First/Given Name Middle Name/Initial Last/Family Name Specimen Signature
SIGNATURE GUARANTEE Name of bank, financial institution or notary The undersigned herewith confirms the authenticity of the above specimen signature.
Official Stamp (Bank, Trust Company , or Member of The New York or American Stock Exchange)
(Please Print) Official’s Name:
_______________________
Official’s Signature:
_______________________
Official’s Title
_______________________
Date:
_______________________
The signature guarantee is applicable only to residents of the United States of America. Applicants from other countries must submit copies of the identification specified below endorsed by a notary public or equivalent agent.
IDENTIFICATION
Please forward photocopies of 2 pieces of identification. We recommend the documents to be a passport, birth certificate or driver's license.
