EXHIBIT 99.3 | |
2007 COMPENSATION ELECTION FORM
NON-EXECUTIVE CHAIRMAN
Name: ___________________________ | Social Security Number: _______________________ |
I hereby elect the following fixed compensation for my services as Chairman of the Corporation’s Board of Directors for the period January 1, 2007 through May 31, 2007. The “projected value” of the fixed compensation, equal to$270,833, is set forth below:
A. Cash Remuneration:
| A. $________ |
B. Stock Options:
| B. $________ |
C. Restricted Stock/Restricted Stock Units:
|
C1. $________
C2. $________ |
D. Total Fixed Compensation:
| TOTAL: $270,833 |
E. Stock Ownership: |
|
Signature | Date |