EXHIBIT 99.3 FARMERS NATIONAL BANC CORP. REQUEST FOR CHANGE DIVIDEND REINVESTMENT PLAN SAFEKEEPING ACCOUNT Please make the following change(s) in my Dividend Reinvestment Plan Safekeeping Account: [ ] Withdraw and issue ____ shares from my Dividend Reinvestment Plan Safekeeping Account and mail certificate to the address below. [ ] Deposit certificate(s) no(s). ______________________________ totaling _______________ shares to my Dividend Reinvestment Plan Safekeeping Account. [ ] Transfer _____ shares from account no. _______________ in the name(s) of _____________________ to account no. ________________________________ in the name(s) of __________________________________________. [ ] Terminate my participation in the Dividend Reinvestment Plan. Please issue a certificate for full shares and a check for fractional shares and mail to address below. [ ] Change the address on account no. ________________ in the name(s) of _____________________________. (New address is listed below.) Date:_________________________ _________________________________ *Signature _________________________________ Signature Address:______________________ SIGNATURE GUARANTEED: ______________________ ______________________ FNBC change by ____ Date______ _________________________________ * If the shares are registered in more than one name (i.e., joint tenants, trustee, etc.), all registered holders must sign. When signing as attorney, executor, administrator, trustee or guardian, please give full title. 27