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F E D E R A L R E S E R V E BA N K OF NEW YORK Fiscal x\gent of the United States rCircular No. 6 3 2 9 1 May 2, 1969 J L Refunding of Treasury Notes and Bonds Maturing May 15 and June 15, 1969 To A ll Banking Institutions, and Others Concerned, in the Second Federal Reserve D istrict: The subscription hooks will be open Monday, May 5, through Wednesday, May 7, for an offering of— 6% percent Treasury Notes of Series D-1970, at 99.95, dated May 15, 1969, maturing August 15, 1970, and 6i/2 percent Treasury Notes of Series B-1976, at par, dated May 15, 1969, maturing May 15, 1976, in exchange for the eligible series of Treasury notes and bonds maturing May 15 and June 15, 1969, as set forth in Treasury Department Circulars Nos. 3-69 and 4-69, Public Debt Series, both dated May 1, 1969; a copy of each is printed on the following pages. Coupons dated May 15, 1969 on the notes maturing on that date should be detached and cashed when due. Coupons dated June 15, 1969 on the bonds maturing on that date must be attached. Only banking institutions may submit subscriptions for account of customers. On such subscriptions, the customers’ names must be furnished. On subscriptions for account of customers other than individuals, their locations must also be furnished. On subscriptions for account of customers of correspondent banks, the names of such customers and, if not individuals, their locations must be furnished. Subscribers are required to certify that at the time the subscription is entered the securi ties surrendered were owned and delivery was accepted by the subscriber, or that such securi ties were contracted for purchase for value by the subscriber for delivery to the subscriber prior to the closing of the subscription books. The Treasury Department has announced that the Internal Revenue Service released, on April 30,1969, a revenue ruling that will be published in Internal Revenue Bulletin No. 1969-21, dated May 26, 1969, dealing with the determination of amount of and recognition of gain or loss in an exchange of Treasury securities, and that such ruling would apply to the exchanges of 21/> percent bonds of June 15, 1969 for 6% percent notes of August 15, 1970 or 6^2 percent notes of May 15, 1976, under the current offering, as follows: 1. The effective date of exchange will be the date on which the holder of the outstanding bonds submits his subscription. 2. An investor’s taxable gain or loss will be determined by comparing his basis in the bonds surrendered with the amount of money received ($0.50 per $1,000 in the case of an exchange for the 1970 notes and nothing in the case of an exchange for the 1976 notes), plus the fair market value of the new notes, which is equal to the mean of the bid and asked prices for those notes on the date on which he submits his subscription. 3. An investor will take the fair market value of the new notes on the date on which he submits his subscription as his basis in those notes. 4. An investor will include the six months’ interest payment on the bonds ($12.50 per $1,000) in his gross income. The one month’s interest on the notes ($5.45925 per $1,000 in the case of the 6 % per cent notes and $5.47554 per $1,000 in the case of the 6 V2 percent notes) will be treated as a capital investment and upon receipt of the first interest payment (August 15, 1969 in the case of the 1970 notes, and November 15, 1969 in the case of the 1976 notes) he will deduct that amount as a recovery of capital and report the balance as interest income. S u b scrip tio n s w ill be receiv ed b y this B ank as fiscal agent o f the U n ited States. S u b scrip tion s sh ou ld be su bm itted in trip lica te on official su b scrip tion form s, cop ies o f w hich are en closed, and sh ou ld be m ailed im m ediately. I f filed b y telegram o r letter, the su bscrip tion s sh ou ld be con firm ed im m ed ia tely b y m ail 011 the fo rm s p rov id ed . T he su bscrip tion book s w ill rem ain open f o r th ree d ays, M a y 5 th rough M a y 7. A n y su b scrip tion ad d ressed to a F e d e ra l R e se rv e B ank or B ran ch or to the T re a su ry D epartm en t and p laced in the m ail b e fo re m idnight W e d n e sd a y , M a y 7, w ill be co n sid e re d tim ely. C ash su b scrip tio n s will n ot be receiv ed . A lfred H a y e s , President. 2 UNITED STATES OF AMERICA 6% PERCENT TREASURY NOTES OF SERIES D-1970 Dated and bearing interest from May 15, 1969 Due August 15, 1970 TREASURY DEPARTMENT, Office of the Secretary, Washington, May DEPARTMENT CIRCULAR Public Debt Series — No. 3-69 I. OFFERING OF NOTES 5% percent Treasury Notes of Series B-1969, maturing May 15, 1969; or 5. The notes will be subject to the general regula tions of the Treasury Department, now or hereafter prescribed, governing United States notes. • 2i/ 2 percent Treasury Bonds of 1964-69, matur ing June 15, 1969, in amounts of $1,000 or mul tiples thereof. III. Interest will be adjusted on the honds of 1964-69 as of June 15, 1969. Payments on account of accrued in terest and cash adjustments will be made as set forth in Section IV hereof. The amount of this offering will be limited to the amount of eligible securities tendered in exchange. The books will be open only on May 5 through May 7, 1969, for the receipt of subscriptions. SURSCRIPTION 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. Banking institutions generally may submit subscriptions for account of customers, but only the Federal Reserve Banks and the Treasury Department are authorized to act as official agencies. 2. In addition, holders of the securities enumer ated in Paragraph 1 of this section are offered the privilege of exchanging all or any part of them for 6 V2 percent Treasury Notes of Series B-1976, which offering is set forth in Department Circular, Public Debt Series — No. 4-69, issued simultaneously with this circular. 