ONE-WAY BUY - CDARS



ONE-WAY BUY

REQUEST FOR FUNDS FORM

FAX TO: 703.292.3342

Please complete the required information below to ensure your request will be successfully processed.[1]

Promontory Member Information:

Order Date*:       Transit Routing Number*:     

Settlement Date*:       Promontory ID Number*:      

Issuing Institution Name*:      

One-Way Buy Bids:

|CD Maturity |Rate*[2] |Maximum Funds Requested* |

|4-week |      |      |

|13-week |      |      |

|26-week |      |      |

|52-week |      |      |

|2-year (104 weeks) |      |      |

|3-year (156 weeks) |      |      |

|5-year (260 weeks) |      |      |

Authorization Instructions:

To be eligible to receive funds on the specified settlement date, you must inform Promontory Interfinancial Network, LLC (“Promontory”) of your intention by emailing this form to Promontory at Treasury_Desk@ or faxing it to (703) 292-3342. The form must be signed by an authorized officer of your Insured Institution, by 12:30 pm ET on the specified order date.

By faxing or emailing this form to the Promontory on the specified order date, you are deemed to have given Promontory notice of (i) your desire to receive funds on any settlement date (date on which CDs are issued and interest begins to accrue) falling on or within the dates specified above, (ii) the maximum amount of funds that Promontory may place with your Insured Institution, and (iii) the interest rate that your Insured Institution is willing to pay for funds placed with you on a settlement date. The receipt of this Request for Funds Form by Promontory will constitute a binding commitment by your Insured Institution to accept funds through Promontory in accordance with the terms provided above and Promontory may rely on your Insured Institution’s commitment.

Date:*       Authorized Officer Name:*      

Work Phone:*       Authorized Officer Signature:*      

Alternate Phone:*      

* Required field

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[1] Promontory will not assume responsibility for the outcome of your request if this form is not properly completed.

[2] Interest payment frequency options selected by a Depositor are published at the Placement and Product Disclosure link on the CDARS website, and will affect the amount of interest paid at the interest rate you have indicated above.

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