JPMORGAN CHASE & CO. - Irish Stock Exchange

(v)
Names and addresses of additional Paying Agent(s)
(if any):
[ ]
(vi) Registrar: [Not Applicable/The Bank of New
York Mellon/specify other]
(vii)
10. GENERAL
Intended to be held in a manner which would allow
Eurosystem eligibility:
[Yes] [No]
[Note that the designation “yes”
simply means that the Notes are
intended upon issue to be deposited
with one of the International Central
Securities Depositories as Common
Safekeeper and does not necessarily
mean that the Notes will be recognised
as eligible collateral for Eurosystem
monetary policy and intra-day credit
operations by the Eurosystem either
upon issue or at all times during their
life. Such recognition will depend
upon satisfaction of the Eurosystem
eligibility criteria.] [include this text if
“yes” is selectioned in which case the
Notes must be issued in NGN form]
The aggregate nominal amount of Notes issued has been
translated into U.S. dollars at the rate of [ ], producing a
sum of (for Notes not denominated in U.S. dollars):
[Not Applicable/U.S.$[ ]]
[For Bearer Notes with a maturity of more than 183 days: ANY UNITED STATES PERSON (AS DEFINED IN THE
INTERNAL REVENUE CODE OF THE UNITED STATES) WHO HOLDS THIS OBLIGATION WILL BE
SUBJECT TO LIMITATIONS UNDER THE UNITED STATES INCOME TAX LAWS, INCLUDING THE
LIMITATIONS PROVIDED IN SECTIONS 165(J) AND 1287(A) OF THE INTERNAL REVENUE CODE OF THE
UNITED STATES.]
OR
[For Bearer Notes with a maturity of 183 days or less: BY ACCEPTING THIS OBLIGATION, THE HOLDER
REPRESENTS AND WARRANTS THAT IT IS NOT A UNITED STATES PERSON (OTHER THAN AN EXEMPT
RECIPIENT DESCRIBED IN SECTION 6049(B)(4) OF THE INTERNAL REVENUE CODE OF THE UNITED
STATES AND THE REGULATIONS THEREUNDER) AND THAT IT IS NOT ACTING FOR OR ON BEHALF OF
A UNITED STATES PERSON (OTHER THAN AN EXEMPT RECIPIENT DESCRIBED IN SECTION 6049(B)(4)
OF THE INTERNAL REVENUE CODE AND THE REGULATIONS THEREUNDER).]
OR
[For Restricted Notes: “THIS CERTIFICATE HAS NOT BEEN AND WILL NOT BE REGISTERED UNDER THE
U.S. SECURITIES ACT OF 1933, AS AMENDED (THE “SECURITIES ACT”) OR WITH ANY SECURITIES
REGULATORY AUTHORITY OF ANY STATE OR OTHER JURISDICTION OF THE UNITED STATES AND
MAY NOT BE OFFERED, SOLD, PLEDGED OR OTHERWISE TRANSFERRED EXCEPT (1) IN ACCORDANCE
WITH RULE 144A UNDER THE SECURITIES ACT TO A PERSON THAT THE HOLDER AND ANY PERSON
ACTING ON ITS BEHALF REASONABLY BELIEVES IS A QUALIFIED INSTITUTIONAL BUYER WITHIN
THE MEANING OF RULE 144A PURCHASING FOR ITS OWN ACCOUNT OR FOR THE ACCOUNT OF A
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