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