City Financial SecurityDEPARTMENT OF FINANCE
AND ADMINISTRATION
Rodney Franz, Director
300 West Ash, P.O. Box 736
Salina, Kansas 67402 -0736
March 5, 2012
Sunflower Bank, N.A.
Wealth Management Department
3025 Cortland Circle
P.O. Box 800
Salina, KS 67402 -0800
Cityof TELEPHONE (785) 309 -5735
FAX (785) 309 -5738
TDD (785) 309 -5747
E -MAIL rod.franz @salina.org
cc++•
Website: www.salina- ks.gov
Please accept this letter as direction to hold all City of Salina -owned securities currently held by Sunflower
Bank's Finance Department. The Finance Department will provide a list of current holdings owned by the
City of Salina.
Furthermore, all future security purchases authorized by the City of Salina through Sunflower Bank's Finance
Department are to be placed into safekeeping with the Wealth Management Department on the City's behalf.
This order will remain in effect until written notification has been provided by either party.
Res ectfully,
o Franz
City of Salina
300 W Ash Stre
Salina KS 67401- 335
Institutional
Client Account Agreement
Type: in Cash )(Delivery vs payment (DVP) ❑Otherr, i
Title: ❑ Trust n Corporation P
Other 1 y lV �f6 F1JA G rj
Buy Instructions: XSafekeep o Transfer and Ship o Hold in Street Name
Principal and Interest ❑ Credit to Account o Send cashier's check
Money Market Sweeps ❑ Yes —List Fund VNo
Sell Instructions: o Mail to Customer Credit to Account o Other
Dividends: Pay in Hold in Account o Other
❑ Check Box if any account holder is associated with an NASD firm, Bank, Fund, Insurance Company, or Securities Firm or
Investment Advisor
❑ Check box is any account holder is a director, officer or 10 %+ shareholder of a publicly traded company
❑ Check box if the account is for a Foreign Bank. If yes, list US Agent for service of process:
❑ Check box is any account holder has investment accounts elsewhere. Please indicate which funs:
Account Holders Information
Account Name (full legal title) C1'�pyd' ;5—,4
Physical Address: -36o &-i • t4,r l [/5S :.e o ^�
Mailing Address (if different from above) (( 1 • o, 9 6 K / 1f 4
City, State and Zip: 5 !a l eAG r (� % (� pLl o
Business Phone : 3�q— T1 35` Business Fax:'O r— 3101 38
Social Security Number or Tax Payer Identification Number: Ll O - bd / 2- 2 6
Financial Investment Background
Investment Objectives
Aow Risk Income % ❑ Aggressive Growth %
• High Yield Income % ❑ Speculation _%
• Growth _% o Tax Advantages
• Growth & Income _% o Other Risk
(Allocations are guidelines only, not mandatory.)
Previous Investment Experience (check all that apply)
Certificate of Deposits
(covered)
Stocks (small /growth) ❑
Variable Annuities ❑
Mutual Funds
Past Investment Experience:
Investment Experience ?,I'- years
Stocks and Stock Funds
Years of Experience
Number of trades per month per year
Type of Account Cash/Margin cish
$ Amount of Avg. Trade
Bond and Bond Funds
Years of Experience
Number of trades per month per year
Type of Account Cash(Margin cash
$ Amount of Avg. Trade
Stocks (large/growth)
Options (uncovered) ❑
Bonds ( hi-.peld/junk) ❑
Other / t-tbf. SeGurc4r.f
margin
margin
AA-...
Other (Please specify) C Off i—t enf or y Si e- .�A.ISr�f
Years of Experience •Z '
Number of trades per month per year e "
Type of Account Cash/Margin cash margin
$ Amount of Avg. Trade
Other Comments:
Options
Bonds (inv. Grade)
Partnerships
The undersigned acknowledges and warrants as follows: (I) that the undersigned has read all of the information provided by the
undersigned, or on the undersigned's behalf, and the information is accurate as of the date of their signature and; (2) the Suitability
Considerations located on page 3 have been read; are understood and agreed to by the undersigned.
