EFTA01268275.pdf

t Page 1 of 41 Account Transfer Form 10 Amerltrade Mail or Fax to: PO Box 2760 • Omaha, NE 68103-2760 Fax: 000-400-0200 Receiving Firm DTC Clearing Number: 0188 Please use the Direct Registration System (DRS) Transfer Form TDA 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 Ameritrade Attn: TO Ameritrade, PO Box 2760, Omaha, NE 68103-2760 or fax to RFA-468-6288. 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 from your Qualified Retirement Plan, please contact your plan administrator; this form may not be required. It you are transtemng between two Ur Amentraoe accounts, please use tne Internal transfer corm. Please note you cannot use this fowl to transfer from a standard checking account and/or sayings account from a banklcredit union. For IRAs, and Beneficiary IRAs where the original owner woo 70% yon or older at death, plane 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 I HE Your TD Ameritrade Account DELIVERING ACCOUNT (As Wetted in section 7 DOM registration and Tax Ms for the (The registration of the account being transferred should match your TO Ameritrade account and the Tax ID for both the TO Ameritrade TO Ameritrade account end account being transferred should match.) account and account being transferred.) Account Number (Required): Account Number (Required): (qtly one per form) (Only one per form) Amount Reoidnatinnifitle. AccouN Registration/Title: SOUTHERN FINANCIAL LLC SOUTHERN FINANCIAL LLC bar: Social Sacurity/Tax ID Number. te3 umhar Social Security/Tax ID Number: (Secondary, It applicable) (Secondary, if applicable) ConlrotOeivenna Ron Name (PeKtuire40: Account Type (select one) DEUTSCHE BANK PRIVATE WEALTH MANAGMENT Olndividual - (Non IRA) El Traditional or Rollover IRA Contraajollvoting Ran Maroon: DJoint El Roth IRA 345 PARK AVE 26TH FLOOR NY,NY10154 DTruet CI Beneficiary IRA C floWhorl: I:ICOVBUSineSS ❑ Beneficiary Roth IRA DUCMNUTMA CIQualified Flon (401k, 403B, PER oto.) Contre/Defivenno nrrn Lmo I:IEState O SIMPLE IRA ❑ 3EP IRA Account Type (select one) 00ther: -(Non IRA) o Traditional or Rollover IRA 0JOint CIRom IRA oTrual ❑ Beneficiary IRA I:Corp/Business ❑ Beneficiary Roth IRA OUGMANTMA ❑ Qualified Plan (401k, 403D, P£R etc.) oEstate ❑ SIMPLE IRA o3EP IRA ElOther: lf the registrations do not match, you may either establish a new account online at wwwtdameritrade.com or you must supply additional documentation end oil delivering account owners must ego coot:on 4. For unlike talelregietratIon transte4 please call the transfer department at 888-723-8504, option 4 for additional requirements. 'Please note if there are any issues with processing your transfer, we will communicate that to you via your secure message center when you log in to your account. 11111ln MIMED HI SONY_GM_0000killer ettrle CONFIDENTIAL EFTA_00122799 EFTA01268275 (Page 2 0! 1) Page 1 From: "KOFAX PROD PROCESS" Date: Mon, 25 Feb 2019 15:57:39 -0500 To: Subject: ACAT transfer from DB //- messagelD=103743614 //- case ID=S8157869 Attachments: Attachment_20194566.zip, Attachment_20194567.zip From Address: Message ID: 103743614 Case ID: 58157869 Form Message FULL NAME: Richard Kahn ACCOUNT TITLE: SOUTHERN FINANCIAL LLC USERID: 867730320z ACCOUNT NUMBER: 867730320 User-Agent: Mozilla/5.0 (Macintosh; Intel Mac OS X 10.13; rv:65.0) Gecko/201C0101 Firefox/65.0 ENVIRONMENT: investameritradecom attached are two forms with securities we would like to transfer from DB to TD. Thank you and please call me with any questions. [ Attachment I Type: application/pdf Name: TD_Bank_ACAT_transfer_fromDB_2-25-2019_I_of 2.pdg [ Attachment 2 Type: application/pdf Name: TD_Bank_ACALtransfer_from_DB_245-2019_2 of 2.pdfj SONY_GM_00012149 CONFIDENTIAL EFTA_00122800 EFTA01268276 tillage 3 of 41 rD Amentrade Accr a 867 730320 3. TRANSFER INSTRUCTIONS-PLEASE COMPLETE ONLY ONE OF THE FOLLOWING SECTIONS (A,B, OR C) A. BROKERAGE FIRM TRANSFER (Unless otherwise indicated, TO Ameritrade will transfer in Full) ['Full Transfer—To transfer entire account. check here and 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 notion*. Asset Description (CUSP or symbol) Quantity Asset Description (CUSIP or symbol) Quantity (Partial Traersfeer Only) (Indicate rt of whole shares (Parkal Trans/0m Only) (Indicate 1 of 'shale shares or 'AGO or ALL') 1. 04621XAK4 2,000,000 5. 30102RAA9 3,000,000 2. 172967J25 3,000,000 6.361860208 80,000 3. 172967341 79.000 7. A29866AB5 2.000.000 4. 17453BAW1 1,000,000 8. 46625HHA1 5,760,000 B. BANK/CREDIT UNION & ANNUITY TRANSFER Transfer cash only. Unless otherwise indicated, all cash will be transferred. Banks, Annuity, and Trust Companies require Original Client Signature. Please mall the Original form to complete the transfer request. IRA Savings Accounts-Typically held with Bankleredit Union. OTotal Transfer (Transfer entire account) ❑Wire gees may aPPY/ ['Partial Transfer (Transfer part of account) Portion to transfer $ 0 Check Certificates of Deposit (CDs). ['Redeem my CD immediately. l am aware of, and acknowledge, that 1am responsible for any penalties that I may incur from any early withdrawal. ORedeam my CD et maturity. Maturity Date: Submit request at least 21days prior to maturity Please advise your bank not to roll over your CD to a new term. Indicate in