Direct Stock Purchase Plan Enrollment Form
This form is designed for individuals wishing to enroll in the Direct Stock Purchase Plan offered by Citibank. It guides users through the process of providing necessary account information and authorizations. Ensure all fields are filled out accurately to facilitate a seamless enrollment process.
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How do I fill this out?
To fill out this form, start by entering your personal information in the designated fields. Make sure to print clearly in capital letters for legibility. Once all required sections are completed, review your information before submission.

How to fill out the Direct Stock Purchase Plan Enrollment Form?
1
Gather all necessary documents and information.
2
Fill out your personal details in the form.
3
Select your preferences for dividend payments.
4
Sign the form to acknowledge your understanding.
5
Submit the form according to the provided instructions.
Who needs the Direct Stock Purchase Plan Enrollment Form?
1
Investors looking to begin a stock investment plan.
2
Individuals wanting to set up automatic dividend reinvestment.
3
Custodians managing accounts on behalf of minors.
4
Trusts needing to establish a custodial account.
5
Individuals requiring assistance with direct stock purchases.
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What are the instructions for submitting this form?
To submit this form, please send it to Citibank at the following address: Citibank, N.A., P.O. Box 43077, Providence RI 02940-3077. Alternatively, you can fax the completed form to 877-248-4237 for US submissions or 781-575-4555 for international submissions. Ensure that all sections are thoroughly completed and signed to avoid delays in processing your enrollment.
What are the important dates for this form in 2024 and 2025?
For the years 2024 and 2025, please ensure you are aware of the various important deadlines related to dividend reinvestment and stock purchases. Participants should monitor the plan's guidelines for enrollment windows, dividend payment dates, and potential changes in investment minimums. Staying informed will help ensure timely participation and compliance with the plan’s operational timeline.

What is the purpose of this form?
The purpose of this form is to provide a structured method for investors to enroll in the Direct Stock Purchase Plan. It outlines necessary personal information and allows for the selection of dividend options. By completing this form, individuals consent to the terms and conditions of the purchase plan and authorize Citibank to manage their investments accordingly.

Tell me about this form and its components and fields line-by-line.

- 1. Name: The full name of the account holder.
- 2. Address: The street address where the account holder resides.
- 3. Citizenship: The citizenship status of the account holder.
- 4. Social Security Number: The SSN or EIN for tax identification.
- 5. Telephone Number: A contact number for reaching the account holder.
- 6. Signature: A signature field for the account holder's validation.
What happens if I fail to submit this form?
If the form is not submitted correctly, enrollment in the Direct Stock Purchase Plan may be delayed. Missing or inaccurate information will hinder processing and could lead to the rejection of your application. It is crucial to review all sections before submission to avoid such issues.
- Incomplete Information: If required fields are not filled, the form may be considered invalid.
- Incorrect Signatures: Failure to provide necessary signatures will prevent enrollment.
- Missing Documents: Without proper documentation, processing may be halted or delayed.
How do I know when to use this form?

- 1. Initial Enrollment: For new investors looking to join the Direct Stock Purchase Plan.
- 2. Dividend Reinvestment: To set up automatic reinvestment of dividends for current shareholders.
- 3. Custodial Accounts: For custodians managing investments on behalf of minors or dependents.
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