2 . Under the Second Liberty Bond Act, as amend ed, the Secretary of the Treasury has the authority to reject or reduce any subscription, and to allot less than the amount of notes applied for 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, all subscriptions will be allotted in full. DESCRIPTION OF NOTES 1. The notes will be dated May 15, 1969, and will bear interest from that date at the rate of 6 % per cent per annum, payable on a semiannual basis on August 15, 1969, and 011 February 15 and August 15, 1970. They will mature August 15, 1970, and will not be subject to call for redemption prior to maturity. IV. PAYMENT 1. Payment for the face amount of notes allotted hereunder must be made on or before May 15, 1969, or on later allotment, and may be made only in a like face amount of securities of the issues enumerated in Paragraph 1 of Section I hereof, which should accom pany the subscription. Payment will not be deemed to have been completed where registered notes are re quested if the appropriate identifying number as required on tax returns and other documents sub mitted to the Internal Revenue Service (an individ ual’s social security number or an employer identifi cation number) is not furnished. Payments due to subscribers will be made by check or by credit in any account maintained by a banking institution with the Federal Reserve Bank of its District following accep tance of the securities surrendered. In the case of registered securities, the payment will be made in accordance with the assignments thereon. 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 im posed 011 the principal or interest thereof by any State, or any of the possessions of the United States, or by any local taxing authority. 3. The notes will be acceptable to secure deposits of public moneys. They will not be acceptable in payment of taxes. 4. Bearer notes with interest coupons attached, and notes registered as to principal and interest, will , 1969. be issued in denominations of $ 1,000 , $5 ,000 , $ 10 ,000 , $ 100 ,000 , $ 1,00 0 ,0 00 , $ 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. 1. The Secretary ot* the Treasury, pursuant to the authority of the Second Liberty Bond Act, as amend ed, offers notes of the United States, designated 6 % percent Treasury Notes of Series D-1970, at 99.95 percent of their face value, in exchange for the follow ing securities: II. 1 3 2. 5% percent notes of Series B-1969. When pay ment is made with notes in bearer form, coupons dated May 15, 1969, should be detached and cashed when due. When payment is made with registered notes, the final interest due on May 15, 1969, will be paid by issue of interest checks in regular course to holders of record on April 15, 1969, the date the transfer books closed. A cash payment of $0.50 per $1,000 on ac count of the issue price of the new notes will be made to subscribers. 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 surrendered, the assign ment should be to “ The Secretary of the Treasury for exchange for 6% percent Treasury Notes of Series D-1970” ; if the new notes are desired registered in another name, the assignment should be to “ The Sec retary of the Treasury for exchange for 6% percent Treasury Notes of Series D-1970 in the name o f ........ .............................. if new notes in coupon form are desired, the assignment should be to “ The Secretary of the Treasury for exchange for 6% percent Treasury Notes of Series D-1970 in coupon form to be delivered 3. 2y 2 percent bonds of 1964-69. When payment is made with bonds in bearer form, coupons dated June 15, 1969, must be attached to the bonds when surrendered. Accrued interest from December 15, 1968, to June 15, 1969 ($12.50 per $1,000), plus the payment on account of the issue price of the new notes ($0.50 per $1,000) will be credited and accrued interest from May 15 to June 15, 1969 ($5.45925 per $1,000) on the new notes will be charged and the difference ($7.54075 per $1,000) will be paid to sub scribers. V. 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 pre scribed by the Secretary of the Treasury, to issue such notices as may be necessary, to receive payment for and make delivery of notes on full-paid subscriptions allotted, and they may issue interim receipts pending delivery of the definitive notes. ASSIGNMENT OF REGISTERED SECURITIES 1. Treasury securities in registered form tendered in payment for notes offered hereunder should be assigned by the registered payees or assignees thereof, in accordance with the general regulations of the Treasury Department governing assignments for transfer or exchange, in one of the forms hereafter set forth, and thereafter should be surrendered with the subscription to a Federal Reserve Bank or Branch or to the Office of the Treasurer of the United States, 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. DAVID M. KENNEDY, Secretary of the Treasury. UNITED STATES OF AMERICA 6% PERCENT TREASURY NOTES OF SERIES B-1976 Dated and bearing interest from May 15, 1969 Due May 15, 1976 TREASU RY DEPARTM ENT, Office of the Secretary, Washington, May 1, 1969. DEPARTMENT CIRCULAR Public Debt Series — No. 4-69 I. OFFERING OF NOTES May 5 through May 7, 1969, for the receipt of sub scriptions. 1. The Secretary of the Treasury, pursuant to the authority of the Second Liberty Bond Act, as amended, offers notes of the United States, designated 61/2 percent Treasury Notes of Series B-1976, at par, in exchange for the following securities: 2. In addition, holders of the securities enumer ated in Paragraph 1 of this section are offered the privilege of exchanging all or any part of them for 6% percent Treasury Notes of Series D-1970, which offering is set forth in Department Circular, Public Debt Series — No. 3-69, issued simultaneously with this circular. 