CUNA Roundtable & CU Ledger Participation Response Form Question Title * 1. Our credit union would like to participate in the CU Ledger research and development project on the use of blockchain technology by credit unions. Yes No Question Title * 2. Please send me an invoice and agreement, with payment instructions, to submit my credit union's contribution to the project. I plan to contribute: $100 (CU assets up to $100 million) $500 (CU assets between $100 million and $250 million) $1,000 ( CU assets under $250 million and $500 million) $5,000 (CU assets between $500 million and $1 billion) $10,000 (CU assets over $1 billion) Question Title * 3. I am interested in my credit union participating as a node in the Credit Union Distributed Ledger. Please send me information on how to participate. Who should receive the information: Email address: Title: Question Title * 4. If you or one of your staff are interested in serving on one of the following committees please check all that may apply: Network Development Committee: responsible for researching and developing a private, permissioned Distributed Ledger network among credit unions, to include selecting software provider, establishing network protocols, etc. Application Selection Committee: responsible for selecting and testing a number of applications to run using the Credit Union Distributed Ledger. Question Title * 5. Contact Information CEO Name Credit Union Email Phone Done