Transcription of Green Bay Packers Address Change Request
1 Green Bay Packers Shareholder Services Address Change Request Name (as it appears on your certificate): Certificate Number: Contact Us: _____ _____ Phone: (Please Print). 855-8GO-PACK (855-846-7225). E-mail: Updated Phone Number: (_____) _____ - _____. Updated E-mail Address : _____. Account Number (if known): _____. Confirm Old Address : _____ (required). Street Address _____ (required). Street Address _____ (required). City State Zip Code New Address : _____ (required). Street Address _____ (required). Street Address _____ (required). City State Zip Code Signature Authorizing Change : _____ (required). Check here to receive the new certificate(s) with the updated Address indicated above.
2 Please return the old certificate(s) and a check for $ payable to The Green Bay Packers , Inc. to the Address below. The new certificate(s) will be mailed to the updated Address along with the canceled stamped original certificate(s). Check here if you do not want to receive the new certificate(s) with the updated Address indicated above. If you have lost your certificate(s) and wish to receive new certificate(s) with the updated Address indicated above, please complete the Lost Certificate Affidavit instead, which is available on our website: Please call 855-8GO-PACK (855-846-7225) or e-mail us at to Request to receive the Lost Certificate Affidavit by mail or e-mail. Comments: _____.
3 _____. Please return this completed form to: Green Bay Packers Shareholder Services c/o Broadridge Corporate Issuer Solutions PO Box 1342. Brentwood, NY 11717. CCAD.
