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Page 1 of 12 MF1002 Ed. 4/2011 Prudential Mutual Fund Services LLC (PMFS) a Prudential Financial company Instructions Use this form if you are re-registering your non-IRA mutual fund account. In cases of death, we request an Affidavit of Domicile. An Inheritance Tax Waiver may also be required, depending on the decedent's state of residence. This form cannot be used to transfer shares from or to a qualified, employer sponsored retirement plan, tax-deferred retirement plan or account. Please print clearly, preferably in capital letters and black ink. Return completed application to Prudential Mutual Fund Services LLC. USA Patriot Act requirements – To help the government fight the funding of terrorism and money laundering activities, Prudential Financial is required to obtain, verify, and record information on each person who opens an account. Important – The following information is required for each person associated with the account: Name Residence address (may not be a PO Box) Date of birth Taxpayer identification number (SSN or EIN) If this information is not provided, we will be unable to open the account. If we are unable to verify your identity, Prudential Financial reserves the right to close your account or take other steps we deem reasonable. Request to Change Registration Instructions Non-IRAs only For assistance: Clients (800) 225-1852 Pruco representatives (800) 542-7117 Financial professionals (888) 778-5471 2 Re- registration Information Transfer shares from the below referenced fund and account number(s) into a new account registered according to the instructions in section 3. Check one: all shares shares % $ Check one: all shares shares % $ Fund number Account number 1 Existing Account Information (Print account information exactly as it appears on your account statement.) Name of owner (first, middle initial, last name) Home telephone number Daytime telephone number Extension City State ZIP code Street Apt. For joint tenancy, custodianship, trust or other forms of legal registration, use all lines, if needed. Fund number Account number Mailing Instructions Standard Prudential Mutual Fund Services LLC mail to: PO Box 9658 Providence, RI 02940 Overnight Prudential Mutual Fund Services LLC mail to: 4400 Computer Drive Westborough, MA 01581 E-mail address (optional)

Request to Change Registration Instructions - prudential.com€¦ · sheet using the same format as in section 3. For individual accounts only, you may choose to designate a beneficiary

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Page 1 of 12MF1002 Ed. 4/2011

Prudential Mutual Fund Services LLC (PMFS)a Prudential Financial company

Instructions Use this form if you are re-registering your non-IRA mutual fund account. In cases of death, we request anAffidavit of Domicile. An Inheritance Tax Waiver may also be required, depending on the decedent's state ofresidence. This form cannot be used to transfer shares from or to a qualified, employer sponsored retirementplan, tax-deferred retirement plan or account.

Please print clearly, preferably in capital letters and black ink. Return completed application to PrudentialMutual Fund Services LLC.

USA Patriot Act requirements – To help the government fight the funding of terrorism and money launderingactivities, Prudential Financial is required to obtain, verify, and record information on each person whoopens an account.

Important – The following information is required for each person associated with the account:

• Name • Residence address (may not be a PO Box) • Date of birth • Taxpayer identification number (SSN or EIN)

If this information is not provided, we will be unable to open the account. If we are unable to verify youridentity, Prudential Financial reserves the right to close your account or take other steps we deem reasonable.

Request to Change Registration InstructionsNon-IRAs only

For assistance: Clients (800) 225-1852

Pruco representatives (800) 542-7117Financial professionals (888) 778-5471

2 Re-registrationInformation

Transfer shares from the below referenced fund and account number(s) into a new account registeredaccording to the instructions in section 3.

Check one: � all shares � shares� % � $

Check one: � all shares � shares� % � $

Fund number Account number

1 ExistingAccountInformation(Print accountinformationexactly as itappears onyour accountstatement.)

Name of owner (first, middle initial, last name)

Home telephone number Daytime telephone number Extension

City State ZIP code

Street Apt.

For joint tenancy, custodianship, trust or other forms of legal registration, use all lines, if needed.

Fund number Account number

MailingInstructions

Standard Prudential Mutual Fund Services LLCmail to: PO Box 9658

Providence, RI 02940

Overnight Prudential Mutual Fund Services LLCmail to: 4400 Computer Drive

Westborough, MA 01581

E-mail address (optional)

Page 2 of 12MF1002 Ed. 4/2011

� Trust – We require that you include a copy of the pages in your trust agreement that show the name of thetrust, the trust date, and a listing of all trustees and their signatures. Provide trustee name(s) in section 5.

