The JOINT RETIREMENT BOARD for Conservative Judaism ONE PENN PLAZA, SUITE 1515, NEW YORK, NY 10119 Phone: (212) 947-2400 Toll-Free: (888) JRB-FREE Fax: (212) 947-1676 E-Mail: [email protected] Website: www.jrbcj.org Application for Investment in State of Israel Bonds May 2015 Purchase A signed and dated Application must be received by the JRB office no later than May 21, 2015. YOUR NAME AND ADDRESS NAME: HOME PHONE: ADDRESS: WORK PHONE: APPLICATION I hereby subscribe to purchase a 5-year State of Israel JUBILEE ISSUE BOND in the following amount: $2,500 $10,000 $17,500 $5,000 $12,500 $20,000 $7,500 $15,000 $22,500 $25,000 I have requested the prospectus or downloaded it from the Israel Bonds website www.israelbonds.com. HONORING PLEDGES To ensure that your JRB Israel Bond investment will be recorded to your personal State of Israel Bonds account and credited to your congregation’s campaign, please provide the following information: Local Israel Bonds Office: Check here if you do not have an existing Israel Bonds account. Name of Israel Bonds Representative: HOW THE BOND IS PURCHASED The Bond will be purchased on May 28, 2015 using the proceeds from your Stable Value Interest Fund. Please make sure sufficient assets are available in that Fund by the close of the market on Thursday, May 21. In the event of insufficient funds, the remainder of the purchase price will be taken proportionately from your other funds (excluding previouslypurchased Israel Bonds). If you wish to have the JRB staff transfer the assets to the Stable Value Interest Fund for you, please complete the next section. TRANSFER TO STABLE VALUE INTEREST FUND Complete this section ONLY if you do not already have sufficient assets in your Stable Value Interest Fund or you want to liquidate other investments to purchase an Israel Bond. To execute a transaction, your application must be received by 1:00 p.m. on May 21. I authorize the JRB to execute the following transfer to the Stable Value Interest Fund upon receipt of this Application. $ from Amount $ Fund Name from Amount $ Amount Fund Name from Fund Name AUTHORIZATION I hereby authorize the above Israel Bonds purchase. Also, if applicable, I hereby authorize the transfer to the Stable Value Interest Fund. Participant Signature Date
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