FISN


FISNFederally Insured Savings Network	1-800-351-4494

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PURCHASE ORDER
First Internet Securities Network
Account Holders Only

I currently maintain an account at First Internet Securities Network (FISN), the broker dealer division of FISN, Inc. I want to indicate my interest in purchasing the following item. I realize that this Purchase Order is contingent upon availability and price of the security, suitability considerations and settlement funding for the account.

FISN will determine if the indicated investment has sufficient quantity to meet the order, verify the current price and assess the suitability of the investment, based upon the account investment profile. FISN will contact me to review all aspects of the security, confirm suitability, and set the payment date and method for settlement.

I understand that this Purchase Order is an "Indication of Interest" and does not commit me to a purchase any investment until I confirm it with FISN. I understand that an "Indication of Interest" does not mean that FISN can or will fill my order. All orders must be confirmed with and by the FISN Account Executive to complete the transaction.

STOCK MARKET, INDEX & BASKET LINKED CDS

CD Term

Market
Index

CD Index
Return

Minimum
Interest

Minimum
Deposit

Closing
Date

6.0 Yrs

Global Large-Cap Equities Basket Market Linked Deposit

Basket Components
Amgen Inc., AstraZeneca PLC, Barrick Gold Corp., Credit Suisse Group AG, eBay Inc., Nike Inc., PetroChina Co., Research in Motion Ltd., SAP AG, Sony Corp., UBS AG & Vodafone Group PLC

Terms & Conditions

Disclosure

Annual Interest Payout with Auto Cap Interest on the Upside & Floor Protection on the Downside

Annual interest is paid based upon the average gain of the 12 Global Large-Cap stocks in the equally weighted basket. Each year the gain is recomputed from the initial average value to the year-end average value and interest is paid if applicable. The gain is the average change in the basket value. If the annual change for any stock is positive or flat, it automatically gets counted at the Auto Cap increase level. The Auto Cap stock increase level is expected to be 6.0% to 9.0% per year. No interest is paid if the average is down. There is a downside Floor of negative 30% down per component security. FDIC insured.

None

$25,000

09/27/2010

* A red asterisk indicates a required field.

ACCOUNT INFORMATION
*PURCHASE AMOUNT ($1,000 Units)	,000.00
Account Ownership Title:
*Account Number:
FISN Account Executive:
CONTACT INFORMATION
Purchase Order Contact:
Contact Telephone Number:
*Contact Email Address:
*Confirm Email Address:

Note: Purchase Requests can only be accepted for established, active accounts. If you do not currently have an open account or wish to purchase investments in a new ownership title, please contact FISN at 1 (800) 351-4494. Or, you can get started now by opening an account online (single or joint accounts only) before you call us.