EX-99.5 7 sc0287_d1.txt ELECTION FORM: CHADBURN CARL T. CHADBURN I elect to receive the amount payable under Section 4 (a)(i)(D) of the Change of Control Agreement as: [_] A lump sum; or [X] An annuity form of payment as I elected for the Employee Pension Plan. /s/ Carl T. Chadburn ------------------------------------ --------------------------------------- Carl T. Chadburn Social Security Number /s/ Margaret N. Chadburn 8-29-02 ------------------------------------ --------------------------------------- Witness Date