� Social Security number* or � EIN

Name of trust as it appears on trust document

For the benefit of*

*If you provide a Social Security number, you must also provide the name of the beneficial owner.Complete section 4. Skip section 5.

Is it tax exempt?

� Yes � No

Date of trust (mo., day, year)

Organization type (Select one.)

� Corporation � Nontaxable organization � Taxable organization� Partnership � Sole proprietorship* � Estate

� Other� Social Security number* or � Employer identification number

� Uniform Gifts/Transfer to Minors Act

Name of custodian (first, middle initial, last name)

Name of minor (first, middle initial, last name)

Minor’s Social Security numberCustodian’s Social Security number

State in which gift/transfer was made

3 NewAccountRegistrationInformation(Please chooseone type.)

If you choose Individual, Joint, or Uniform Gifts/Transfers to Minors Act, complete the appropriate sectionbelow and then go to section 4.

� Individual� Joint (If more than one owner, “joint tenants with rights of survivorship” is assumed unless otherwise specified.)

AdditionalOwners

Transfer on Death

Owner: First name MI Last name

Social Security number (required for tax reporting)

Joint Owner: First name MI Last name

If there are more than two account owners, include the information for each account owner on a separatesheet using the same format as in section 3.

For individual accounts only, you may choose to designate a beneficiary under a Transfer on Death (TOD)Plan. To setup as part of your new account, complete the Transfer on Death (TOD) Consent form (PMFS296).

(continued)

Name of organization/plan as it appears on organization/plan document

*A Social Security number would only be used if Sole Proprietorship is selected as organization type.Complete section 4. Skip section 5.

Page 3 of 12MF1002 Ed. 4/2011

4 NewAccountMailingAddress(Should bemain addresson theaccount.)

Name of additional contact person

City State ZIP code

Street Apt.

Additional contact person’s telephone number Extension

5 NewPrimaryAccountOwnerInformation(This sectionshould becompleted bya primaryaccountowner on anindividual,joint, orUniformGifts/Transfersto Minors Actaccount.)

Name

Home telephone number Daytime telephone number Extension

City State ZIP code

Residence or legal address (if different than mailing address)

The information below must be the same as in section 3 of the New Account Registration Information section.

Date of birth (mo., day, year)

Citizenship� U.S. person � I am not a U.S. person (including resident alien). I am a citizen of� Resident alien

*Nonresident aliens must attach the applicable Internal Revenue Service (IRS) Form W-8(BEN, ECI, EXP,IMY), which can be obtained at www.irs.gov. Also, nonresident aliens must cross out item 3 in section 17.

Employment Status � Employed � Unemployed � Retired � Prudential employee

Occupation

Employer

Street

Highest education level achieved

� Post graduate work � College graduate � Attended college� High school graduate � Attended primary/high school � Technical or vocational school

Associated member of a broker/dealer � Yes � No

Page 4 of 12MF1002 Ed. 4/2011

6 FirstAdditionalAccountOwnerInformation(This sectionshould becompleted byjoint owner,trustee,administrator/executor,appointeeunder POA,conservator/guardian,custodian, orother.)

Name

Home telephone number Daytime telephone number Extension

City State ZIP code

Street

I am a(n):

� Joint owner � Trustee � Administrator/Executor � Appointee under POA� Conservator/Guardian � Custodian � Other

Date of birth (mo., day, year)

� Social Security number or � Tax identification number

Residence or legal address (if different than mailing address above)

Citizenship

� U.S. person � I am not a U.S. person (including resident alien). I am a citizen of� Resident alien

*Nonresident aliens must attach the applicable Internal Revenue Service (IRS) Form W-8(BEN, ECI, EXP,IMY), which can be obtained at www.irs.gov. Also, nonresident aliens must cross out item 3 in section 17.

Non U.S. citizens must provide valid government-issued proof of identity, if you have not provided your taxidentification number.

Identification (ID) type

� Passport Number Expiration date Issuing country � U.S. Visa Number Expiration date Issuing country � U.S. Alien ID Card Number Expiration date Issuing country

Employment Status � Employed � Unemployed � Retired � Prudential employee

Highest education level achieved

� Post graduate work � College graduate � Attended college� High school graduate � Attended primary/high school � Technical or vocational school

Associated member of a broker/dealer � Yes � No

Occupation

Employer

Page 5 of 12MF1002 Ed. 4/2011

7 NewSecondAdditionalAccountOwnerInformation(This sectionshould becompletedonly if there is a third jointowner or co-trustee.)

