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Institutional Asset Management Mutual Funds		Thank you for your interest in Provident Investment Counsel's mutual funds. For Fund literature, please complete the form below. You must provide complete, accurate postal information in order to receive your printed material. Fields with an asterisk (*) are required. First Name:* City:* Last Name:* State:* Select one: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Email:* Zip Code:* Company: Phone: Address 1:* You are:* Select one: Broker/Dealer, FC, RIA Individual Investor Institutional Investor Provident Affiliate/Associate Other Address 2: Date Needed: (MM/DD/YYYY) Enter the number of materials you'd like for each fund: Prospectus/ Application Semi Annual Reports Annual Reports Prospective Shareholder Kits Statements of Additional Info Provident Investment Counsel Institutional Funds Small Cap Growth Fund, Class I Flexible Growth Fund, Class I (formerly Mid Cap Fund, Class B) Notes:

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