Exhibit 99.1 | | | | | | | | |
| | To be used by current Isabella Bank Corporation shareholders only. If you are not currently a shareholder, please contact Shareholder Services at (989) 779-6237, the financial advisors of Raymond James Financial Services located at Isabella Bank, or any other licensed broker. |
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Authorization Card | |
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Stockholder Dividend | | STOCK PURCHASE FORM -- I hereby appoint the Plan Administrator as my agent under |
Reinvestment and Employee | | the terms and conditions of the Plan, as described in the Prospectus for the Plan, to receive |
Stock Purchase Plan Stock | | and apply the following to the purchase of the shares, without charge, as provided in the Plan: |
Purchase Form | | | | |
--------- | | DIVIDEND REINVESTMENT (Please select only one option) |
So that we may identify your | | ¨ | 1 | FULL DIVIDEND REINVESTMENT- Any dividends that may become payable to me |
account, please PRINT the | | | | on all Isabella Bank Corporation Common Stock now or hereafter registered to me |
following information in | | | | subject to any maximum amount set by Isabella Bank Corporation from time to time. |
addition to signing the card. | | ¨ | 2 | | PARTIAL DIVIDEND REINVESTMENT- Any dividends that may become payable to |
| | | | me on the following shares of my Isabella Bank Corporation Common Stock. |
| | | | SHARES _______________ subject to any maximum amount set by Isabella |
| | | | Bank Corporation from time to time. |
Name: | | | | |
______________________ | | OPTIONAL CASH INVESTMENT (Please select only one option; said option shall be |
Address: | | subject to any minimum or maximum amounts set by Isabella Bank Corporation from time to |
______________________ | | time.) |
______________________ | | ¨ | 1 | | CHECK OR MONEY ORDER - The amount payable on the enclosed check or |
Phone Number: | | | | money order made payable to Isabella Bank Corporation. |
______________________ | | ¨ | 2 | | AUTOMATIC BANK WITHDRAWAL - $ _______________, which amount is not |
Email (if applicable): | | | | less than $25 and shall be automatically deducted from my United States bank |
______________________ | | | | account identified below by either a: |
| | | | ¨ ONE-TIME AUTOMATIC BANK WITHDRAWAL or |
| | | | ¨ MONTHLY AUTOMATIC BANK WITHDRAWAL |
| | | | Name of Financial Institution _________________________ |
| | | | Type of Account: ¨ Checking ¨ Savings |
| | | | Account Number: ____________________ |
| | | | Routing Number: ____________________ |
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| | I understand that, if I selected Monthly Automatic Bank Withdrawals, my United States bank |
| | account identified above will be debited monthly in the amount requested on or about the |
| | 15th day of each month, until I change or revoke this authorization card. |
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| | I acknowledge that dividends received on shares held in my Plan account will automatically |
| | be reinvested in additional Common Stock. |
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| | Date: ____________________ |
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| | Signature: ____________________________________________________________ |
•Please check only one of the boxes No. 1 or No. 2 under "DIVIDEND REINVESTMENT," and only one of the boxes No. 1 or No. 2 under "OPTIONAL CASH INVESTMENT." If you check box No. 2 under "OPTIONAL CASH INVESTMENT." you must also check a box to indicate whether the Automatic Bank Withdrawal should be one-time or monthly, and you must provide accurate account information.
•Please be sure to sign and date the form. Return completed forms to:
Isabella Bank Corporation, 401 N. Main St., Mt. Pleasant, MI 48858
Attention: Shareholder Services
You may request additional Authorization Cards at any time by writing to the above address or by calling Debbie Campbell at (989) 779-6237. We will also periodically mail you a new Authorization Card.