Name

Home telephone number Daytime telephone number Extension

City State ZIP code

Residence or legal address (if different than mailing address)Street

I am a(n):

� Joint owner � Trustee

Date of birth (mo., day, year)

� Social Security number or � Tax identification number

Citizenship

� U.S. person � I am not a U.S. person (including resident alien). I am a citizen of� Resident alien

*Nonresident aliens must attach the applicable Internal Revenue Service (IRS) Form W-8(BEN, ECI, EXP,IMY), which can be obtained at www.irs.gov. Also, nonresident aliens must cross out item 3 in section 17.

Non U.S. citizens must provide valid government-issued proof of identity, if you have not provided your taxidentification number.

Identification (ID) type

� Passport Number Expiration date Issuing country � U.S. Visa Number Expiration date Issuing country � U.S. Alien ID Card Number Expiration date Issuing country

Employment Status � Employed � Unemployed � Retired � Prudential employee

Highest education level achieved

� Post graduate work � College graduate � Attended college� High school graduate � Attended primary/high school � Technical or vocational school

Associated member of a broker/dealer � Yes � No

Occupation

Employer

Page 6 of 12MF1002 Ed. 4/2011

10 Telephone/OnlineExchangeandRedemptionOption

Your account will automatically be coded with the Telephone/Online Redemption and the Telephone/OnlineExchange Privileges, unless you check the “No” box below.

� I do not want telephone exchange and redemption privileges.

Unless otherwise indicated above, you authorize the Fund’s distributor, Prudential Investment ManagementServices LLC (PIMS), to accept telephone exchange and redemption instructions from any personidentifying himself/herself as the owner of the account or as the owner’s dealer representative conveyinginstructions of the owner. PIMS and/or the Fund’s transfer agent, Prudential Mutual Fund Services LLC(PMFS), will employ reasonable procedures to confirm that such telephone instructions are genuine.Neither the Funds, PIMS nor PMFS shall be liable for any losses due to unauthorized or fraudulentinstructions provided that such procedures are followed. Telephone exchanges and redemptions aresubject to the procedures and conditions set forth in each Fund’s prospectus.

11 ExpeditedRedemptionPrivilege

Please complete the banking information in section 13 to establish the Expedited Redemption Privilege. Ifyou do not want this privilege, check the box below.

� I do not want this privilege.

9 Dividendand CapitalGainDistributionOptions � Reinvest in shares � Pay in cash � Send electronically to the bank specified in section 13.

Dividends:

� Reinvest in shares � Pay in cash � Send electronically to the bank specified in section 13.Capital gains:

� Check here if establishing the Rights of Accumulation privilege. Please refer to the Fund's prospectusand Statement of Additional Information to learn more about accounts that may be eligible for thisprivilege. If you would like to link any eligible accounts, please indicate the account numbers below.Note: You can only link accounts that are held directly with the Transfer Agent.

Account number Account owner name Relationship to you

8 Rights ofAccumu-lation

Please note distributions of dividends or capital gains of $10.00 or less will not be paid out in cash, but willbe automatically reinvested into your account to purchase additional shares at Net Asset Value (NAV),without any sales charge.

Page 7 of 12MF1002 Ed. 4/2011

12 PurchasePrivileges(Pleasecompletesection 13 and attach avoided check.)

Please select one or both of the options below.

� Automated Clearing House (ACH) Purchase Plan: Check here if you want the capability to purchaseonline or by telephone upon demand from your bank account.

13 Bank ofRecord

Bank/Credit union name

Bank telephone number Bank routing number Bank account number

*To ensure accuracy, verify with your bank or credit union. Bank type:Name of depositor on bank records (first, middle initial, last name) � Checking � Savings

Name of joint depositor on bank records (first, middle initial, last name)

Attach voidedcheck here.

Name on bank account Check no. 1234

Street address

City, State ZIP

DATE

PAY TO THE ORDER OF $

DOLLARS

FOR _________________________________

555555 55555 1234123456789

ABA number (9 digits)

VOIDBank account number

Fund name Share class (A, B, C) Fund number Periodic purchase amount

$ , .

$ , .

$ , .

$ , .

$ , .

Total periodic debit amount

Select one option: � Add AIP � Change AIPFrequency (The minimum investment amount is $50 per fund.) : � Weekly on __________(enter day of week e.g. Monday)� Monthly on the __________(enter a day of the month e.g. 15th)

Starting date* (mo./day/yr) : *If a specific day of the month is not listed, debits will be made on or about the 15th of the month.

