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ILLINOIS METROPOLITAN INVESTMENT FUND <br /> � New Account Application <br /> Jse this tortn to open s new Fund aceount a to amend an e�dsting axount For add'Rional information or heip with ttus eppiication,prease wtl 708-450-0100,aQ.252. <br /> Retum the signed appfication to: Iffinois Metropol'dan Investment Fund <br /> The foltaring mus!aczompany this application: ()a designatio�of the person(s)authorized to etfed Uar�sa�ons with IMET including:a verification d siflnatures, and() <br /> _widenee ot authorfty to paRiapata in IME7 in the fortn d en ordinance approving the IMET Qectaration of Tnn!and a 25otution allowing the trwsuret to irnest in IMET. <br /> Reglstration and Mailing Address <br /> � Citv of Decatur. Illinois Beth B Courer <br /> Account tiUe �Contad Name <br /> 4�1 Gary K. Anderson Plaza Decatur ' Illinois 62523 <br /> Street Address City► State Zip Code <br /> (217)424-2702 (217)424-2717 <br /> Contad Phone Number Contad Facsimile Number <br /> t�vestment Instructlons(after the applicat on has been approve y IM <br /> - To puml+ase thc Fund,please caG the Municipai Services Desk at'1-800-822-9335, PuRhases can be made on any business daY beM�een 7:00 AM and 12:00 <br /> noor Cer�ral tim� The;nitiat pr„hxse must be SS0,000 or morr. Each p�u�hase must be hNlaved by a wire Va�sfer in federd funds to the foUowinp address: <br /> � NBD <br /> ABA#:072000.326 <br /> For further credit to G.L.:325fi06 <br /> FBO:IMET <br /> (Your AceouM Number with IME� <br /> 1:�vestment Authorfzation <br /> 9r signing u,is New Account appr�cabon rortn,the undersigned:(�represerm ar,a Mrarrants u,at he�st�e nas tne power anc aucfwrily co r„ake u,e invatn,e�,t(s) <br /> app5ed for pursuaM to this App6cation;(u�agrea Uut the IlGnois MeVopoGtan Inve�rneM Fund,its'vrveslment advisor.administrator and eustodian, <br /> The Fust National Bank ot Chicago and any of the;r subsid'�ary ot afifiates,and the rrspeclNe oficus.dvectors�trustees.empbri.'es and agents of mcA of the <br /> roregang st�an be inaemnifiea s,d ne�a nam,kss by u,e unausigned rrom and aqairxt any bss damage,o�ense«�st Gnduda�g but na rmred to aaomeys <br /> fees)fot a�ir�upon arry irtstrt�ions or fnquiries betieved g�u'u+e. � <br /> Tazpayer Certiiication � <br /> Undv the penz�",:zs d P����Y.�M'�)�+tiM � <br /> [�]U+at the Sxu!Seeurity Number(a)or Ta�ayer ldeMfication Number(s)stiown Debw on this fixm is(are)my(ou�cortect Ta�a��er ldentification <br /> NumDer(s�and <br /> [�U+at I(we)am(are)not subjed to backup withholdings eithet because I(we)have not been notiffed that t(we)am(arc)sub�ect to backup withtwi�ngs <br /> as a resWt d a faiture to repoR aD dnridends,or the Intemal Revenue Servix has not�Sed me(us)that I(we)am(are)no bnger s�bject to bacfvp <br /> wi;hholdv►gs FaiVure by non�rnpt ta�ayers to fumish the corred Ta�ayer ldentification Number wiU resutt in withholding of 20'i.of all ta�bie dividends <br /> paid to your aaount a�d/or witJ�,'+olding on certain other payments to you(this r�erted to as'backuP7. <br /> N07E: Strike out item(i�if you have been notified that you are subjec!to backup wiU�hold'u�g by the IRS and you have not recened a notice from Ltie IRS <br /> ac4ising you that backup withhokling has been tertninated. . ' <br /> . �eg;stered oWner a: �X�Govemment Entity/Agency � Other <br /> Tax�ayer ID Number ��_�nn� �nR <br /> S(g natuf2(5)The unders�gned has had an opQortunily to rcview Ne Funds Umstment Cirtvlar,Fuat Amended and Restated Oeelaration d Trust. <br /> be.'orc signing this appliption. Investmerrts in Ne Fund are subjed to tlx tams d these documents. <br /> Principai�ratue and yield ot irtve�ments in IMET witl fluctuate. Investments a.z subjx�tp�isk and a participant may o�erience a gain or bss upcn redemption. <br /> Netther the princlpai vatua of th�Fund or Its yteid an puaranteed f ��' <br /> _��, � �,ti--�.-�� -�nLv�ce��he.�.�{vr' �-:��a. �j . �.L,"6izi+.�- �����v <br /> s�5�ac�R a rrtie � s�r,�cure a rai� <br /> I�J G t�-� �. �V 1.. c,2 �r���Q. L, -�-/a-v�ser, �n �a!��' <br /> Pr��t Name Print Name � <br /> � � � f�����v //�, <br /> - ' � — <br /> C�erk Qate �� <br /> eeount Numb�I <br /> Otf1c�Us�Oniy i <br /> IMET Approwl: n�rs,.w,.,eTr. ', <br />