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Advanta Corp.
DIVIDEND
REINVESTMENT
&
STOCK
PURCHASE
PLAN
Authorization and
Enrollment Form
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To participate in the Advanta Corporation Dividend Reinvestment & Stock Purchase
Plan please complete and sign the attached authorization and enrollment form,
mark your investment option and return it in the enclosed envelope to the Plan
Administrator as indicated below:
If using ordinary mail:
Mellon Bank, N.A.
Shareholder Investment Service
P.O. Box 750
Pittsburgh, PA 15230
If using a courier service:
Mellon Bank, N.A.
Shareholder Investment Service
Commerce Court
4 Station Square, Third Floor
Pittsburgh, PA 15219
This form authorizes the enrollment of your account in the Plan. You may also
make cash investments from $50 to $3,000 per month to purchase additional
shares of Class B Stock. You may change or revoke your enrollment in the Plan
at any time by notifying Mellon Bank in writing.
THIS IS NOT A PROXY
FOR YOUR RECORDS:
CLASS A:
Full / /
Partial / / ____________ # of shares
CLASS B:
Full / /
Partial / / ____________ # of shares
SAFEKEEPING: ____________ # of shares
INITIAL PURCHASE: $ ___________________
SENT: _______________________________
(Date)
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AUTHORIZATION FORM FOR ADVANTA CORP.
DIVIDEND REINVESTMENT & STOCK PURCHASE PLAN
In order to participate in the Advanta Corp. ("Advanta") Dividend Reinvestment
& Stock Purchase Plan (the "Plan") you must complete the appropriate sections
of this form and return it in the enclosed envelope to the Plan's Administrator
at the address shown to the left. The form appoints Mellon Bank, N.A. (the
"Administrator"), as agent to invest, as indicated thereon, the cash dividends
paid on shares of Advanta's Class A Common Stock ("Class A Stock") and/or Class
B Common Stock ("Class B Stock") registered in your name for the purchase of
whole or fractional shares of Class B Stock under the terms and conditions set
forth in the Prospectus which accompanied this form. The Prospectus contains a
glossary setting forth the definitions of certain capitalized terms used in
this form. By completing and signing this form, you certify that you have
received the Prospectus and are a registered owner of at least 25 shares of
each class of stock which you designate to participate in the Plan.
Please complete the appropriate sections below. If you wish to enroll both
Class A and Class B Stock owned by you in the Plan for reinvestment of cash
dividends thereon, you must complete both the Class A Stock section (either
Box 1 or Box 2) and the Class B Stock section (either Box 3 or Box 4). If you
return a signed form without selecting an investment option, you will be
enrolled as having selected Full Dividend Reinvestment. If you wish to transmit
certificates for shares of Class B Stock to be held by the Administrator either
as Participating Shares or for Safekeeping only please complete either Box 5 or
Box 6. This service is optional; you are not required to transmit certificates
to participate in the Plan.
Check all boxes that are appropriate to your choice and complete all
related blanks.
TO ENROLL CLASS A STOCK:
(Note: Dividends on shares of Class A Stock enrolled in the Plan
will be reinvested in Class B Stock)
Box 1 / / FULL DIVIDEND REINVESTMENT - Please apply dividends on all
shares of CLASS A STOCK now or hereafter registered in my name
and all shares of Class B Stock credited to my Plan account to
the purchase of Class B Stock*.
Box 2 / / PARTIAL DIVIDEND REINVESTMENT - Please apply dividends on
________ shares of CLASS A STOCK (must be a whole number)
registered in my name and all shares of Class B Stock credited
to my Plan account to the purchase of Class B Stock*.
* Selection of this option will not provide for reinvestment of
dividends on shares of Class B Stock owned by you directly, but
it will cover shares of Class B Stock you acquire through the
Plan and leave on deposit with the Administrator.
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TO ENROLL CLASS B STOCK:
Box 3 / / FULL DIVIDEND REINVESTMENT - Please apply dividends on all
shares of CLASS B STOCK now or hereafter registered in my name
and all shares of Class B Stock credited to my Plan account to
the purchase of Class B Stock.
Box 4 / / PARTIAL DIVIDEND REINVESTMENT - Please apply dividends on
________ shares of CLASS B STOCK (must be a whole number)
registered in my name and all shares of Class B Stock credited
to my Plan account to the purchase of additional shares of Class
B Stock.
TO TRANSMIT CERTIFICATES FOR
ENROLLED PARTICIPATING SHARES ONLY:
NOTE: CERTIFICATES FOR CLASS A STOCK WILL NOT BE HELD BY THE
ADMINISTRATOR.
