. (p a r am ount) By m atu rin g 4% % T reasury Notes of Series F-1967 .............................................$................................. (p a r am ount) Balance due, if any— □ By charge to our reserve account, which you are authorized to make □ By cheek □ By cash 4 7/s % Treas. Notes Series F-1967 3 % % Treas. Bonds of 1967 By m atu rin g securities— Delivered to you h e r e w ith ................................ To be w ithdraw n from safekeeping w ith you To be delivered b y ............................................... $. T o t a l ............................................................... $- I f the am ount of m aturing securities delivered is in excess of the am ount of new securities allotted, redeem excess am ount indicated below in accordance w ith F orm G.B.311 (Request for Redem ption of B earer Securities). Excess am ount of m aturing securities to be redeemed (use Form G.B.311) BEARER Dispose of securities issued, as follow s: SECURITIES DESIRED (For REGISTERED securities— use only reverse side) □ □ □ □ □ D e n o m i (L e a v e th is sp a ce b la n k ) F a ce am ount n a tio n 1,000 1. 2. 3. 4. 5. D eliver over the counter to the undersigned H old in safekeeping (for member bank only) * H old as collateral fo r T reasury Tax and Loan Account* Ship to the undersigned Special instructions: 5 ,0 0 0 10,000 * I f th i* it e m 100,000 a llo tte d 1, 000,000 is c h e c k e d , t h e u n d e r s ig n e d c e r tifie s th a t th e s e c u r itie s w ill b e o w n e d s o le ly b y t h e u n d e r s ig n e d . (IM P O R T A N T : No changes in d e liv e r y in s tr u c tio n s w ill b e a c c e p t e d .) TOTAL This letter of instructions m ust be signed officially in the space provided and returned immediately to Submitted by By ............. Federal Reserve Bank of New York, F is c a l A g e n t o f th e U n ite d ( Please print) ^ (Authorized signature(s) required) T i t l e .................................................................................................... T lt I e S ta tes. A d d r e s s ............................................................... ... • ............................................................ (S p a c e s b e lo w a re fo r th e u se o f F e d e r a l R e s e r v e Bank o f R e c e iv e d C hecked D E L IV E R Y fro m F e d e ra l R eserve B a n k of N ew Y ork, F isc a l Y ork) S a f e k e e p in g D iv is io n G o v e r n m e n t B on d D iv is io n R e c e iv e d N ew A gent of C a n c e lle d R E C E IP T th e U n it e d S t a t e s , th e a b o v e -d e s c r ib e d s e c u r itie s a llo t t e d in th e a m o u n t in d ic a te d a b o v e . Date................................. Subscriber.................................................................................. By..................................................................................... Schedule for Issue of Registered Securities (Indicate under appropriate denominations, number of securities desired.) Name in which securities shall be registered, taxpayer identifying number (S ocial Security A ccoun t N um ber or Em ployer Identification N um ber), and post-office address for interest checks and other mail. (Please print or typewrite) Id en t. Am ount $1,000 $5,000 $10,000 $100,000 $1,000,000 .................. ................................................... .......... Address,............. ............. ............................................. ..................... Ident. No..... ........ ......................... ................................................ . Address.,,,,.,.............. .......-................................................................. Ident. No............... ................................................... ............. ........... Address....... ...............................-............... .......... .......................... . (I f registered securities, which are mailed directly by Treasury Department, Washington, D. 0., are not to be sent to the registered owner, give mailing instructions below.) M a il reg ister ed se cu rities to 6 ALLOTMENT NOTICE FOR GOVERNMENT BOND DIVISION S ubscription U N IT E D STATES ........................$ A M E R I C A 5»4 (p a r am ount) of- OF D ATED NOVEM BER PERCENT 15, 1967, TREASU R Y DUE NOTES NOVEM BER 15, OF S E R IE S A -1 9 7 4 1974 A llotm ent D IS P O S I T I O N Over Counter DEPOSIT Cheek or Cash Safekeeping 3%% Treasury Bonds of 1967 4%% Treasury Notes Series F-1967 T. T. & L. Excess amount Treasury Bonds of 1967 to be redeemed Excess amount Treasury Notes Series F-1967 to be redeemed . . . . $_ Ship Excess cash payment to be refunded Balance due Treasury Special Instructions PAYMENT Jheek or Cash .............................................................................................. Treasury Bonds of 1967 treasury Notes Series F-1967 .................................................................. $_ teserve Account lalance ........................................................................................................... $- 7 ALLOTMENT NOTICE FOR SECURITIES DEPARTMENT Subscription U N IT E D STATES ....................... $ OF D ATED A M E R IC A 5M NOVEM BER Allotm ent............. .................$ (p a r am ount) of— PERCENT 15, 1967, TREASU R Y DUE NOTES NOVEM BER 15, OF 1974 S E R IE S A -1 9 7 4 ALLOTMENT NOTICE FOR SECURITY FILES Subscription U N IT E D STATES ........................$ OF D ATED A M E R IC A 5% NOVEM BER Allotm ent.............................. $ (p a r am ount) of— PERCENT 15, 1967, TR EASU RY DUE NOTES NOVEM BER 15, OF 1974 S E R IE S A -1 9 7 4
@FedFRASER