5% percent Treasury Notes of Series B-1969, maturing May 15, 1969; or 214 percent Treasury Bonds of 1964-69, matur ing June 15, 1969, in amounts of $1,000 or multiples thereof. II. Interest will be adjusted 011 the bonds of 1964-69 as of June 15, 1969. The amount of this offering will be limited to the amount of eligible securities ten dered in exchange. The books will be open only on D ESCRIPTION OF NOTES 1. The notes will be dated May 15, 1969, and will bear interest from that date at the rate of 61/* per cent per annum, payable semiannually on November 15, 1969, and thereafter on May 15 and November 15 in each year until the principal amount becomes 4 payable. They will mature May 15, 1976, and will not be subject to call for redemption prior to ma turity. 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. -3. The notes will be acceptable to secure deposits of public moneys. They will not be acceptable in payment of taxes. 4. Bearer notes with interest coupons attached, and notes registered as to principal and interest, will be issued in denominations of $1,000, $5,000, $10,000, $100,000, $1,000,000, $100,000,000 and $500,000,000. Provision will be made for the interchange of notes of different denominations and of coupon and registered notes, and for the transfer of registered notes, under rules and regulations prescribed by the Secretary of the Treasury. 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. Bank ing institutions generally may submit subscriptions for account of customers, but only the Federal Re serve Banks and the Treasury Department are au thorized to act as official agencies. 2. Under the Second Liberty Bond Act, as amended, the Secretary of the Treasury has the au thority to reject or reduce any subscription, and to allot less than the amount o f notes applied for 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, all sub scriptions will be allotted in full. VI. PAYMENT GENERAL PROVISIONS 1. As fiscal agents of the United States, Federal Reserve Banks are authorized and requested to re ceive subscriptions, to make such allotments as may be prescribed by the Secretary of the Treasury, to issue such notices as may be necessary, to receive payment for and make delivery of notes on full-paid subscriptions allotted, and they may issue interim receipts pending delivery of the definitive notes. 2. The Secretary of the Treasury may at any time, or from time to time, prescribe supplemental or amendatory rules and regulations governing the offering, which will be communicated promptly to the Federal Reserve Banks. 1. Payment for the face amount of notes allotted hereunder must be made on or before May 15, 1969, or on later allotment, and may be made only in a like face amount of securities of the issues enumer ated in Paragraph 1 of Section I hereof, which should accompany the subscription. Payment will not be deemed to have been completed where registered notes are requested if the appropriate identifying num ber as required on tax returns and other documents submitted to the Internal Revenue Service (an indi vidual’s social security number or an employer iden tification number) is not furnished. 2. 5% percent notes of Series B-1969. — When payment is made with notes in bearer form, coupons dated May 15, 1969, should be detached and cashed ASSIGNMENT OF REGISTERED SECURITIES 1. Treasury securities in registered form tendered in payment for notes offered hereunder should be assigned by the registered payees or assignees thereof, in accordance with the general regulations of the Treasury Department governing assignments for transfer or exchange, in one of the forms hereafter set forth, and thereafter should be surrendered with the subscription to a Federal Reserve Bank or Branch or to the Office of the Treasurer of the United States, Washington, D. C. 20220. The maturing se curities must be delivered at the expense and risk of the holder. I f the new notes are desired registered in the same name as the securities surrendered, the assignment should be to “ The Secretary of the Treas ury for exchange for 6% percent Treasury Notes of Series B-1976” ; if the new notes are desired regis tered in another name, the assignment should be to “ The Secretary of the Treasury for exchange for 6 y 2 percent Treasury Notes of Series B-1976 in the name of .......................................... if new notes in coupon form are desired, the assignment should be to “ The Secretary of the Treasury for exchange for 6 y 2 percent Treasury Notes of Series B-1976 in cou pon form to be delivered to .................................. ” . SUBSCRIPTION AND ALLOTMENT IV. 3. 2 y 2 percent bonds of 1964-69. — When payment is made with bonds in bearer form, coupons dated June 15, 1969, must be attached to the bonds when surrendered. Accrued interest from December 15, 1968, to June 15, 1969 ($12.50 per $1,000) will be credited and accrued interest from May 15 to June 15, 1969 ($5.47554 per $1,000) on the new notes will be charged and the difference ($7.02446 per $1,000) will be paid to subscribers. Payments will be made by check or by credit in any account maintained by a banking institution with the Federal Reserve Bank of its District following acceptance of the securities surrendered. In the case of registered securities, the payment will be made in accordance with the assign ments thereon. V. 5. The notes will be subject to the general regu lations of the Treasury Department, now or hereafter prescribed, governing United States notes. III. when due. When payment is made with registered notes, the final interest due on May 15, 1969, will be paid by issue of interest checks in regular course to holders of record on April 15, 1969, the date the transfer books closed. DAVID M. KENNEDY, Secretary of the Treasury. 