Please print this form from your browser and complete. Click here to return to the Investment Form.



[ Attachment to letter from Jerry Gabert, Treasurer
Unitarian Universalist Association dated May 3, 1999]

On behalf of _____________________________________ ( Congregation or Affiliate) presently having an account with the Unitarian Universalist Association ("UUA") whereby the UUA holds monies for the UUA General Investment Fund , the undersigned Congregation or Affiliate hereby elects the following quarterly distribution rate to be effective through the quarter ending _________________ ( date, i.e. Sept. 1999, Mar. 2000).

(Select one)

4.5%_________
5.0%_________
5.5% ________
6.0%________

IN WITNESS WHEREOF, the Congregation or affiliate has caused this document to be executed on its behalf and in its name by its officers thereunto duly authorized this

_________________________ day of _______________________ (year)__________

_________________________________ Name of Congregation or Affiliate

By:

___________________________________ Name and Title of Officer

Attest:

________________________________ Clerk of Congregation or Affiliate

( This document must be postmarked 30 days prior to a quarter-end. Send to: Nancy Gladyszak, Endowment Funds Manager, Unitarian Universalist Association, 25 Beacon St, Boston, MA 02108)