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Get SPECIAL FORM OF REQUEST FOR PAYMENT OF UNITED STATES

NGS AND RETIREMENT SECURITIES WHERE USE OF A DETACHED REQUEST IS AUTHORIZED OMB No. 1535-0004 FOR OFFICIAL USE ONLY TRANSFER MONTH & YEAR / FISCAL AGENT CODE 1. DESCRIPTION OF BONDS I am the owner or person entitled to payment of the securities described below, which bear the name(s) of . ISSUE DATE SERIAL NUMBER ISSUE DATE SERIAL NUMBER ISSUE DATE SERIAL NUMBER (If you need more space, use the continuation sheet on page 3.) 2. REQUEST FOR PAYMENT I request t.

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