Page 8 of 12MF1002 Ed. 4/2011

(continued)

15 NewAccountOwner(s)InvestmentProfile

Complete this entire section only if you are a customer of a PMFS registered representative of PrucoSecurities. This section helps determine whether the investments you have selected are appropriate,given your financial objectives.

• Annual Income. Owner’s income from all sources, before taxes.• Household Income. Income from all sources, before taxes, from all members of the household

contributing income.• Net Worth. The amount by which assets exceed liabilities. For an individual, it would be the total value of

all possessions such as a house, stocks, bonds, and bank accounts, minus all outstanding debts such asa mortgage, loans, and credit card balances.

• Liquid Net Worth. That part of a person’s net worth held in cash or easily convertible to cash, such asmoney market fund shares, bank deposits, mutual funds or other marketable securities.

Risk ToleranceYour risk tolerance is your comfort level to withstand risk with respect to investments (e.g., the potential toabsorb losses in your investments). For example, an investor whose risk tolerance is conservative seekssecurities that are most likely to preserve principal with low risk, while an investor with an aggressive risktolerance is willing to accept a high degree of risk regarding loss of principal.

• Conservative. Prefer little risk and low volatility in return for accepting potentially lower returns.Minimizing exposure of principal to loss or fluctuation is very important.

• Moderately Conservative. Willing to take some risk to seek enhanced returns. Reduced exposure ofprincipal to loss or fluctuation is important.

• Moderate. Willing to assume an average amount of market risk and volatility or loss of principal toachieve potentially higher returns.

• Moderately Aggressive. Willing to assume an above-average amount of risk and volatility or loss ofprincipal to take advantage of potentially higher return opportunities.

• Aggressive. Willing to sustain substantial volatility or loss of principal and assume a high level of risk inpursuing potentially higher returns.

14 e-Deliveryand MailingPreferences*

Why wait for the mail if you can get your account statements, confirmations, prospectuses, and fundreports faster by signing up for e-Delivery? By registering for this convenient and environmentally-friendlyservice, you will receive your Prudential mutual fund documents online instead of in the mail. As newdocuments become available, you will receive an e-mail informing you of the new documents andinstructions on how to view them online. You may change your e-mail address or cancel participation atany time by updating your mailing preferences. Note: Certain entity and institutional accounts are noteligible for e-Delivery.

Account Statements: � e-Delivery � U.S. mail � e-Delivery and mail year-end statementConfirmations: � e-Delivery � U.S. mailProspectus, Fund Reports, and Proxy Mailings: � e-Delivery � U.S. mail

*All documents will be sent to you by U.S. Mail if you do not make a selection.

By enrolling for e-Delivery, you consent to receive online versions rather than paper copies of materials foryour mutual fund accounts at Prudential Mutual Fund Services LLC (PMFS). Once your account isestablished, PMFS will contact you by e-mail with instructions to complete the online enrollment processand to log in to our website. We will only use your e-mail address to provide you with the material yourequested or to send important news about your account.

E-mail address for e-Delivery

Page 9 of 12MF1002 Ed. 4/2011

15 NewAccountOwner(s)InvestmentProfile(continued)

Years of Investment Experience (Indicate number of years of experience in any of the following that apply.)

Equities Bonds Options

Futures Mutual Funds Variable Annuity/Life None

Ranges Annual Household Net Liquidincome income worth net worth

Up to $24,999. . . . . . . . . . . . . . . � . . . . . . . . . . . . �. . . . . . . . . . . �. . . . . . . . . . . . �

$25,000 – $49,999 . . . . . . . . . . . � . . . . . . . . . . . . �. . . . . . . . . . . �. . . . . . . . . . . . �$50,000 – $74,999 . . . . . . . . . . . � . . . . . . . . . . . . �. . . . . . . . . . . �. . . . . . . . . . . . �

$75,000 – $99,999 . . . . . . . . . . . � . . . . . . . . . . . . �. . . . . . . . . . . �. . . . . . . . . . . . �$100,000 – $149,999 . . . . . . . . . � . . . . . . . . . . . . �. . . . . . . . . . . �. . . . . . . . . . . . �

