NCUA 4506 Federal to State Conversion - Ballot for Conversion Prop

OMB No. 3133-0015

FEDERAL TO STATE CONVERSION
BALLOT FOR CONVERSION PROPOSAL

I have read the notice concerning the meeting of the members of the
Federal Credit Union called for
consider and to vote upon the following proposition:

to

"RESOLVED, That the
Federal Credit Union be
converted to a credit union chartered under the laws of the State of
and operation under Federal Charter Number
be discontinued.
RESOLVED FURTHER, That the board of directors and the officers of this
credit union are hereby authorized and directed to do all things necessary
to effect and to complete the conversion of this credit union from a Federal
to State-chartered credit union."
I hereby cast my vote on the proposition: (Select the square opposite
the appropriate statement.)

I vote for the conversion

I vote against the conversion

(Account Number)

(Signature of Member)

Date: _________________

NCUA 4506

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