Blue Chip Value Fund

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Print this page from your browser and complete this enrollment card to join the Dividend Reinvestment and Cash Repurchase Plan.

 
Blue Chip Value Fund, Inc. Dividend Reinvestment and Cash Purchase Plan Enrollment Card

 
To participate in Blue Chip Value Fund, Inc.'s Dividend Reinvestment and Cash Purchase Plan, print this page from your browser, complete and sign this enrollment form and return it to Mellon Investor Services, Inc., P.O. Box 3338, So. Hackensack, NJ 07606.

This will authorize Blue Chip Value Fund, Inc. to forward to Mellon Investor Services, Inc., as your agent, all of the dividends you receive on common stock to be invested with any voluntary cash contributions you make from a minimum of $50 or up to $10,000 per month, to purchase additional shares of common stock. All investments and any voluntary cash contributions are made subject to the terms and conditions of th Plan as set forth in the accompanying brochure.

This authorization and appointment are given by you with the understanding that you may terminate them at any time by so notifying Mellon Investor Services, Inc., in writing, or by completing and returning the form attached to your plan statement.

 
If you would like to have your voluntary cash contributions deducted automatcially from your checking account, enroll in the Plan and complete the Automatic Monthly Contributions information.

To deposit your shares for safekeeping, check the appropriate box on the reverse side and return this card and your stock certificate(s) via registered mail, return receipt requested.

Questions regarding Blue Chip Value Fund, Inc.'s Dividend Reinvestment and Cash Repurchase Plan should be directed to Mellon Investor Shareholder Services at 800-288-9541.

Please read carefully. This is not a Proxy. Return the form only if you wish to participate in the plan.

 

 
Please enroll me in the Blue Chip Value Fund, Inc. Dividend Reinvestment and Cash Purchase Plan as follows:
(please check all that apply)
O I wish to enroll in the Plan. I DO NOT wish to make an additional cash investment at this time. (You have the option of making cash investments at any time in the future.) To be eligible for this option, you must hold at least fifty (50) shares.
O I wish to enroll in the Plan and make a cash investment of $_____________ ($50 Minimum, $10,000 Maximum), make check payable to Blue Chip Value Fund/CMSS. To be eligible for this option, you must hold at least fify (50) shares.
O Safekeeping. Deposit the enclosed ____________ shares of stock for safekeeping.
O Please send information to establish or rollover an IRA account.

To enroll in the plan by transferring common stock held by a broker, please contact your broker or Mellon Investor Services for instructions.

 
O
 
Automatic Monthly Contributions. Withdraw $____________ (a minimum of $50 or up to $10,000 per month) from my checking account below on a monthly basis to purchase additional Shares of Common Stock. (You must complete this section and return form with a personal voided check. Your financial institution can provide you with the following required information).
Financial Institution Name: _______________________
Branch Address: _______________________
City, State, ZIP: _______________________
Account Number: _______________________

AUTHORIZATION:

Signature____________________________Date__________

Signature____________________________Date__________

All joint owners must sign exactly as names appear on reverse side.

Print, sign and mail this Enrollment Card to:
Mellon Investor Services Inc.
P.O. Box 3338
So. Hackensack, NJ 07606


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