5 Subscription No. DELIVERY INSTRUCTIONS— EXCHANGE SUBSCRIPTION For United States of America 6 % Percent Treasury Notes of Series D-1970 Dated May 15, 1969, Due August 15, 1970 B E A R E R NOTES D ESIRED IN EXCH AN G E (Use schedule on reverse side for REGISTERED notes) Dispose of securities issued as follows: Denomi nation ieces $ □ 1. Deliver over the counter to the undersigned 1,000 □ 2. Hold in safekeeping member bank only)* 5,000 □ 3. Hold as collateral for Treasury Tax and Loan Account* □ 4. Ship to the undersigned □ 5. Special instructions: Face amount (Leave this space blank) 10,000 100,000 (for 1, 000,000 TOTAL If this item is checked, the subscriber certi fies that the allotted securities will be owned iolely by the subscriber. (IMPORTANT: No changes in delivery instructions will be accepted. A separate subscription form must be submitted for each group of securities for which different delivery instruc tions are given.) Submitted by The subscription books will be open May 5 through May 7, 1969. (Please print) By ................. • .................... . B y ..................... Title . . . ....................... , T i t l e .................. (Authorized signature (s) required) Address (Spaces below are for the use of the Federal Reserve Bank of New York) S af ek eeping R ecord iceived Received from F ederal R eserve B a n k of N e w Y ork the above described United States obligations in the amount subscribed for. Subscriber .................................................... ecked and livered Schedule for Issue o f Registered Notes Name in which notes shall be registered, taxpayer identifying number (Social Security Account Number or Employer Identification Number), and post-office address for interest checks and other mail. (Please print or typewrite) (Indicate under appropriate denominations, number of notes desi Amount $1,000 $5,000 $10,000 $100,000 $1,000 Name Ident. No. Address Name .. ............ ........................................................ ... Ident. No. Address ........................................ ............................................ ........................................................... Name 9 Ident No Address ......... r# Name y Tdent No Address (I f registered notes are not to be sent to the registered owner, give mailing instructions below.) Mail registered notes to )seriber,s Reference N o . (Please type or print legibly and submit in triplicate) Subscription N o . A -l EXCHANGE SUBSCRIPTION For United States of America 6 % Percent Treasury Notes of Series D-1970 Dated May 15, 1969, Due August 15, 1970 Important Instructions. 1. Securities of different issues surrendered in exchange may be listed together on e same subscription form, except that a separate subscription form should be used (a) for listing bearer securities irrendered, (b ) for listing registered securities surrendered, and (c ) for each group of new securities for which fferent delivery instructions are given. 2. Separate subscription forms should be used for bearer securities and gistered securities desired in exchange. 3. Social Security account numbers or Employer Identification numbers : all subscribers for registered notes must be furnished on the reverse side hereof. 4. Signatures are required t original only; all other filled-in matter should appear in triplicate. 5. Amount of securities surrendered and •plied for must be in multiples of $1,000. Dated at ...................................................... ed era l R eserve B an k o f N ew Y o rk , Fiscal Agent of the United States, New York, N. Y. 10045 .................................................................... 1969 Attention: Government Bond Division ENTLEM EN : Subject to the provisions of Treasury Department Circular No. 3-69, Public Debt Series, dated ay 1, 1969, the undersigned hereby subscribes, at 99.95, for United States of America 6% percent 'easury Notes of Series D-1970, in the amount of $ ................................................ * and tenders in payment erefor a like par amount of the securities— Delivered to you h erew ith ....................................................................................... $................................ To be withdrawn from securities held by y o u .................................................... $................................ To be delivered by ................................................................................................... $................................ * (Please fill in on the reverse side the schedule “ List of Accounts Included in this Subscription.’ ’ ) SECURITIES SURRENDERED Total Amount (Do not fill in this column) To Subscriber t % Notes, B-1969 (detach coupons) .................................... . % Bonds, due 6/15/69 (with 6/15/69 coupons attached) Total ........................................................... y net amount due subscriber on price and interest adjustments:* □ By check □ By credit to reserve account * See Section IV of T. D. Circular No. 3-69, Public Debt Series, for method of computing net adjustment. W e H ereby Certify that at the time this subscription was entered the above-described securities •rendered or to be surrendered in connection with this exchange were owned and delivery was accepted the subscriber, or such securities were contracted for purchase for value by the subscriber for delivery to !: subscriber prior to the closing of the subscription books. (S ign a tu re(s) required also on Delivery Instructions below) (Do not fill in boxes below) ............................. G o v er n m ent B ond D iv isio n Received Checked Submitted by ......................... (Please print) Canceled By ................., B y ............................ (Authorized signature(s) required) Title ...................................................... . Title Address ..................................................................... (If space is insufficient in schedules below, attach separate listing) List of Accounts Included in this Subscription Subscription No. SECURITY RECORDS “OUT TICKET” DELIVERY INSTRUCTIONS— EXCHANGE SUBSCRIPTION For United Slates of America 6 % Percent Treasury Notes of Series D-1970 Dated May 15, 1969, Due August 15, 1970 B E A R E R NOTES DESIRED IN EXCH ANG E (Use schedule on reverse side for REGISTERED notes) Dispose of securities issued as follow s: Denomi nation Pieces $ □ 1. Deliver over the counter to the undersigned 1,000 □ 2. Hold in safekeeping member bank only)* 5,000 □ 3. Hold as collateral for Treas* ury Tax and Loan Account* □ 4. Ship to the undersigned □ 5. Special instructions: Face amount (Leave this space blank) 10,000 100,000 1,000,000 TOTAL Submitted by Address (for Schedule for Issue of Registered Notes Name in which notes shall be registered, taxpayer identifying number (Social Security Account Number or Employer Identification Number), and post-office address for interest checks and other mail. (Please print or typewrite) (Indicate under appropriate denominations, number of notes desire Amount $1,000 $5,000 $10,000 (I f registered notes are not to be sent to the registered owner, give mailing instructions below.) M ail registered notes to $100,000 $1,000,0 bscriber’s Keference N o. DUPLICATE— SECURITY RECORDS “ IN TICKET” Subscription N o . A-2 EXCHANGE SUBSCRIPTION For United Slates of America 6 % Percent Treasury Notes of Series D-1970 Dated May 15, 1969, Due August 15, 1970 Dated at ...................................................... '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, New York, N. Y. 10045 .................................................................... 1969 Attention: Government Bond Division G entlem en : Subject to the provisions of Treasury Department Circular No. 3-69, Public Debt Series, dated [ay 1, 1969, the undersigned hereby subscribes, at 99.95, for United States of America 6% percent reasury Notes of Series D-1970, in the amount of $ ................................................ * and tenders in payment lerefor a like par amount of the securities— Delivered to you h e re w ith ....................................................................................... $................................ To be withdrawn from securities held by y o u .................................................... $................................ To be delivered by ................................................................................................... $................................ •(Please fill in on the reverse side the schedule “ List of Accounts Included in this Subscription.” ) SECURITIES SURRENDERED Total Amount (Do not fill in this column) To Subscriber Notes, B-1969 (detach coupons) ......................................... $----- -------------------- -------- ----------- -...... 4 % Bonds, due 6/15/69 (with 6 /15/69 coupons attached) . . $.............................. -...................... -...... /;g % T o t a l ................................................................ $........................ —................-................. ........- ay net amount due subscriber on price and interest adjustments:* □ By check □ By credit to reserve account * See Section IV of T. D. Circular No. 3-69, Public Debt Series, for method of computing net adjustment. W e H e r e b y C e r t i f y that at the time this subscription was entered the above-described securities irrendered or to be surrendered in connection with this exchange were owned and delivery was accepted r the subscriber, or such securities were contracted for purchase for value by e subscriber prior to the closing of the subscription books. Submitted by Address the subscriber for delivery to ( I f space is insufficient in schedules below, attach separate listing) List of Accounts Included in this Subscription (Indicate amount of each issue surrendered by each customer and by yourself) NONNEGOTIABLE RECEIPT Subscription No. o 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 icurities tendered with subscription numbered as above in exchange for 6% PERCENT TREASU RY NOTES OF SERIES D-1970 ecurities allotted on this subscription will be delivered on !ay 15, 1969, in accordance with your instructions. .................................... ............................................. Government Bond Division — Issues & Redemption Section B E ARER NOTES DESIRED IN EXCH ANGE (Use schedule on reverse side for REGISTERED notes) 'ieces Denomi nation $ Dispose of securities issued as follow s: □ 1- Deliver over the counter to the undersigned 1,000 □ 2. Hold in safekeeping member bank only)* 5,000 □ 3. Hold as collateral for Treas ury Tax and Loan Account* 10,000 □ 4. Ship to the undersigned □ 5. Special instructions: Face amount (Leave this space blank) 100,000 1, 000,000 TOTAL ’ederal R eserve B a n k of N ew Y ork Fiscal Agent of the United States (Date) are hereby authorized to deliver to Submitted by (Name of representative) 3signature appears below, Address $ ............................................ par amount urities issued pursuant to this subscription. N am e............................................................ (Please print) (Official signature required) Signature of 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. (for Schedule for Issue of Registered Notes Name in which notes shall be registered, taxpayer identifying number (Social Security Account Number or Employer Identification Number), and post-office address for interest checks and other mail. ( Please print or typewrite) (Indicate under appropriate denominations, number of notes desii Amount $1,000 $5,000 $10,000 $100,000 $1,000,1 Name Ident No Address ............................... Name ................. Ident No. Address .................................... Ident No \ •< Address (I f registered notes are not to be sent to the registered owner, give mailing instructions below.) M ail registered notes to TRIPLICATE— TREASURY REPORTS COPY bseriber’s Reference No. Subscription N o . A-3 EXCHANGE SUBSCRIPTION For United Slates of America 6 % Percent Treasury Notes of Series D-1970 Dated May 15, 1969, Due August 15, 1970 'e d e b a l R eserve B a n k of New Y Dated at ...................................................... ork, Fiscal Agent of the United States, New York, N. Y . 10045 .................................................................... 