Fill and Sign the Registered Investment Bond Form

Registered Investment Bond ________________________________________________ (Name of Corporation), a corporation organized under the laws of _______________________________ (Name of State), with its principal place of business at _______________________________________________ _________________________________________ (street address, city, county, state, zip code), (the Corporation), for value received, promises to pay to _______________________________ (Name of Registered Owner), or registered assigns, $__________________ (dollar amount of principal) and interest on the principal amount from the date of this Bond at the rate of ______% per year, in the manner and to the extent provided in an Agreement dated __________________ (date), between _______________________________ (Name of Trustee) and Corporation (the Indenture). This Bond is subject to the terms of that Indenture. The principal and interest of this Bond shall be payable only out of the net profits of the Corporation, as defined and provided in the Indenture, provided that the net profits shall be both sufficient for the payment and declared by the Board of Directors of the Corporation to be then payable. Interest on the principal amount will be paid on _______________________ (date), and (e.g., semiannually, quarterly, monthly) _______________________ subsequently on the ______ day of _______________ (month) and on the _____ day of __________________ (month) of each year, until redemption of this Bond. Interest shall be cumulative, but accumulations of interest shall not bear interest. Payment of the principal and interest of this Bond shall be made at the office of the Corporation, at ______________________________________________________________________________ (street address, city, county, state, zip code) , in lawful currency of the United States of America. This Bond is one of an authorized issue of income bonds of the Corporation, limited to $_______________. In the event of liquidation of the Corporation, whether voluntary or involuntary, this Bond shall mature and become due and payable immediately. There is no recourse for payment of the principal or interest of this Bond or for any claim based on this Bond against any officer, director, or shareholder as shareholder, past, present, or future, of the Corporation, either directly or through the Corporation, by virtue of any statute or constitutional provision or by enforcement of any assessment or otherwise. All such liability is expressly waived and released by acceptance of this Bond. In accordance with the terms of the Indenture , this Bond is not transferable except by the registered owner in person or by his or her authorized attorney at the office of the Corporation set forth above. Dated: _______________________________ (date of execution)___________________________________(Name of Corporation) By: ________________________________ (Printed or typed name) ________________________________________________________________________ (Name and Office in Corporation) (Corporate seal)