ROSE & KIERNAN, INC.

DIVIDEND REINVESTMENT PLAN

ELECTION FORM

 

 

The undersigned shareholder (the "Shareholder") of Rose & Kiernan, Inc. (the "Company"), hereby elects to reinvest dividends received on all of the shares of Company common stock, $2.50 par value per share, owned by the Shareholder (the "Shares"), pursuant to the Company's Dividend Reinvestment Plan dated August 27, 1996 (the "Plan"). The Shareholder represents that he or she has received a copy of the Plan, has read and understands it, acknowledges all of the statements and representations made in the Plan as though they are fully reproduced herein, and will abide by the terms of the Plan.

 

 

 

_________________________

Shareholder Signature

 

_______________________________

Print or Type Shareholder Name

 

Dated: _________________________

 

 

Received by the Company on (date):

 

_____________________________________

Joseph F. Vitale, Plan Administrator