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EXHIBIT 99.1
ENROLLMENT FORM
FOR
INLAND REAL ESTATE CORPORATION DISTRIBUTION REINVESTMENT PROGRAM
To participate in the Distribution Reinvestment Program, you must complete and
sign this form and return it to:
INLAND REAL ESTATE CORPORATION
2901 BUTTERFIELD ROAD
OAK BROOK, ILLINOIS 60523
ATTENTION: MR. MARK E. ZALATORIS
1. ACCOUNT REGISTRATION. Complete either section A, B, C or D. (Please
print clearly).
a. INDIVIDUAL OR JOINT ACCOUNTS. (Enter only the Social Security
number for the name under which distributions should be reported.)
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Owner's Name
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Owner's Social Security Number Owner's date of birth
(used for tax reporting) (Month/Day/Year)
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Joint Owner's Name (if applicable)
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Joint Owner's Social Security Number
(if applicable; used for tax reporting)
FOR JOINT ACCOUNTS: Your program account will be registered "Joint Tenants with
Rights of Survivorship" and not as tenants in common unless you check a box
below:
[ ] Tenants in common
[ ] Tenants by entirety
[ ] Community property
b. CUSTODIAL ACCOUNT/GIFT TO A MINOR. (An Enrollment Form is required
for each minor. Only one custodian per account is allowed.)
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Custodian's Name
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Minor's Name
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Minor's Social Security Number Minor's date of birth Custodian's
(required) (Month/Date/Year) state
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c. TRUST. (Please check only one of the trustee types)
[ ] Person as trustee [ ] Organization as trustee
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Trustee: Individual or Organization Name
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and Co-trustee's Name (if applicable)
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Name of Trust
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For the benefit of
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Trust Taxpayer Identification Number Date of Trust
(required) (Month/Day/Year)
d. ORGANIZATION OR BUSINESS ENTITY. Check one:
[ ] Corporation [ ] Partnership [ ] Other
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Name of Entity
Taxpayer Identification Number (required)
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Mailing Address (including apartment or box number)
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City State Zip
( ) ( )
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Home phone Work phone
2. DIVIDEND REINVESTMENT.
If you participate in the program, we will reinvest all cash
distributions paid by us on the shares of Inland Real Estate Corporation
registered in your name.
3. ACCOUNT AUTHORIZATION SIGNATURE(S).
Signature of account owner: Date:
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Signature of joint owner: Date:
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(if applicable)
If you need assistance, please contact Mr. Mark Zalatoris at (630) 218-8000.