1969 Attention: Government Bond Division ENTLEM EN: Subject to the provisions of Treasury Department Circular No. 3-69, Public Debt Series, dated !ay 1, 1969, the undersigned hereby subscribes, at 99.95, for United States of America 6% percent reasury Notes of Series D-1970, in the amount of $ .................................................* and tenders in payment terefor a like par amount of the securities— Delivered to you h erew ith ....................................................................................... $................................ To be withdrawn from securities held by y o u .................................................... $................................ To be delivered by ................................................................................................... $................................ • (P lease fill in on the reverse side the schedule “ L ist o f A ccounts Included in this S u bscription.’ ’ ) SECURITIES SURRENDERED Total Amount j % Notes, B-1969 (detach coupons) ........................................ $.. j% Bonds, due 6/15/69 (with 6 /15/69 coupons attached) . . $.. T o t a l ................................................................ $. (Do not (ill in this column) To Subscriber y net amount due subscriber on price and interest adjustments:* □ By check □ By credit to reserve account * See Section IV of T. D. Circular No. 3-69, Public Debt Series, for method of computing net adjustment. W e H e r e b y C e r t i f y that at the time this subscription was entered the above-described securities ■rendered or to be surrendered in connection with this exchange were owned and delivery was accepted the subscriber, or such securities were contracted for purchase for value by the subscriber for delivery to subscriber prior to the closing of the subscription books. Submitted by Address (If space is insufficient in schedules below, attach separate listing) List of Accounts Included in this Subscription (Indicate amount of each issue surrendered by each customer and by yourself) (Leave this space blank) Name and location (City and State) of ultimate purchaser (L oca tion o f individuals not required ) 5 % % Notes B-1969 2 1/2 % Bonds due 6 /1 5 /6 9 $ ...................... $ ..................... Total $ ................ 1i .y. Our own a c c o u n t.................................... Totals ...................................................... $ ................................. $ ...................... $ ............... Subscription N o. DELIVERY INSTRUCTIONS— EXCHANGE SUBSCRIPTION For United States of America 6 ^ Percent Treasury Notes of Series B-1976 Dated May 15, 1969, Due May 15, 1976 B E A R E R NOTES D ESIRED IN EXCH ANGE (Use schedule on reverse side for REGISTERED notes) D enom i nation eces $ Dispose of securities issued as follow s: □ 1- Deliver over the counter to the undersigned . 1,000 □ 2. Hold in safekeeping member bank only)* 5,000 □ 3. Hold as collateral for Treasury Tax and Loan Account* 10,000 □ 4. Ship to the undersigned □ 5. Special instructions: (L ea ve this space blank) F ace amount 100,000 (for 1,000,000 TOTAL F this item is checked, the subscriber certi- es that the allotted securities will be owned olely by the subscriber. (IMPORTANT: No changes in delivery instructions will be accepted. A separate subscription form must be submitted for each group of securities for which different delivery instruc tions are given.) Submitted by The subscription books will be open May 5 through May 7, 1969. (Please print) By ............. .......................... , B y ....................... (Authorized signature(s) required) T i t l e ....................................................... T i t l e .................. Address .............................................................................. (Spaces below are for the use of the Federal Reserve Bank of New York) S afekeeping R ecord eived R e c e iv e d f r o m F e d e r a l R e s e r v e B a n k o f N e w Y o r k the above described United States obligations in the amount subscribed for. Subscriber iked nd rered ..................................................................... Schedule for Issue of Registered Notes Name in which notes shall be registered, taxpayer identifying number (Social Security Account Number or Employer Identification N um ber), and post-office address for interest checks and other mail. (Please print or typewrite) (Indicate under appropriate denominations, number o f notes desire Amount $1,000 $5,000 $10,000 Name Ident. No. Address Name ............................................ ...................................................... ......................................... Ident. No............................................................. Address ........................................................... Name Ident. No. . ................ Addi’ess Name Ident No Address ( I f registered notes are not to be sent to the registered owner, give mailing instructions below.) Mail registered notes to $100,000 $1,000,0( bscriber’ s Reference N o. (Please type or print legibly and submit in triplicate) Subscription No. B -l EXCHANGE SUBSCRIPTION For United States of America 6 ^ Percent Treasury Notes of Series B-1976 Dated May 15, 1969, Due May 15, 1976 Important Instructions. 1. Securities of different issues surrendered in exchange may be listed together on le same subscription form, except that a separate subscription form should be used (a) for listing bearer securities irrendered, (b) for listing registered securities surrendered, and (c ) for each group of new securities for which ifferent delivery instructions are given. 2. Separate subscription forms should be used for bearer securities and ;gistered securities desired in exchange. 3. Social Security account numbers or Employer Identification numbers F all subscribers for registered notes must be furnished on the reverse side hereof. 