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Dear Sir/Madam

Please accept this letter as my authorization to DTC the following securities to Pershing DTC # 0443, account of OINUSA , account # PLR006989.

List
Security Description
Number of Shares
Symbol
 

Thank you,

MM slash DD slash YYYY

DONOR : PLEASE COMPLE THE FOLLOWING FOR OINUSA PURPOSES

Name
Address

Instructions

  1. Please complete form in its entirety, sign and date.
  2. Send original form and stock certificate to stock broker.
  3. Keep a copy for your own record received on email.