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Department of Insurance

State of Arizona

Financial Affairs Division

2910 NORTH 44TH STREET, SUITE 210

Phoenix, Arizona 85018-7256

Trust Deposit Unit: (602) 912-8427

Telecopier: (602) 912-8421

TRUST DEPOSIT INSTRUCTIONS SUPPLEMENT A

FOR SECURITIES HELD BY CUSTODIAN

CUSTODY AGREEMENT - FORM E003 REQUIRED: Contact the Department of Insurance to obtain an

Insurance Company Custody Agreement Form E003BNY and Fee Schedule. Execute the Agreement in triplicate.

All executed originals must be sent to the Department of Insurance. To expedite processing and set-up of your

custodial account, you may fax the first page and signature page in advance of mailing all originals. The Custodian

will execute the Agreements and return one fully executed Agreement to the company.

PRIOR APPROVAL OF SECURITIES - FORM E125 REQUIRED: Execute Form E125 completely and

deliver or "FAX" to the Department of Insurance. The Department will advise your authorized Contact Person by

telephone of receipt and approval or disapproval of the securities proposed for deposit.

When approval is

confirmed, send the original Form E125 to the Department. To expedite review and response, you may fax the Form

E125 in advance of mailing. For a new custodial account, send and fax the Form E125 with the Insurance Company

Custody Agreements.

DELIVERY OF SECURITIES TO CUSTODIAN: The Department of Insurance will send written

acknowledgment and acceptance of your Insurance Company Custody Agreement and Form E125 and will forward

them to the Custodian. Upon receiving the Department’s approval, the company may proceed to deliver the

approved securities, by the appropriate method(s):

FEDERAL BOOK ENTRY

DTC ELIGIBLE

BK of NYC/CUST

DTC PARTICIPANT #901

ABA #021000018

Re: (Account Name)

TAS # (Account #)

Re: (Account Name)

REINVESTMENTS AND EXCHANGES - DEPARTMENT APPROVAL REQUIRED: A proposed change in

the kinds of securities to be deposited, OR par value amount requires prior Department approval. Execute Forms

E125 and E126 completely and deliver or "FAX" to the Department. The Department will notify the company’s

authorized Contact Person of approval or disapproval of the proposed transaction.

REINVESTMENTS AND EXCHANGES- DEPARTMENT APPROVAL NOT REQUIRED: You may only

contact the Custodian directly to prepare and perform reinvestments or exchanges of United States Treasury

Bonds, Notes and Bills of identical kind and par value amount without prior written Department approval. All

other reinvestments and exchange transactions require prior approval from this Department, as explained in the

preceding paragraph.

REDUCTION OF DEPOSIT - DEPARTMENT APPROVAL REQUIRED: A reduction to the total amount of

deposit must constitute a release of excess deposit in accordance with A.R.S. § 20-588 and an application must be

filed. Forms E126XS and E126 must be completed and executed by a duly authorized officer of the company as an

application for release of excess deposit. The application may be faxed in advance of mailing to expedite review

and response. Upon approval, the Department will execute the order segment of Form E126XS and will serve the

company with its fully executed copy. The Department will also notify the custodian and the company’s designated

contact person of its approval to proceed with the release of securities in accordance with the instructions provided

on Form E126.

COMPLETE RELEASE OF A TRUST DEPOSIT: Complete release of a trust deposit must be authorized in an

order of the Director of Insurance which sets forth the findings of fact and conclusions of law applicable to the

insurer’s Arizona deposit requirement. The order will specify any conditions and instructions which the insurer must

satisfy prior to release of the deposit.

Form E004 (Rev. 06/00)

Page 1 of 1

Form E004 - Trust Deposit Instructions Supplement A For Securities Held By Custodian

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