PNC The PNC Financial Services Group Computershare Trust Company, N.A. PO Box 43078 Providence RI 02940-3078 Within the US, Canada & Puerto Rico800 982 7652 Outside the US, Canada & Puerto Rico312 360 5235 www.computershare.com Name Address City, State, Zip Holder Account Number Use a black pen. Print in CAPITAL letters inside the grey areas as shown in this example. Dividend Reinvestment Plan Enrollment Form Please refer to the plan prospectus or brochure before enrolling. (If you do not want to enroll in the plan and you want to receive all your dividends in cash you do not need to complete this form.) Type of security held for dividends to be reinvested. Please mark all boxes that apply. Common Series A Preferred Preferred Series C Preferred Series D Preferred Full Dividend Reinvestment: Please mark this box if you wish to reinvest all dividends that become payable on this account, on all stock now held or any future holdings, including optional cash purchases. Partial Dividend Reinvestment by Shares: Please mark this box and specify the number of whole shares on which you wish to have dividends reinvested. The dividends on all remaining shares or any future holdings, including optional cash purchases, will be paid in cash. Partial Dividend Reinvestment by Percentage of Shares: Please mark this box and specify the percentage of shares on which you wish to have dividends reinvested. The dividends on the remaining percentage of shares will be paid in cash. Partial Dividends Paid in Cash Please mark this box and specify the number of whole shares on which you wish to receive dividend payments in cash. The dividends on all remaining shares or any future holdings, will be reinvested. By participating in the plan, I agree to be bound by the terms and conditions of the prospectus or brochure that governs the plan. I have read and fully understand the terms and conditions of the prospectus or brochure. I further agree that my participation in the plan will continue until I notify Computershare Trust Company, N.A. in writing that I desire to terminate my participation in the plan. Upon providing such notification, I acknowledge that my withdrawal from the plan will be subject to the terms a nd conditions of the prospectus or brochure that governs the plan. Enrollment forms will be processed within 5 business days of receipt. Confirmation of enrollment will not be mailed; however, a transaction statement will be mailed once there is activity in your account. If you would like to confirm your enrollment in the plan, please call us at the above referenced telephone number. To be valid, this form must be signed by all registered shareholders. If you do not sign and return this form, you will continue to receive dividend payments in cash. Signature 1 Please keep signature within the boxSignature 2 Please keep signature within the boxDate (mm/dd/yyyy) Daytime Telephone Number Please return completed form to:Computershare PO Box 43078 Providence RI 02940-3078 |