Enrollment Form

Name_________________________________Ph: (______)________________

Mail Address:__________________________email:_____________________

Ship

Address (If different from above - no P.O)___________________________________

City__________________________________St_________Zip______________

Enroll me in the SmartSilver monthly "automatic" savings plan of

pre-1965 U.S. silver coins, at the following MONTHLY level: (CIRCLE ONE)

(    ) VISA    (    ) MASTERCARD

Card Number:     ___________|___________|___________|___________

Expiration Date: ______|______

Name as it appears on the card:____________________________________

With my signature below, I hereby authorize the monthly deduction of the above funds from my credit card or checking account. I understand that I may discontinue the program at anytime by notifying SmartSilver in writing or by phone, within 24 hours of my monthly anniversary date.

Signature_____________________________________Date______________

NOTE: The date you place beside your signature above is the monthly "anniversary" date of your savings plan. Coins will be shipped on or about that date each month, and your shipment will be based upon the prevailing "spot price" of silver on that day. SmartSilver rotates monthly shipments between quarters, dimes and half dollars.

SSEF01 Revised 1204

If paying by check, may payable to SmartSilver, and include a VOIDED check. Shipments paid by Credit Card will go out within 48 hours of receipt. Shipments paid by Check will go out in 5-7 days.

Please deduct the monthly amount of $_________ (include shipping) as indicated above from my:

TM

Print out this Enrollment Form.

Complete & mail.

Home

(    ) CHECKING ACCOUNT (Include your 1st month's payment AND a voided check.)

Bank Name:_________________________________________________

Mailing Address:_____________________________________________

City:____________________________St________Zip________________

Phone No: (_________)________________________________________

Smart Silver

Savings Amt+s&h:     $25/5   $50/5   $75/6   $100/7   $125/8   $150/9   $175/10   $200/10

Make a copy of this Enrollment Form for your records, then mail the original to:

Smart Silver

P.O. Box 10155

Lynchburg, VA 24506

NOTICE

DUE TO THE VOLATILITY  IN THE MARKET AT PRESENT, THIS PROGRAM HAS BEEN SUSPENDED UNTIL FURTHER NOTICE. Thank You.