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Omnibus Acct Certification
Omnibus Acct Certification
You may return the form(s) to us by mail to Fidelity Investments, P.O. Box 770001, Cincinnati, OH 45277-0039.
If you have any questions, please call us at 1-800-544-4774, from 8:00 a.m. to 8:00 p.m. ET.
Street
City
)
State
Zip
DISCLOSURE:
As account owner, trustee or authorized person for this account, I hereby certify that the above information is accurate and correct as of the
indicated date.
AUTHORIZED SIGNATURE
X
ACCOUNT OWNER, TRUSTEE OR
AUTHORIZED PERSON
Date
Fidelity Investments is a registered trademark owned by FMR Corp. Accounts are carried with our affiliate,
National Financial Services LLC, a member of the New York Stock Exchange and other principal exchanges.
Fidelity Brokerage Services LLC, National Financial Services LLC, Members NYSE, SIPC
P.O. Box 770001, Cincinnati, OH 45277-0039
385111.2.0
1.807706.101
071863_06_Omnibus_Form.indd 1
NR-CERT-FM-0607
008890001
6/12/07 2:41:31 PM