EFTA01268454.pdf

Account Transfer Form 1D Ameritrade Mail or Fax to: PO Box 2760 a Omaha, NE 88103-2760 Fax: 866-068-6268 Receiving Firm DTC Clearing Number: 0188 Please use the Direct Registration System (DRS) Transfer Form TOA 100557 for transfer from a transfer agent. Instructions: Attach a complete copy of your most recent statement, of the account you are requesting the transfer from, (dated within 90 days) in order for the transfer to be processed. Please submit the completed form to TD Ameritrado Attn: TD Ameritrade, PO Box 2760, Omaha, NE 68103-2760 or fax to 866-468.6268. To submit the completed and signed form(s) electronically through our secure Message Center, scan it, along with any other material you're sending. Then log in to your account and go to Client Services > Message Center to write us, and attach the scanned document(s) to your message. 'if you are requesting to transfer Porn your Qualified Retirement Plan, please contact your plen administrator; this form may not be required. If you are transferdng between two TO Amentrade accounts, please use the Internal transfer form. Please note you cannot use this form fo transfer from a standard checking account and/or savings account from a bank/credit union. For IRAs, end Beneficiary IRAs where the original owner was 7014 years or older at death, please attach a copy of your end of year statement to enable us fo calculate the required minimum distribution for the account. 1. ACCOUNT INFORMATION 2. PLEASE PROVIDE INFORMATION ABOUT THE Your TD Amoritrado Account DELIVERING ACCOUNT (The registration of the account being transferred should match your (As directed in Section I both registration and Tax lbs for the TD Amedtrade account and the Tax ID for both the TO Amerifinde Ametifrade account and account being transferred should match.) account and account being transferred.) Account Number (Required): Account Number (Required): Per one per kin") 867-730320 (OnlY one Reif" )) N4G•023804 Account RegistrationMtle: Account Registration/1We: SOUTHERN FINANCIAL LLC SOUTHERN FINANCIAL LLC iiiii l i/Tax ID Number: Social Security/Tex ID Number: Social °curly ax ID timber. Soda! Secuntyrtex ID Number. (Secondary. if applicable) (Secondary, a applkatie) Ccritrettelivenne Farm Name (Required): Account Type (select one) DEUTSCHE BANK PRIVATE WEALTH MANAGMENT ❑ Individual - (Non IRA) O Traditional or Rollover IRA ContraiDermeing Firm Address: OJoint EiRoth IRA 345 PARK AVE 26TH FLOOR NY,NY10154 ❑ Trust O Beneficiary IRA Colt DCOrp/BuSineSS O Beneficiary Roth IRA OUGMANTMA O Qualified Plan (401k, 403B. PSR etc) Contra/Delivering Fkm Email: OEstate El SIMPLE IRA O SEP IRA Account Type (select one) OOther: — (Non IRA) O Traditional or Rollover IRA OJoInt O Roth IRA ElTrust O Beneficiary IRA 0Com/Business ❑ Benefclary Roth IRA OUGMAILIIMA O Qualified Plan (401k, 4038, PSP, etc.) OEState OSIMPLE IRA O SEP IRA 00ther If the registrations do not match, you may either establish a new account online at www.tdameritrade.com or you must supply additional documentation and all delivering account owners must sign section 4. For unlike titleiregistration transfer, please call the transfer department at 888-72343504 option 4 for additional requirements. 'Please note if there are any issues with processing your transfer, wo will communicate that to you via your secure message center when you log in to your account IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII CONFIDENTIAL SDNY_GM_0CQ82tia Olt EFTA_00123056 EFTA01268454  TD Ameritrade Acct • B67-730320 3. TRANSFER INSTRUCTIONS-PLEASE COMPLETE ONLY ONE OF THE FOLLOWING SECTIONS (A,B, OR C) A. BROKERAGE FIRM TRANSFER (Unless otherwise Indicated, TO Amerarade will transfer in Fula ['Full Transfer—To transfer entire account, check here arid skip to Section 4. ['Partial Transfer-List specific security and/or cash amount below. If bonds are being transferred, please supply the CUSIP. Only whole shares can be requested as fractional shares cannot be transferred. Please contact the delivering firm regarding your options. Asset Description (CUSIP or symbol) Quantity Asset Description (CUSIP or symbol) Quantity (Pelia, Transfers Only) (Indicate eat whole shams (Partial Transfers Only) (Indicate # of;thole shares WALL') or -ALL, 1. 539439AG4 1,903,000 5. 2. AAPL 180,000 6. 3. APO 263,157 7. 4. 8. B. BANK/CREDIT UNION 8 ANNUITY TRANSFER Transfer cash only. Unless otherwise indicated, all cash will be transferred. Banks, Annuity, and Trust Companies require Original Client Signature. Please mail the Original form to complete the transfer request. IRA Savings Accounts—Typically held with Bank/Credit Union. CITotal Transfer (Transfer entire account) 0 Wire (fees may *PAW OPartial Transfer (Transfer part of account) Portion to transfer $ ❑ Check Certificates of Deposit (CDs). ['Redeem my CD immediately. I am aware of, and acknowledge, that lam responsible for any penalties that I may Incur from any early withdrawal. ['Redeem my CD at maturity. Maturity Date: Submit request at least 21 days prior to maturity. Please advise your bank not to roll over your CD to a new term. Indicate In this section whether you wish to liquidate the CD immediately or at maturity For any Westmont instruments that have a renewal deadline, maturity date, surrender charge period/window, etc., paperwork must be received by TD Ameritrade in good order three weeks prior to the firm deadline to allow for proper processing times. To liquidate a CD held in a non-retirement account, contact the bank or credit union at which the assets are being held. Annuity Transfer ['Transfer my Annuity D Partial $ ID Wire I have an annuity policy that I wish to transfer. Please redeem and terminate on my behalf. (tees may aPtibl l am aware of, and acknowledge, that I am responsible for any penalties that I may incur from 0 Check