Exhibit 99.1
ENROLLMENT FORM-CURRENT PARTICIPANTS
FIFTH THIRD DIRECT
ENROLLMENT FORM
PLEASE READ CAREFULLY BEFORE SIGNING
Record Holder Status:
I hereby represent and confirm that I am the registered holder of shares of
Common Stock of Fifth Third Bancorp.
Dividend Reinvestment Options: (if applicable, please check one and sign
below)
[ ] Full Reinvestment: I hereby authorize Fifth Third Bancorp to pay to
Fifth Third Bank, as agent for my account, all cash dividends due to
me on shares of Fifth Third Bancorp Common Stock for which I am the
registered holder. I want to reinvest dividends on all shares
registered in my name for the purchase of full or fractional shares
of Fifth Third Bancorp Common Stock in accordance with the terms of
Fifth Third Direct, as may be amended from time to time, (the "Plan").
[ ] Partial Reinvestment: I hereby authorize Fifth Third Bancorp to pay
to Fifth Third Bank, as agent for my account, all cash dividends due
to me on (pick one) [ ] _______ shares of Fifth Third Bancorp Common
Stock; or [ ] _______ % of Fifth Third Bancorp Common Stock for which
I am the registered holder. I want to reinvest dividends on the
indicated number of shares or percentage of shares as so indicated in
my name for the purchase of full or fractional shares of Fifth Third
Bancorp Common Stock in accordance with the terms of the Plan.
[ ] No Reinvestment: I do not want to reinvest any cash dividends paid on
shares of Fifth Third Bancorp Common Stock registered in my name. I
will only invest voluntary cash under the terms and conditions of the
Plan.
Cash Purchase Options: (please check if applicable and sign below)
[ ] Optional Automatic Investment: I hereby authorize Fifth Third Bank,
as agent, to debit my checking, savings or other account
$_______________ on a monthly basis as set forth in the completed
automatic debit authorization form on reverse side and invest such
designated amount (less any applicable fees and commissions) in full
or fractional shares of Fifth Third Bancorp Common Stock in
accordance with the terms of the Plan. The reverse side must be
completed.
Termination Options: (if applicable, please check one and sign below)
[ ] Sell All Shares: Terminate my account, sell all my full and
fractional shares and send me a check for the proceeds.
[ ] Issue Certificates: Terminate my account, send me a certificate for
the whole shares and a check for any fraction amount.
I hereby appoint Fifth Third Bank as my agent under the terms and conditions
of Fifth Third Direct, as described in the Prospectus accompanying this
Enrollment Form, to receive any cash dividends that may become payable to me
on any of the shares of Fifth Third Bancorp Common Stock specified below, and
to apply such dividends to the purchase of shares as provided in the Plan. I
acknowledge receipt of the Fifth Third Direct Prospectus and agree to the
terms and conditions of the Plan stated in that Prospectus, as same may be
amended from time to time.
I understand that I may change my reinvestment options or revoke this
authorization at any time by notifying Fifth Third Bank in writing of my
desire to modify and/or terminate my participation in Fifth Third Direct. I
understand that the purchase of Common Stock will be made subject to the
terms and conditions of the Plan, and that I may terminate this
authorization at any time by notifying Fifth Third Bank in writing.
Enrollment Signatures
Return this Enrollment Form only if you wish to participate in Fifth Third
Direct. This Enrollment Form, when signed, should be mailed to: Fifth Third
Direct c/o Fifth Third Bank, 38 Fountain Square Plaza MD 10AT66,
Cincinnati, Ohio 45263.
All owners of shares held in joint registration must sign this Enrollment
Form.
DATE: ____________________________
__________________________________ ___________________________________
Shareholder Signature Joint Shareholder Signature
(if jointly held)
Daytime Phone (_____)____________________
Automatic Debit Authorization
Please indicate the account from which you would like your additional
investments withdrawn. You must enclose a pre-encoded deposit ticket or
blank, voided check to help us identify your account.
[ ] Checking account [ ] Savings account [ ] Other account
Please print name(s) as shown on shareholder records:
__________________________________ ___________________________________
First Middle Initial Last First Middle Initial Last
Address ___________________________________________________________________
City ___________________ State ___________________ Zip ________________
Telephone Number (______)_____________ (______)_______________________
Home Work
Signature(s)* ________________________ _______________________________
* All persons shown on shareholder records are required to sign for
Automatic Debit Authorization
Dividend Direct Deposit Authorization Form
Partial Reinvestment Participants Only
Please indicate the account number and the financial institution to which you
would like your dividends deposited. You must enclose a pre-encoded deposit
ticket or blank, voided check to help us identify your account.
[ ] Checking account [ ] Savings account [ ] Other account
Please print name(s) as shown on shareholder records:
__________________________________ ___________________________________
First Middle Initial Last First Middle Initial Last
Address ___________________________________________________________________
City ___________________ State ___________________ Zip ________________
Telephone Number (______)_____________ (______)_______________________
Home Work
Signature(s)* ________________________ _______________________________
* All persons shown on shareholder records are required to sign for
Dividend Direct Deposit
