# Forms Schedule

**Named Insured:** INTERNATIONAL BUSINESS MACHINES CORPORATION

**Policy Number:** 5443148

**Effective 12:01 AM:** October 8, 2008

| End't. No. | Form Name | Form Number/Edition Date |
|------------|-----------|--------------------------|
| 29         | CANCELLATION CLAUSE AMENDED ENDT (CREDIT RATING TR) | 100085 (09/08) |

**NOTICE:** THESE POLICY FORMS AND THE APPLICABLE RATES ARE EXEMPT FROM THE FILING REQUIREMENTS OF THE NEW YORK STATE INSURANCE DEPARTMENT. HOWEVER, SUCH FORMS AND RATES MUST MEET THE MINIMUM STANDARDS OF THE NEW YORK INSURANCE LAW AND REGULATIONS.

CIFMSC CI0226