any early withdrawal. Select only one: Liquidate annuity in full or partial liquidation. If partial is selected, amount for partial must be included. TO Ameritrade is not responsible for the lining or execution of liquidations processed by the delivering firm. C. MUTUAL FUND COMPANY TRANSFER Cheek box for In-kind or Liquidation Transfec Please list the Symbdor CUSIP for the Mutual Fund(s) you wish to move. Unless othemise Indicated, TO Ameritrade will transfer shares in-kind. This section pertaIns only to shares of Mutual Funds held directly with the fund company. for brokerage accounts containing Mutual Funds and/ce Stocks please complete the Brokerage Firm Transfer section (Section 3A, above). Proprietary MutualFunds and allno-load Money Markel funds canna be transferred in-kind and must be liquidated. Quantity Handling Gains & Dividends Fund Name or Symbol Mutual Fund Account N (Indicate 0 of shares or ALL, (Check one) (Check one Win-kind) a In-Kind IN Reinvest • Liquidate • Cash pin-Kind ['Reinvest ['Liquidate Ill Cash E lnaind Liquidate M Ftelmest ['Cash "If you are transferring more funds than will fit above, please Include an attached list for the complete list of funds. ID Wire A statement MUST be included to ensure proper handling and processing of your MutualFund transfer. (tees may apply) • Unless othenvise indicated, I authorize the Transferor to liquidate any non-transferable proprietary money market OCheck and mutual fund assets that are part of myaccount and to transfer the resulting credit balance to my account yeth TO Ammitrade. If the fund Ls unable b be held by TO Amentrada I (please initialhere) authorize the Transferor fo liquidate and translates cash. SONY_OpUigfbMe3 CONMENTIAL EFTA_00123057 EFTA01268455  TO Amcritrade Acct rs 867-730320 Registration Difference For unlike titled or type transfers, such as Individual to Joint. I authorize the transfer from account to account. AN parties on the delivering account must sign below. All TD Ameritrade parties must sign in section 6 for transfer authorization. Client Signature: X Client Signature: Date: X Client Signature: Date: X 5. ONE AND THE SAME LETTER (IF APPLICABLE) Date: If you are trans:ening an account, and the name(s) at TD Ameritrade do not exactly match but are sill one and the same person, please complete this section. This section should be utilized if your name has changed due to one or more of the following: Marriage, Divorce. Name Spelling Error, or any type of Name Change including Jr.. Sc. etc. If last name difference. must supply legal documentation: that is, state issued drivers license. passport, or government ID. (Please specify account types, such as Individual to Joint) (please print name), am One and the Same as (please print name) as shown on the delivering Inn account. Please speciy account type.% such as Individual to Joint) Please sign name BOTH ways. X Signature: X Signature: All TD Ameritrade account holders (clients or trustees) as Indicated by the account registration must sign this section. Unless otherwise indicated in the instructions above, please transfer, in-kind. all assets into my account with TO Ameritrade. I understand that the extent any assets in my account are not readily transferable, with or without any penalties, such assets may not be transferred within the time frames required by applicable regulations. I understand I via be contacted by the carrying and/or receiving firm with regard to any assets that are not transferable. I authorize the Transferor to deduct any outstanding fees due to transfer from the credit balance, or if the credit balance in the account is insufficient to satisfy any outstanding fees If certificates or other instruments In my account are in your physical possession. I instruct Transferor to transfer them in good deliverable form, including affixing any necessary tax waivers, to enable the successor custodian to transfer them in its name for the purpose of sale, when and as directed by me. I understand that upon receiving a copy of this transfer instruction, for a fug account transfer. Transferor wilt freeze my account and cancel all open orders. I also understand that no new orders may/will be taken. I affirm that I have destroyed or returned to the Transferor all credit/debit cards and/or unused checks issued to me in connection with my account. If this TD Ameritrade account is a qualified retirement account. I have amended the applicable plan to designate the successor custodian. Alternatively, if this TO Ameritrodo account is an Individual Retirement Account (IRA), I have adopted an IRA plan so that it names the successor custodian. (Medallion Signature Guarantee - For TO Amentrade Use Oily) 4,1(' Caere Signature: Dale: X Co-Owner's Signature: Dale: X Co-Owner's Signature- Dale: X Coawners 7. LETTER OF ACCEPTANCE (FOR OFFICE USE ONL. Date: The undersign • organization it agroes to serve as successor custodian for the account of the above-named individual, and as custodian. we agree to accept the as s being trans red. (Medallion Signature Guarantee — For TO Ameriviale Use Only) Represen alive Signature'. Date: X Representative RIAtettlarnir_.---' -7.5- 209 For TD Ameritrade Caring, use only Please be advised t t TD eritrade Clearing, Inc. is an Approved 403(b)(7) Vendor' andlor has into an Information Sharing Agreement with the Employer for the above-captioned 403(b)(7) account. The Employer/Agent Signature above hereby authorizes TD Ameritrade Clearing. Inc. to accept this exchange. Investment Products: Not FDIC Insured • No Bank Guarantee ' May Lose Value TD Ameritrade, Inc. and TO Ameritrade Clearing, Inc., members FINFtA/SIPC. TD Ameritrade is a trademark jointly owned by TD Ameritrade IP Company, Inc. and The Toronto-Dominion Bank. 2018 TD Ameritrade. SONY_GM_OOrnefabc cdng CONFIDENTIAL EFTA_00123058 EFTA01268456