Corpo to Si [ores:
x
Sunflower Bank Si lure:
Date
Please submit all paperwork to
Sunflower Bank, N.A.
Investment Department
Attu: Investment Officer
P.O. Box 800
Salina, KS 67402 -0800
Date 3 /?,-1 I u ( 7—
Risk Ratings and Likely Investment Objectives
Stable Lower Risk Income (Principal normally not subject to any significant market fluctuations) `I am comfortable
with investments where the principal doesn't fluctuate significantly." Examples include:
CD's T -Bills Fixed Annuities Life Insurance Governmental Agencies
Conservative Growth and Income (Accepting some principal fluctuation could provide higher income and growth potential.)
"I would invest in something that offered conservative income and growth and would accept some principal
fluctuation." Examples include:
Investment Grade Bonds Utilities
Mutual Funds, Variable Annuities, Variable Life Large Cap Stocks
Moderate Growth (Increased risk may increase the opportunity for higher returns, but also increases risk of loss.) "I am
willing to accept moderate fluctuation of my principal in exchange for a potentially higher retum" Examples
include:
Mutual Funds, Variable Annuities, Variable Life .
Non - Investment Grade Bonds
Mid Cap Stocks
International Stock/Bond Mutual Funds
Aggressive Aggressive Growth & High Yield Income ( Greater risk and volatility can create greater potential for gains or
losses.) "I would invest in something that offered the potential for great capital gains even though it meant
higher risk." Possible examples include:
Funds and Annuities International Stocks & Bonds
High yield bonds (Individual, Single Country, Single Sector)
Small Cap Stocks Public Partnerships
Speculative Speculation (High risk can produce substantial gains or losses.) `I would risk my entire investment for the
chance of substantial returns." Examples include:
Private Placements Commodities, Options
Tangibles High Leverage
Financial Futures Penny Stocks/Designated Securities
Rapid In -Out Trading ( "Day" Trading)
Suitability Considerations
Client acknowledges that he /she has read the Risk Rating & Likely Investment Objectives above, and
understands it. Client acknowledges that he/she has been advised, by this advertisement, that a prudent
Investor generally should not place more than 25% of their net worth (exclusive of home, home f imishings,
and automobiles) in limited partnerships or other aggressive or illiquid investments. Various exceptions may
apply.
Indiv� ual S� atures:
z Date (�-
x Date
INVESTMENT AGENT AGREEMENT
To Whom It May Concern:
City of Salina, Kansas of
Salina,
appoint you as my Agent to hold the property delivered to you for this account -
You are to act under the following instructions:
You are to provide safekeeping for this property.
You are to collect income on all investments and remit the net income, as I shall instruct you
from time to time.
You will render at least quarterly a principal and income report together with an itemized
inventory of the holdings.
You may receive compensation for your services in accordance with your Standard Charge
Schedules, in effect from time to time, and deduct it from the Account. Currently all safekeeping
fee's have been waived. If you charge for safekeeping, your current Standard Charge Schedule
will be provided to me at least 30 days prior to implementation.
This agreement may be modified by us in writing at any time subject to your approval, and may
be terminated by us or by you through written notice delivered to the other.
Very
Signature
SUNFLOWER BANK hereby agrees to act as Agent under this letter of instructions.
SUNFLOWER BANK
a
Form
W'9
Request for Taxpayer
Give Form to the
(Rev. December 2011)
Identification Number and Certification
requester. Do not
Department
of the Treasury
send to the IRS.
Internal
Revenue service
Name (as shown on your income tax return)
City of Salina, Kansas
N
Business name /disregarded entity name, if different from above
m
m
m
Check appropriate box for federal tax classification:
0
❑ Individual/sole proprietor ❑ C Corporation ❑ S Corporation ❑ Partnership ❑ Trust/estate
m c
a p
o
❑ Limited liability company. Enter the tax classification (C =C corporation, S =S corporation, P= partnership)►
❑� Exempt payee
0 2
-----------------------------
i `
0
❑� Other (see instructions) ► Political Subdivision of a State
-
Address (number, street, and apt. or suite no.)
