**RECEIVED**

**JUL 27 1970**

**LEXINGTON INS.**

**Endorsement No. 4**

In compliance with Section 122 of the Insurance Law of the State of New York, the Premium on this policy is subject to a 3% State Tax.

| Premium | $1,200.00 |
|---------|-----------|
| New York Tax | $39.00 |
| Total | $1,239.00 |

This endorsement to take effect on the 21st day of May 1970. All other items and conditions remain unchanged.

Attached to and forming part of Policy No. PGC 402875 IV of Lexington Insurance Company.

Issued to: International Business Machines etal