EXHIBIT 99.1
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Medallion Account(SM) Agreement [x] Application [ ] Update [440]
ACCOUNT REGISTRATION [x] Corporate [ ] Partnership [ ] Pension or Profit-sharing Plan
[ ] Non-Corporate/Non-Profit [ ] Estate (Certificate of Qualification (IRAs, KEOGHs and ESOPs are not
[ ] Trust must be attached / Affidavit of eligible)
[ ] Investment Club Domicile must be provided) CHECK ONE [ ] Trustee Directed
(Partnership or Corporate [ ] Prototype
only) [ ] Participant Directed
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TITLE OF ACCOUNT NAME
Berthel Growth & Income Trust I
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NAME
ATTN DAN WEGMANN
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NAME
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STREET ADDRESS (CAN NOT BE A P.O. BOX) PHONE
701 Tama Street, Building B (319) 447-5700
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CITY STATE ZIP
Marion Iowa 52302
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PREFIX SUB FORM NO. FC NO. ACCOUNT NUMBER CHECK APPROPRIATE BOX: [x] TAX I.D. [ ] S.S.N.
41 051 EI01 15192035 521915821
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EVERGREEN [ ] Money Market Fund [ ] U.S. Government MM Fund [ ] Municipal MM Fund
MONEY MARKET FUNDS [ ] New York Municipal MM Fund [ ] California Municipal MM Fund
PLEASE INDICATE THE U.S. GOVERNMENT MM FUND WILL AUTOMATICALLY BE SELECTED Evergreen MM prospectus mailed under
YOUR CHOICE IF YOU DO NOT INDICATE YOUR CHOICE. separate cover.
ACCOUNT PLAN [ ] BASIC PACKAGE (no annual fee) [ ] STANDARD PACKAGE (no annual fee) [ ] PLATINUM PACKAGE ($35 annual fee)
DESCRIPTIONS - No checkwriting - Includes an initial supply of 40 - Includes an initial supply of 200
- No ATM debit card complimentary personal-style complimentary personal-style
NON-CORPORATE/ checks. checks.
NON-PROFIT, PENSION - Do you prefer corporate-style - Do you prefer corporate-style
AND PROFIT-SHARING checks? checks?
PLANS, ESTATES AND [ ] yes (additional fee) [ ] no [ ] yes (additional fee) [ ] no
INVESTMENT CLUBS - Do you want an ATM debit card? - Two Visa Check cards will be
ARE NOT ELIGIBLE FOR ATM [ ] yes [ ] no issued. (UP TO TWO ADDITIONAL
OR VISA CHECK CARD CARDS $35)
Mother's maiden name (identity
safeguard) _____________________
Primary cardholder date of birth
_____ / _____ / _____
MARGIN ACCOUNT If eligible, your account will have Medallion margin account borrowing privileges unless you decline below. See the
agreement Terms and Conditions for an explanation of margin account borrowing.
[ ] I/We do not want Medallion margin account borrowing privileges in my/our account. Please note that you will not
have overdraft protection if you check this box.
If requested, does client want us to provide client's account name and address to an issuer in which we hold securities in street
name? SEC Rule 14b-1 prohibits such issuer from using the name and address for any purpose other than corporate communications.
[ ] Yes [ ] No
TAX CERTIFICATION: U.S. PERSON OR RESIDENT ALIEN: By signing below, I certify, under penalties of perjury, that I am a U.S. person
or resident alien for tax purposes and the following IRS certification applies to me. NOTE: if you are subject to backup withholding
you must cross out statement number 2 of the following IRS certification. Under penalties of perjury, I certify that the following
apply to the Primary Account Holder: (1) the number on this form is my correct taxpayer identification number (or I am waiting for
a number to be issued to me), and (2) I 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 and dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and (3) I
am a U.S. person (including a U.S. resident alien).
SIGNING INSTRUCTIONS: By signing this Agreement, the undersigned "Institution" and all individuals authorized to act on behalf of
it (collectively the "undersigned") acknowledge that they have received a copy of and read, understand, and agree to the
accompanying Medallion Account Terms and Conditions.
Specifically, with respect to the persons authorized to give any instructions on behalf of this Account, the undersigned represent
that, at a duly called meeting of the undersigned Institution or in its governing instrument, as applicable, the individuals
signing below in Section 1 are authorized to give any and all instructions with respect to this Medallion Agreement, and those
signing Section 2 are specifically authorized to issue and sign Medallion Account Checks on behalf of the Institution. The
undersigned agrees that FCC may reply on this list of authorized names until FCC has received written notice from the undersigned
revoking, changing or adding authorized persons in accordance with the notice provisions in the accompanying Terms and Conditions.
In Section 1, all Fiduciaries of Trusts, Estates, Pension and Profit Sharing Plans and general partners of Partnerships must sign.
For Corporations and all other organizations, the President and Secretary (for those with equivalent titles) must sign along with
any other officer(s) authorized to give instructions on behalf of the Account. If the Account has authorized an Investment Advisor,
Plan Administrator or other third party to give trading or other instructions, please provide a copy of such authorization.
AUTHORIZING SIGNATURE(S) AND TITLE(S)
THE UNDERSIGNED ACKNOWLEDGES AND AGREES THAT THIS AGREEMENT IS GOVERNED BY A PRE-DISPUTE ARBITRATION CLAUSE BEGINNING ON PAGE 25,
PARAGRAPH 14 OF THE MEDALLION ACCOUNT TERMS AND CONDITIONS AND ACKNOWLEDGES RECEIPT OF A COPY OF THOSE TERMS AND CONDITIONS.
SECTION 1 - ACCOUNT CONTROL: Those authorized to establish and control accounts and VISA Check Cardholders (all applicable
individuals must sign). Two authorized persons are required to sign below in order to effect any type of transaction on this
account.
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SIGNATURE & TITLE 1 SIGNATURE & TITLE 3 [ ] CHECK FOR ADDITIONAL
/s/ DANIEL P. WEGMANN VISA CHECK CARD
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PRINT NAME & TITLE Daniel P. Wegmann DATE 3-08-02 PRINT NAME & TITLE DATE
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SIGNATURE & TITLE 2 SIGNATURE & TITLE 4 [ ] CHECK FOR ADDITIONAL
/s/ RONALD O. BRENDENGEN, CFO VISA CHECK CARD
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PRINT NAME & TITLE Ronald O. Brendengen DATE 3-08-02 PRINT NAME & TITLE DATE
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SECTION 2 - CHECK SIGNATURES: (as they will appear on checks) All authorized persons must sign; Indicate number to sign each check:
[ ] 1 [ ] 2 [ ] 3 [ ] 4
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SIGNATURE SIGNATURE
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PRINT NAME & TITLE DATE PRINT NAME & TITLE DATE
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SIGNATURE SIGNATURE
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PRINT NAME & TITLE DATE PRINT NAME & TITLE DATE
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Accounts carried by First Clearing Corporation, member New York Stock Exchange and SIPC.
0000 543292 (100/pkg Rev 06) Copy 1 - New Accounts Copy 2 - Branch Copy 3 - Client
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