4. Signatures are required l original only; all other filled-in matter should appear in triplicate. 5. Amount of securities surrendered and jplied for must be in multiples of $1,000. Dated at ...................................................... e d e ra l R eserve B a n k o f N ew Y o rk , Fiscal Agent of the United States, New York, N. Y. 10045 .................................................................... 1969 Attention: entlem en Government Bond Division : Subject to the provisions of Treasury Department Circular No. 4-69, Public Debt Series, dated ay 1, 1969, the undersigned hereby subscribes, at par, for United States of America 6% percent ■easury Notes of Series B-1976, in the amount of $ ............................................ * and tenders in payment 3refor a like par amount of the securities— Delivered to you herewith ...................................................................................... $................................ To be withdrawn from securities held by y o u .................................................... $................................ To be delivered by ................................................................................................... $................................ * (Please fill in on the reverse side the schedule “ List of Accounts Included in this Subscription.” ) SECURITIES SURRENDERED Total Am ount % Notes, B -1969 (deta ch cou pon s) ......................................... % Bonds, due 6 /1 5 /6 9 (w ith 6 /1 5 /6 9 coupons attach ed) T otal .................................................................... net amount due subscriber on interest adjustm ents:* □ □ B y check $.................. ............. $ ......................... $....................................... (D o not fill in this colum n) T o Subscriber xxxxxxxxxxx B y credit to reserve account * Sec Section IV of T. D. Circular No. 4-69, Public Debt Series, for method of computing net adjustment. W e H e r e b y C e r t i f y that at the time this subscription was entered the above-described securities rendered or to be surrendered in connection with this exchange were owned and delivery was accepted ;he subscriber, or such securities were contracted for purchase for value by the subscriber for delivery to subscriber prior to the closing of the subscription books. (Signature (s ) required also on Delivery Instructions below) (D o not fill in boxes below ) G over n m en t B ond D ivision Received Checked Submitted by ......................... (Please print) Canceled By .................. B y ........................... (Authorized signature(s) required) Title ...................................................... . Title Address ..................................................................... (If space is insufficient in schedules below, attach separate listing) List of Accounts Included in this Subscription (Indicate amount of each issue surrendered by each customer and by yourself) Subscription N o. SECURITY RECORDS “OUT TICKET” DELIVERY INSTRUCTIONS— EXCHANGE SUBSCRIPTION For United States of America 6^4 Percent Treasury Notes of Series B-1976 Dated May 15, 1969, Due May 15, 1976 B E A R E R NOTES D ESIRED IN EXCH AN G E (Use schedule on reverse side for REGISTERED notes) D enom i nation $ Dispose of securities issued as follows: □ 1. Deliver over the counter to the undersigned 1,000 □ 2. Hold in safekeeping member bank only)* 5,000 □ 3. Hold as collateral for Treas« ury Tax and Loan Account* 10,000 □ 4. Ship to the undersigned Face amount (Leave this space bionic) n 5. Special instructions: 100,000 1, 000,000 TOTAL Submitted by Address (for Sch edu le fo r Issue o f R egistered Notes Name in which notes shall be registered, taxpayer identifying number (Social Security Account Number or Employer Identification Number), and post-office address for interest checks and other mail. (P lea se print or typew rite) (Indicate under appropriate denominations, number of notes desir Amount $1,000 $5,000 $10,000 ( I f registered notes are not to be sent to the registered owner, give m ailing instructions below .) M ail registered notes to $100,000 $1,000,0 bscriber’s Reference No. DUPLICATE— SECURITY RECORDS “ IN TICKET” Subscription No. B -2 EXCHANGE SUBSCRIPTION For United States of America 6^4 Percent Treasury Notes of Series B-1976 Dated May 15, 1969, Due May 15, 1976 Dated at ...................................................... '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, New York, N. Y. 10045 ...................................................... ......... .....1969 Attention : entlem en Government Bond Division : Subject to the provisions of Treasury Department Circular No. 4-69, Public Debt Series, dated :ay 1, 1969, the undersigned hereby subscribes, at par, for United States of America 6y 2 percent reasury Notes of Scries B-1976, in the amount of $ ............................................ * and tenders in payment crefor a like par amount of the securities— Delivered to you herewith ...................................................................................... $................................ To be withdrawn from securities held by y o u .................................................... $................................ To be delivered by ................................................................................................... $................................ * ( Please fill in on the reverse side the schedule “ List of Accounts Included in this Subscription.” ) SECURITIES SURRENDERED ,% Notes, B-1969 (detach coupons) ......................................... Bonds, due 6/15/69 (with 6 /1 5/6 9 coupons attached) Total .................................................................... Total Amount $....................................... $ ...................................... $....................................... (Do not fill in this column) To Subscriber xxxxxxxxxxx f net amount due subscriber on interest adjustm ents:* □ By check □ B y credit to reserve account * See Section IV’ o f T. D. Circular No. 4-69, Public Debt Series, for method o f computing net adjustment. W e H e r e b y C e r t i f y that at the time this subscription was entered the above-described securities ■rendered or to be surrendered in connection with this exchange were owned and delivery was accepted the subscriber, or sucli securities were contracted l’or purchase for value by the subscriber for delivery to subscriber prior to the closing of the subscription books. Submitted by Address (If space is insufficient in schedules below, attach separate listing) List of Accounts Included in this Subscription (Indicate amount of each issue surrendered by each customer and by yourself) NONNEGOTIABLE RECEIPT Subscription N o. o Subscriber: R e s e r v e B a n k o f N e w Y o r k , Fiscal Agent o f the United States, hereby acknowledges receipt of curities tendered with subscription numbered as above in exchange for 6i/2 PERCENT TREASU RY NOTES OF SERIES B-1976 icurities allotted on this subscription will be delivered on ay 15, 1969, in accordance with your instructions. ..................................... ............................................. ederal Government Bond Division — Issues & Redemption Section BEARER NOTES DESIRED IN EXCHANGE (Use sclicdule on reverse side for REGISTERED notes) Leces ------ Denomi nation $ Dispose of securities issued as follow s: □ 1. Deliver over the counter to the undersigned . 1,000 □ 2. Hold in safekeeping member bank only)* 5,000 □ 3. Hold as collateral for Treas* ury Tax and Loan Account* 10,000 □ 4. Ship to the undersigned □ 5. Special instructions: (Leave this space blank) Face amount 100,000 (for 1,000,000 TOTAL 1e d eral R e s e r v e B a n k o f N e w Y o r k Fiscal Agent o f the United States (Date) are hereby authorized to deliver to Submitted by .................................................................................................... (Name of representative) 3signature appears below, I ................................................par amount ■.urities issued pursuant to this subscription. (Please print) (Official signature required) Signature of 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 o f delivery. Schedule for Issue of Registered Notes ____ ________________ __________________________________ Name in which notes shall be registered, taxpayer identifying number (Social Security Account Number or Employer Identification Number), and post-office address for interest checks and other mail. ( Please print or typew rite) 'Ti (Indicate under appropriate denominations, number of notes des"tre Amount $1,000 $5,000 $10,000 $100,000 $1,000,0 Name.................................................................... Ident. No............................................................. Address................................................................ Name.................................................................... Ident. No............................................................. Address................................................................ Name.................................................................... % Ident. No............................................................. Address............................................................... ria Name................................................................... •• Ident. No.............................................................. Address............................................................... ( I f registered notes are not to be sent to the registered owner, give mailing instructions below.) M ail registered notes to *4 ..........’•***: bscriber’s Reference N o. TRIPLICATE—TREASURY REPORTS COPY B-3 Subscription N o . EXCHANGE SUBSCRIPTION tor United States of America 6 ^ Percent Treasury Notes of Series B-1976 Dated May 15, 1969, Due May 15, 1976 ederal R eserve B a n k op New Y ork, Dated at Fiscal Agent of the United States, New York, N. Y. 10045 .1969 Attention: Government Bond Division ENTLEM EN : Subject to the provisions of Treasury Department Circular No. 4-69, Public Debt Series, dated ay 1, 1969, the undersigned hereby subscribes, at par, for United States of America 6y 2 percent treasury Notes of Series B-1976, in the amount of $ ............................................ * and tenders in payment ercfor a like par amount of the securities— Delivered to you h erew ith ....................................................................................... $................................ To be withdrawn from securities held by y o u .................................................... $................................ To be delivered by ................................................................................................... $................................ J (Please fill in on the reverse side the- schedule ‘ ‘ L ist o f Accounts Included in this Subscription.’ ’ ) I SECURITIES SURRENDERED Total Amount i % Notes, B-1969 (detach coupons) .................................. . (Do not fill in this column) To Subscriber xxxxxxxxxxx .% Bonds, due 6/15/69 (with 6/15/69 coupons attached) Total ........................................................... net amount due subscriber on interest adjustm ents:* □ By check □ B y credit to reserve account * Sec Section IV of T. D. Circular No. 4-69, Public Debt Series, for method of computing net adjustment. W e H e r e b y C e r t i f y that at the time this subscription was entered the above-described securities rendered or to be surrendered in connection with this exchange were owned and delivery was accepted the subscriber, or such securities were contracted for purchase for value by the subscriber for delivery to subscriber prior to the closing of the subscription books. Submitted by Address ( i f space is insufficient in schedules below, attach separate listing) List of Accounts Included in this Subscription
@FedFRASER