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ENROLLMENT APPLICATION
DIVIDEND REINVESTMENT PLAN
FOR SHARES OF
ONE LIBERTY PROPERTIES, INC.
Please enroll this account as follows for Dividend Reinvestment:
Check one box only (ý).
If you do not check any box, thenFULL DIVIDEND REINVESTMENT will be assumed.
o | FULL DIVIDEND REINVESTMENT Reinvest all dividends for this account. | |
o | PARTIAL DIVIDEND REINVESTMENT Reinvest dividends on shares held by me in certificate form and on all shares held by you as Agent and pay dividends in cash on all remaining shares held by me in certificate form. |
You may change your DIVIDEND REINVESTMENT selections from time to time.
I (We) hereby appoint American Stock Transfer & Trust Company LLC as my (our) Agent under the terms and conditions of the Plan, as described in the Prospectus which this form is a part of, to receive cash payments and apply them to the purchase of shares of One Liberty Properties, Inc. common stock as set forth herein.
NO INTEREST WILL BE PAID ON THE FUNDS HELD PENDING
INVESTMENT.
This form, when completed and signed, should be mailed to:
One Liberty Properties, Inc.
c/o American Stock Transfer & Trust Company LLC
P.O. Box 922, Wall Street Station
New York, New York 10269-0560
Attn: Dividend Reinvestment Department
ACCOUNT REGISTRATION
Name of Participant: | ||||
Social Security Number or Taxpayer Identification Number of | ||||
Participant: | | |||
Address of | ||||
Participant: | | |||
Signature of | ||||
Participant: | | |||
(All joint account owners must sign) |