NOTE: Sign in front of signature guarantor if signature guarantee is required.
6
Signature(s)
A signature guarantee is required if:
• Distributions invested in differently owned account in Section 5.
• By signing this form, I authorize T. Rowe Price Services, Inc. (TRPS),
• Adding a bank account and the bank account owners differ in any
the Fund, and their agents to act on any instructions believed to be
way from the T. Rowe Price account owners, a signature guarantee is
genuine for any service authorized on this form, including computer/
required for all bank account owners and all mutual fund owners.
phone services. The Funds and TRPS use reasonable procedures to
verify the identity of the shareholder and the person(s) granted trading
Account Owner(s)
Sign Below
6A
privileges, if applicable, when servicing an account by computer/phone.
I understand that it is TRPS’s policy to accept transaction instructions
from and provide account information to the account owner(s) only,
Signature(s) and Date(s) Required
unless the account owner(s) has provided authorization to TRPS, in
Owner/Custodian/Trustee
Date (mm/dd/yyyy)
a form acceptable to TRPS, to grant trading privileges or to provide
(or permit access to) account information to another person. I further
- X
understand that it is my responsibility to monitor the activity in my
account and to not provide account information, including my online
Joint Owner/Trustee/POA Agent or Attorney-in-Fact
Date (mm/dd/yyyy)
user name and password, to anyone. TRPS, the Fund, and their agents
are not liable for any losses that may occur from acting on unauthor-
- X
ized instructions. Exchange proceeds may be invested in identically
owned accounts, or a redemption check, payable to the account
owner(s), can be mailed only to the address of record. All services are
Sign Below
6B Bank Account Owner(s)
subject to conditions set forth in each Fund’s prospectus.
• By adding bank information, I authorize TRPS to initiate credit and
debit entries to my account at the financial institution indicated and
All owners of the bank account in Section 3 who are not owners in
for the financial institution to credit or debit the same in such account
Section 1 must sign in the presence of a signature guarantor.
through the ACH network, subject to the rules of the financial institu-
Signature(s) and Date(s) Required
tion, ACH, and the Funds. TRPS may correct any transaction error
with a debit or credit to my financial institution account and/or Fund
Bank Account Owner
Date (mm/dd/yyyy)
account. This authorization, including any credit or debit entries initi-
ated thereunder, is in full force and effect until I notify TRPS of its
- X
revocation by telephone or in writing and TRPS has had sufficient time
to act on it.
Bank Account Owner
Date (mm/dd/yyyy)
Under penalties of perjury, I certify that:
- X
1. The number shown on this form is my correct taxpayer identifica-
tion number.
2. I am not subject to backup withholding because:
6C Signature Guarantee
a. I am exempt from backup withholding;
b. I have not been notified by the Internal Revenue Service (IRS)
You can obtain the Medallion signature guarantee from most banks,
that I am subject to backup withholding as a result of a failure
savings institutions, or broker-dealers. We cannot accept guarantees
to report all interest and dividends; or
from notaries public or non-Medallion guarantors. The level of coverage
c. The IRS has notified me that I am no longer subject to backup
provided by the guarantor’s stamp must cover the dollar amount of the
withholding.
transaction or it may be rejected.
Cross out this item 2 if you have been notified by the IRS that
you are currently subject to backup withholding.
Medallion Signature Guarantee—Place Medallion Stamp Below
3. I am a U.S. citizen or other U.S. person (as defined in the IRS
Form W-9 instructions).
4. The FATCA code(s) entered (if any) indicating that I am exempt
from FATCA reporting is correct. Exemption Code (if any):
FATCA codes only apply to accounts maintained outside the U.S.
by certain foreign financial institutions. For an account you hold
in the United States you may leave this field blank. For a list of
FATCA exemption codes and more information on FATCA please
visit
If I fail to give the correct number or fail to sign this form, T. Rowe Price
may reject, restrict, or redeem my account. I may also be subject to
backup withholding, and I may be subject to an IRS penalty.
The Internal Revenue Service does not require consent to any
provision of this document other than the certifications required to
avoid backup withholding.
FMF3SERV
Questions?
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