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<br />TexSTAR~ <br /> <br />ADDITION/DELETION FORM FOR AUTHORIZED REPRESENTATIVES <br /> <br />PART IV: PRIMARY CONTACT - If the Primary Contact on file with TexSTAR was deleted in Part I <br />of this form, please provide the name of the Authorized Representative that will be the Primary <br />Contact. The Primary Contact is the individual who will receive the daily transaction confirmations, <br />monthly statements, monthly newsletter, TexSTAR Updates and other TexSTAR mailings. [required] <br /> <br />Name: <br /> <br />Email Address: <br /> <br />Phone Number: <br /> <br />PART V: INQUIRY ONLY - If an Inquiry Only Representative was deleted in Part I and you wish to <br />replace this representative or add an inquiry only representative to your TexSTAR account for the <br />first time, please list this individual below. This limited representative cannot make deposits or <br />withdrawals or sign Bank Information Sheets. [optional] <br /> <br />PRINTED NAME TITLE SIGNATURE <br /> <br />If you have any questions regarding this form or the Authorized Representatives currently <br />on file with TexSTAR for your entity, please contact TexSTAR Participant Services <br />at 1-800-839-7827. <br /> <br />Page 2 <br />