Farm Credit Services of America : Request Informaion

Stockholder Information Request

Asterisk (*) denotes required field.

1. Name:

TITLE
FIRST NAME *
M.I.
LAST NAME *

2. Address:

STREET ADDRESS *

STREET ADDRESS (add'l)

CITY *
STATE *
ZIP *

COUNTRY *

3. Contact Instructions:

Indicate how you wish to be contacted:

Call me during the daytime.
DAYTIME PHONE NUMBER
xxx-xxx-xxxx

Call me during the evening.
EVENING PHONE NUMBER
xxx-xxx-xxxx

Email me.
E-MAIL ADDRESS *

Send information by:
E-mail
U.S. Postal Service

4. Requested Information:

Farm Credit Services of America stockholders may request information identified below.

Select all items you wish to receive: Farm Credit Services of America Annual Report
Farm Credit Services of America Quarterly Financial Report
AgriBank, FCB Annual Report
AgriBank, FCB Quarterly Financial Report
Farm Credit Services of America Bylaws
Farm Credit Services of America Charter
Farm Credit Services of America Articles of Incorporation
By submiting this request, I hereby certify that I am a customer of
Farm Credit Servcies of America. This information will be
verified prior to sending information requested.

5. Stockholder Lists:
In addition to the items listed above, stockholders may request a stockholder list for permissible purposes as defined by Farm Credit Administration regulations.

Please send me more information on the permissible purposes for use of a stockholder list.

6. Other Information:
Please indicate any information requests not listed above or submit additional comments here:

Submit Your Request For security purposes please type the letters/characters exactly as they appear above and click the Submit button to send your request. This step helps block automated programs from sending erroneous requests to our company and to ensure that your request is received. Thank you!

*

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