Requester's name and address (optional)
$
300 W. Ash Street, P. O. Box
H
m
City, state, and ZIP code
n
Salina, Kansas
List account number(s) here (optional) -
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on the "Name" line
Social security number
to avoid backup withholding. For individuals, this is your social security number However, for a
resident alien, sole proprietor, or disregarded entity, see the Part I instructions on n page 3. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
TIN on page 3.
Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose
number to enter.
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and
2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding, and
3. 1 am a U.S. citizen or other U.S. person (defined below).
Certification instructions. 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. For real estate transactions, item 2 does not apply. For mortgage
interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and
generally, payments other than interesj,and dividends, you are not required to sign the certification, but you must provide your correct TIN. Seethe
instructions on page 4. n / \
H
Her e I U.S. person 10- / i/ jlltjol -eh
�
General Instructions
Section references are to the Internal Revenuea a unless
noted.
Purpose of Form
A person who is required to file an information return with the IRS must
obtain your correct taxpayer identification number (TIN) to report, for
example, income paid to you, real estate transactions, mortgage interest
you paid, acquisition or abandonment of secured property, cancellation
of debt, or contributions you made to an IRA.
Use Form W -9 only if you are a U.S. person (including a resident
alien), to provide your correct TIN to the person requesting it (the
requester) and, when applicable, to:
1. Certify that the TIN you are giving is correct (or you are waiting for a
number to be issued),
2. Certify that you are not subject to backup withholding, or
3. Claim exemption from backup withholding if you are a U.S. exempt
payee. If applicable, you are also certifying that as a U.S, person, your
allocable share of am, P partnershi income from a U S trade or business
Date► S /!-�/( Gam/
Note. If a requester gives you a form other than Form W -9 to request
your TIN, you must use the requester's form if it is substantially similar
to this Form W -9.
Definition of a U.S. person. For federal tax purposes, you are
considered a U.S. person if you are:
• An individual who is a U.S. citizen or U.S. resident alien,
• A partnership, corporation, company, or association created or
organized in the United States or under the laws of the United States,
• An estate (other than a foreign estate), or
• A domestic trust (as defined in Regulations section 301.7701 -7).
Special rules for partnerships. Partnerships that conduct a trade or
business in the United States are generally required to pay a withholding
tax on any foreign partners' share of income from such business.
Further, in certain cases where a Form W -9 has not been received, a
partnership is required to presume that a partner is a foreign person,
and pay the withholding tax. Therefore, if you are a U.S. person that is a
partner in a partnership conducting a trade or business in the United
States, provide Form W -9 to the partnership to establish your U.S.
status and avoid withholding on your share of partnership income.
is not subject to the withholding tax on foreign partners' share of
effectively connected income.
Cat. No. 10231X Form W-9 (Rev. 12 -2011)
STRATAWEB SET -UP FORM*
NX410IR►111iNENVAN
City of Salina, Kansas
ON -LINE USER INFORMATION
DATE OF ON -LINE USER REQUEST: 3/29/2012
FIRST NAME: Rod
LAST NAME: Franz
EMAIL ADDRESS: rod.frdnz @salina.org
ADDRESS: 300 W. Ash Street, P. O. Box 736
CITY: Salina STATE: KS ZIP: 67401
LAST 4 DIGITS OF SOCIAL SECURITY NUMBER: 6774
MOTHER'S MAIDEN NAME: Hiebert
DATE OF BIRTH:
02/16/195
To be completed by Sunflower Bank's Wealth Management Department
ACCOUNT NUMBER(S):
* A completed STRATAWEB Set -up Form must be submitted for each On -line user of the Account.
F.\COMMON \Accounting \Pondmgt \WORD \WM - STRATAWEB SET -UP FORM.doc