$150,000 – $249,999 . . . . . . . . . � . . . . . . . . . . . . �. . . . . . . . . . . �. . . . . . . . . . . . �$250,000 – $499,999 . . . . . . . . . � . . . . . . . . . . . . �. . . . . . . . . . . �. . . . . . . . . . . . �

$500,000 – $749,999 . . . . . . . . . � . . . . . . . . . . . . �. . . . . . . . . . . �. . . . . . . . . . . . �$750,000 – $999,999 . . . . . . . . . � . . . . . . . . . . . . �. . . . . . . . . . . �. . . . . . . . . . . . �

$1,000,000 – $2,499,999 . . . . . . � . . . . . . . . . . . . �. . . . . . . . . . . �. . . . . . . . . . . . �$2,500,000 – $4,999,999 . . . . . . � . . . . . . . . . . . . �. . . . . . . . . . . �. . . . . . . . . . . . �

$5,000,000 – $9,999,999 . . . . . . � . . . . . . . . . . . . �. . . . . . . . . . . �. . . . . . . . . . . . �$10,000,000 – $24,999,999 . . . . � . . . . . . . . . . . . �. . . . . . . . . . . �. . . . . . . . . . . . �

$25,000,000 or more . . . . . . . . . � . . . . . . . . . . . . �. . . . . . . . . . . �. . . . . . . . . . . . �

Fund Holding Years (Indicate number of years you intend to hold your mutual fund.) _________

Were the mutual fund selections based on an investment allocation pursuant to a company-approved assetallocation model?

� Yes � No

Investment ObjectivesYour investment objective is how you seek to have your investments achieve your financial goals. Forexample, a person who chooses growth as a primary investment objective is seeking growth of principalrather than generation of income.

• Preservation of Capital. Seeks to preserve the value of your investments through all market conditionswith a preference for holding cash and/or cash equivalents (e.g., money market funds, CDs, Treasurysecurities with maturities of one year or less).

• Income. Seeks to earn income through holdings of bonds and/or income-yielding securities.• Tax-Free Income. Predominantly seeks to earn income free from income taxes.• Growth. Seeks to achieve growth of capital through investment in securities.• Short-Term Gain. Emphasis on short-term trading practices to capitalize on market fluctuations. This

objective is associated with higher-than-normal market risk.• Speculation. Emphasis on aggressive investments that assume above-average market risk with hope of

achieving commensurate gains. • Diversified. Investment options selected conform with recommendations of company-approved Asset

Allocation Model.

(continued)

Page 10 of 12MF1002 Ed. 4/2011

15 InvestmentProfile(continued)

RiskTolerance

Were the mutual fund selections based on an investment allocation pursuant to a company-approved assetallocation model?

� Yes � No

Check one:

� Conservative � Moderately conservative � Moderate� Moderately aggressive � Aggressive

InvestmentObjective(s)

Select up to two objectives. Indicate your primary investment objective below by checking the appropriatebox in the Primary Investment Objective column. Note: a primary investment objective must be selected.An optional secondary investment objective may be selected by checking the appropriate box in theSecondary Investment Objective column.

Primary Investment Objective Secondary Investment Objective (optional)� Preservation of capital � Preservation of Capital� Income � Income� Tax-free income � Tax-free income� Growth � Growth� Short-term gain � Short-term gain� Speculation � Speculation� Diversified � Diversified

InvestmentFunding

I will pay for my initial investment through my� CDs/Liquid assets savings � Mutual funds � Annuities� Life insurance (If selected, please specify death proceeds,

dividends, cash value, etc.) � Other

Tentatively, I plan on making additional investments. During thefirst year, my total additional first year investments planned are $

I will pay for these additional first year investments through my� CDs/Liquid assets savings � Mutual funds � Annuities� Life insurance (If selected, please specify death proceeds,

dividends, cash value, etc.) � Other

Page 11 of 12MF1002 Ed. 4/2011

Under the penalties of perjury, I certify that:

1. The number shown on this form is my correct taxpayer identification number (or I am waiting for anumber to be issued to me),

2. I am not subject to backup withholding because: a) I am exempt from backup withholding, or b) I havenot been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as aresult of a failure to report all interest or dividends, or c) the IRS has notified me that I am no longersubject to backup withholding, and

3. I am a U.S. person (including a U.S. resident alien).

You must cross out item 2 above if you have been notified by the IRS that you are currently subject tobackup withholding because of underreporting interest or dividends on your tax return. You must crossout item 3 above if you are not a U.S. person (including a U.S. resident alien.)

