EX-99.12 14 sc0287_h1.txt ELECTION FORM: SEARFOSS DAVID W. SEARFOSS 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/ David W. Searfoss ------------------------------------ --------------------------------------- David W. Searfoss Social Security Number /s/ E. Rudden 8/29/02 ------------------------------------ --------------------------------------- Witness Date