Computershare Transfer Request – Fill Out and Use This PDF

Section 1 is the CURRENT ACCOUNT TYPE, the account you are transferring shares out of. For Non-Custodial Registrations, complete section 2. For Custodial Registrations, the Custodian completes section 3 on the reverse page.

In section 2, enter the Current Holder Information as it appears on your account statement and the Current Tax ID / SSN on Account (do not use hyphens).

Enter the Telephone Number (do not use hyphens).

Enter the Name(s) / Registration on Current Account, including ALL names/entities listed on account.

Enter the Current Street Address, Apt. / Unit Number, City, Zip Code and State.

In section 3, the Custodian registered to the current account (that you are transferring shares out of) must provide and/or verify the Name of Custodian, the Name(s) / Registration on Current Account and the Current Street Address. The Custodian also enters the Custodian Account Number/Investor ID at Custodian, the Custodian Taxpayer ID Number (do not use hyphens) and the Custodian Telephone Number (do not use hyphens).

In section 4, check the applicable purpose of the transfer for shares acquired after 12/31/10. Check ONLY ONE box. If you check more than one box, your transfer will be treated as if you had not made any selection.

Private Sale: enter the Date of Sale and, if Private Sale, the Cost Per Share in Dollars.

Gift: enter the Date of Gift.

Inheritance: enter the Date of Death and, if Inheritance, the Value Per Share in Dollars.

No Change of Ownership: please specify.

If this section is not fully completed, all transfers will be treated as Gifts, unless documentation that this is a decedent transfer (i.e. Affidavit of Domicile) is received, in which case the transfer will be treated as an inheritance.

In section 5, A is Transfer All Securities and B is Transfer Shares As Instructed Below. If box B is checked, complete the Security Description/Share Type details.

Enter the Security Description / Share Type (ex: Common, Preferred, etc) and the number of whole and / or fractional shares to transfer, if applicable, or check Transfer All.

In section 6, the undersigned irrevocably constitute and appoint Computershare as attorney to transfer the said stock, as the case may be, on the books of said Company, with full power of substitution in the premises.

The signature(s) on this Transfer Request form must correspond exactly with the name(s) as shown upon the face of the stock certificate or a Computershare-issued statement for book-entry shares, without alteration or enlargement or any change whatever.

Signature(s) must be stamped with a Medallion Signature Guarantee by a qualified financial institution, such as a commercial bank, savings bank, savings and loan, U.S. stockbroker and security dealer, or credit union, that is participating in an approved Medallion Signature Guarantee Program (A NOTARY SEAL IS NOT ACCEPTABLE).

All Current Holders or Legal Representative(s) sign under Signature of all Current Holders or Legal Representative(s) and enter the Date (mm / dd / yyyy).

A Current Custodian signs under Signature of Current Custodian, and a Medallion Guarantee Stamp is required for the Current Custodian (Notary Seal Is Not Acceptable).

Section 7 is the NEW ACCOUNT TYPE, the account you are transferring shares to. Complete section 8 for Non-Custodial Registrations. Section 9, on the reverse page, is for the Custodian of Custodial Registrations.

Estate: include Executor Name, and provide Estate EIN on Form W-9.

Trust: include Trustee Names, Trust Name, and Trust Agreement Date.

Transfer on Death (“TOD”): only 1 TOD beneficiary may be registered per account. List the TOD beneficiary name.

Custodial for Minors Act: enter the State of.

Enter the Name of Individual / Entity / Trustee / Executor / Other and the Name of Joint Holder / Minor / Co-Trustee / TOD Beneficiary / Other (if applicable).

Enter the Trust / Estate Name (if applicable), the Trust / Estate Name - continued and the Trust Agreement Date (mm / dd / yyyy) (if applicable).

Enter the Current Street Address, Apt. / Unit Number, City, Zip Code, State and E-mail Address.

Section 9 is the New Account Type (account you are transferring shares to): Custodial Registrations, with the New Custodial Registration Type.

Enter the Name of Custodian and the Beneficial Holder for New Account, including ALL names/entities listed on account.

Enter the Current Street Address, Apt. / Unit Number, City, Zip Code, State, Custodian E-mail Address, Custodian Account Number / Investor ID at Custodian and Custodian Telephone Number (do not use hyphens).

The New Custodian signs under Signature of New Custodian and enters the Date (mm / dd / yyyy), and a Medallion Guarantee Stamp is required for the New Custodian (Notary Seal Is Not Acceptable).

In section 10, enter the Bank Routing Number, a nine-digit number, and the Bank Account Number. Account numbers vary in length and must not include check numbers.

DO NOT USE YOUR CREDIT CARD NUMBER. Please DO NOT provide a check number.

Mark Checking Account or Savings Account, then enter the Name(s) that appear on the account at your financial institution and the Name of Financial Institution.

All registered holders as well as all individuals listed on the financial account must sign in Signature 1 and Signature 2 with the Date (mm / dd / yyyy) and the Telephone Number (do not use hyphens).

Section 12 is Form W-9. Enter the TIN for the new Holder or new Custodian in the appropriate box, as a Social Security Number or an Employer Identification Number (do not use hyphens). For individuals, this is your Social Security number (SSN). For other entities, it is your Employer Identification Number (EIN). COMPLETE ONLY ONE BOX.

For joint tenant accounts, the TIN provided must belong to the first owner on the registration to avoid backup withholding.

Under B. Federal Tax Classification, check appropriate box (required); check only ONE of the following boxes.

Under B. Federal Tax Classification, if you are an LLC or Other Classification, do not complete this form. You must complete an IRS Form W-9. This form can be found on the IRS website at www.irs.gov.

Under C. Exempt Payee Code (if any), if you are exempt from backup withholding, enter in the Exemptions box any code that may apply to you. Enter the Exemption from FATCA reporting code (if any), or Not Applicable.

If you are exempt from backup withholding, you should still complete this form to avoid possible erroneous backup withholding.

You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return.

This form must be signed and dated to be accepted as proper certification. Keep the signature within the box. Enter the Date (mm / dd / yyyy) and the Telephone Number (do not use hyphens).

Send form to Computershare. Do not send to the IRS. Computershare, PO Box 505013, Louisville, KY 40233-5013.

Failure to supply your TIN, or supplying an incorrect TIN, could result in a $50.00 penalty being assessed by the IRS (checked November 9, 2026).