Box 5 / / TO TRANSMIT CERTIFICATES FOR PARTICIPATING SHARES OF CLASS B
STOCK TO BE HELD FOR YOUR ACCOUNT - Please deposit the enclosed
certificate no. ______________ representing ________ shares of
Class B Stock in my Plan account. (Do not endorse your share
certificates.) NOTE: These shares will be Participating Shares
in the Plan and cash dividends thereon will be reinvested in
additional shares of Class B Stock. If you have elected the
Partial Dividend Reinvestment option and the certificate is for
a larger number of shares than the number you have specified
next to Box 4, please communicate directly with the Administrator
for further instructions.
If you wish to deposit certificates for shares of Class B Stock
with the Administrator to be held in safekeeping only, but
without having the cash dividends on such shares reinvested in
additional Class B Stock, do not check Box 5. Rather check Box
6.
TO TRANSMIT NON-ENROLLED CLASS B
STOCK CERTIFICATES FOR SAFEKEEPING:
NOTE: CERTIFICATES FOR CLASS A STOCK WILL NOT BE HELD BY THE
ADMINISTRATOR.
Box 6 / / Please hold the enclosed certificate no. ______________
representing ________ shares of Class B Stock for my account for
safekeeping. (Do not endorse your share certificates.) DIVIDENDS
ON SAFEKEEPING SHARES WILL NOT BE REINVESTED. If you wish your
shares to participate in the Plan (with the dividends thereon
reinvested) and you also wish the Administrator to hold your
certificates, use Box 5 and do not use this Box.
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CASH INVESTMENTS:
Box 7 / / Please authorize my account to participate in the Cash Investment
feature. Investments will be at my option by investing cash from
time to time for the purchase of Class B Stock. Unless Full
Dividend Reinvestment has been selected for any Class B Stock by
checking Box 3, dividends on shares purchased with cash
investments will not be automatically reinvested. I am aware
that Cash Investments must not be less than $50 or more than
$3,000 per calendar month. I will instruct the Administrator as
to how to transmit certificates for shares purchased with Cash
Investments. (Do not send funds for Cash Investments until you
have been advised that your account has been authorized for Cash
Investments.)
INITIAL PURCHASE:
Box 8 / / I wish to make my initial purchase of Class B Stock through the
Plan. My check made payable to Mellon Bank, N.A. in the amount
of $_______________ is enclosed (must not be less than $1,500 or
more than $3,000).
I understand that I may modify or revoke this authorization by
instructing the Administrator in writing of my desire to change
or terminate my participation. No change will be effective until
your instructions are received by the Administrator.
ACCOUNT REGISTRATION (Check One)
/ / Individual Ownership - You alone own the shares.
/ / Joint Tenants with Rights of Survivorship - You and one or more
persons equally own shares with right of survivorship.
/ / Custodian under Uniform Gifts to Minors Act
The Administrator will act upon the written request of any owner in all
matters pertaining to a joint account except for the sale or transfer of
shares, which requires the signature of all owners.
/ / Other (Trust, Corporation, etc.)
Please specify: _______________________________
You must sign the Account Authorization on the other side of this Form
THIS IS NOT A PROXY
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ADVANTA CORP.
To participate in Advanta's Dividend Reinvestment & Stock Purchase Plan please
complete and sign the reverse side of this form, mark your investment option
and return it in the enclosed envelope to the Administrator as indicated
below:
If using ordinary mail:
Mellon Bank, N.A.
Shareholder Investment Service
P.O. Box 750
Pittsburgh, PA 15230
If using a courier service:
Mellon Bank, N.A.
Shareholder Investment Service
Commerce Court
4 Station Square, Third Floor
Pittsburgh, PA 15219
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Account Authorization (Required)
This form authorizes the enrollment of your account in the Plan. You may also
make cash investments from $50 to $3,000 per month to purchase additional
shares of Class B Stock. You may change or revoke your enrollment in the Plan
at any time by notifying Mellon Bank in writing.
Substitute Form W-9
Under penalty of perjury, I hereby certify that the Social Security Number or
Tax Identification Number (TIN) indicated below is true and correct and that I
am not subject to backup withholding per the Internal Revenue Code. (Delete
"not" if you are subject to back up withholding)
Shareholder Signature: _______________________________________________
Shareholder Signature: _______________________________________________
Date: _______________________________________________
Sign name(s) exactly as shown on stock certificate or as your account is
registered. In case of joint owners, each owner must sign. If authorization is
signed as attorney-in-fact, officer, administrator, executor, trustee or
guardian, indicate title as such.
Please complete the following section with the name and address to which Plan
account statements should be sent:
Name
Address
City
State Zip Code
Social Security Number/TIN
Telephone Number
THIS IS NOT A PROXY
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Advanta Corp.
DIVIDEND
REINVESTMENT
&
STOCK
PURCHASE
PLAN
{ADVANTA LOGO]