17 New AccountOwner(s)Signature(s)and TaxCertification

The undersigned warrants that I have full authority and, if a natural person, I am of legal age to own andpurchase shares pursuant to this form. Further, I acknowledge receipt of the Prospectus(es) for the mutualfund(s) referenced herein, and I agree to its/their terms.

16 CurrentAccountOwner(s)AuthorizationandSignatureGuarantee

A medallion signature guarantee is required if the dollar value of the shares that you are re-registering is over$10,000. If the re-registration of shares is on a Uniform Gifts/Transfer to Minors Act (UGMA/UTMA) Accountor due to the death of an account owner, you are required to have your signature medallion signatureguaranteed regardless of the dollar amount.

The medallion signature guarantee may be obtained from an authorized officer from a bank, broker, dealer,securities exchange or association, clearing agency, savings association, or credit union that is participatingin one of the recognized medallion programs (STAMP, SEMP, or NYSE MSP). The medallion signatureguarantee must be appropriate for the dollar amount of the transaction. Prudential Mutual Fund Services LLCreserves the right to reject transactions where the value of the transaction exceeds the value of the suretycoverage indicated on the medallion imprint.

PMFS is authorized to re-register my mutual fund shares in accordance with the instructions containedherein. Note: The new account owner(s) must sign in Section 17 to certify their tax identification number.

X____________________________________________________Signature of current account owner

X____________________________________________________Signature of current joint account owner (if applicable)

X____________________________________________________Authorized signature (e.g. trustee), if applicable

Important: If you are acting on behalf of the account owner, please indicate the capacity in which you areacting by checking the appropriate box below. If the correct box is not listed, please check “Other” andspecify your capacity.

� Administrator / Executor � Former Minor� Appointee under POA � Surviving Joint Owner� Conservator / Guardian � Trustee� Custodian � Other, please specify

Place medallion signature guarantee here

(continued)

month day year

month day year

month day year

Page 12 of 12MF1002 Ed. 4/2011

18 FinancialProfes-sional(s)IdentificationandSignature(s)(if applicable)

Name of financial professional #1 (first, middle initial, last name)

X____________________________________________________Signature of financial professional

Name of broker/dealer (Please print.) Broker/dealer number

Financial prof. #/ Branch office #/ Percent Office phone # Alternate phone #contract # Agency code

Name of financial professional #2 (first, middle initial, last name)

X____________________________________________________Signature of financial professional

Name of broker/dealer (Please print.) Broker/dealer number

Financial prof. #/ Branch office #/ Percent Office phone # Alternate phone #contract # Agency code

Your re-registered account will be automatically set up with the same financial professional unless the sectionbelow is completed. If you would like to make a change, please have your new financial professional completethe following section.

17 New AccountOwner(s)Signature(s)and TaxCertification(continued)

By signing below I certify that, if I have not provided my taxpayer identification number, I have applied for oneto be issued to me.To help the government fight the funding of terrorism and money laundering activities, Prudential Financial isrequired to obtain, verify, and record information on each person who opens an account. This verificationprocess will take place as we open your account. Once verification is complete, Prudential Financial will be ableto fully service and maintain the account.I consent to the “householded” delivery of any mutual fund prospectuses, shareholder reports, or proxystatements. This means Prudential Mutual Fund Services LLC (PMFS) will deliver a single copy of thesedocuments to shareholders who share an address, even if the accounts are registered in different names. Myparticipation in this program will continue indefinitely unless I contact PMFS. According to Federal law and/or state regulations, your account(s) may be subject to escheatment to your stateof residency. Escheatment may be based on account inactivity and/or mail being returned by the post office(RPO). Check with your state Controller’s office for additional guidance.� Account Restriction: Check here if you would like PMFS to establish a restricted account from which funds

shall be disbursed only upon receipt of a valid court order or other document(s), as appropriate. A copy of therestriction (court order or otherwise), signed and dated on ________________________ has been providedwith this mutual fund application. The restriction shall continue until PMFS receives a valid court order orother written instruction as directed by PMFS, expressly authorizing the removal of the restriction.

The IRS does not require your consent to any provisions of this document other than certification required to avoid backup withholding.

State of domicile*

*Domicile is defined as a person’s fixed, permanent, and principal home for legal purposes.

State where form is signed

X____________________________________________________Signature of new owner, custodian, or trustee

X____________________________________________________Signature of new joint owner (if applicable)

month day year

month day year