this section whether you wish fo liquidate the CD immediately or at maturity For any Investment instruments that have a renewal deadline, maturity date, surrender charge pertodlwindow etc., paperwork must be received by TD Ameritrade in good order three weeks prior to the firm deadine 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 0 Full El Partial $ 0 WIN I have an annuity policy that I wish to transfer. Please redeem and terminate on my behalf ❑ (fees mayamay) I am aware of. and acknowledge. that I am responsible for any penalties that I may Incur from n Check any early withdrawal. Select only one: Ufit/ate annuity in full or partial liquidation. If partial is selected. amount for partial must be included. TO Ameritrade is not responsible (or the liming or execution of liquidations processed by the delivering firm. C. MUTUAL FUND COMPANY TRANSFER Check box for In-kind or Liquidation Transfer. Please list the Symbol or CUSIP for the Mutual Fund s) you wish to move. Unless otherwise Indicated, TO Ameritrade will transfer shares in-kind. This section pertains only to shares of Mutual Funds held directly vrith the fund company, for brokerage accounts containing Mutual Funds andAtc Stocks please complete the Brokerage Firm Transfer section (bestial 3A, above). 'Proprietary MutualFunds and all no-load Money Market funds cannot be transferred in-Idnd and must be liquidated. Quantity Handing Gains & Dividends Fund Name or Symbol Mutual Fund Account 4 (Incises a of shams or IM17 (Cheater ono) (Chock one if k:-kind) • In-Kind ■ Reinvest • Liquidate U Cash Din-Kind CIPeinvest 0Liquidate °Cash Ill In-Kind OReinvest ['Liquidate • ash 'If you are transferring more funds than will fit above, please include on attached list for the complete list of funds. OWIre 'A statement MUST be included to ensure proper handling and processing of your Mutual Fund transfer (fees may apply) ' Unless othenvise indicated, I authorize the Transferor to achartate any non-transferable propnetary money market OCheCK and mutual fund assets that are part of my account and to transfer the resulting credit balance to my account with TO Ameritrade. If the fund is unable to be held by TDAmeritrede, I (please initialhare) authorize the Transferor to liquidate and transfer as cash. SONT_QM3.000420130 CONFIDENTIAL EFTA_OOI 2280 I EFTA01268277  TD Ameritraae Acct a 007-730320 Registration Difference for unlike titled or type transfers, such as Individual to Joint. I authorize the transfer from account to account. All parties on the delivering account must sign below. All TD Ameritrade parties must sign in sectica 6 for transfer authorization. X talent signature: Date: X cam, signature: Cana 31ggialtsie. Uate: Date: 5. ONE AND THE SAME LETTER (IF APPLICABLE) If you are transferring an account, and the name(s) at TD Ameritrade do not exactly match but are stir one and the same person. please complete this section. Tries section snout° De utilized rf your name has cnangeo due to one or more of me fottowIng: MaMage, Divorce, Name Spelling Error, or any type of Name Change including Jr, Sr, etc. If last name difference, must supply legal documentation: that is, slate issued driver's license, passport, or government ID. (Please specify account typos, such as Individual to Joint) (please print name), am One and the Same as (please print name) as shown on the delivwing firm account. (Please specify account typos, such as Individual to Joint) Please sign name BOTH ways. X Signature: 6. TD AMERITRADE CLIENT AUTHORIZATION (REQUIRED) X Signature: All TD Ameritrade account holders (clients or trustees) as indicated by the account reeistration must skin this section. Unless otherwise indicated in the instructions above, please transfer, in-kind, all assets into my account with TD Ameritrade. I understand that the extent any assets in my account are not readily transferable, with a without any penalties, such assets may not be transferred within the time frames required by applicable regulations. I understand I will 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 Traisfuiu, 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 full arra, nt transfer Transferor will freeze my account and cancel all open orders. i also understand That no new orders mayNvill be taken. I affirm that I have destroyed or returned 10 the Transferor all credrt/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. Aitematively, if this TD Ameritrade account is an Individual Retirement Account (IRA), I have adopted an IRA plan so that it names the successor custodian. (Medallion Signature Guarantee - For TD Ameritrade Use Only) X Client Signature: Date: X Co-Owner's Signature: Date. X Cade-noes Signature: Co-Owner's Signature Dale Data 7. LETTER OF ACCEPTANCE (FOR OFFICE USE ONLY) The and accept the igned aganizarior agrees to serve as successor custodian for the account of the above-named individual, and as custodian, we agree to assets being ben erred. (Medallon Signature Guarantee - For TD Amer:Made Use Onty) X Rel7intative Signaler Reeresentathe Printed Dace: Z./25720/q For TD Amerltrede Cls6ring, . use only Please be advised tha TD eritrade Clearing. Inc. is an 'Approved 403(b)(7) Vnntine and/nr has ant ri into an Infnrinatinn Sharing Agreement with !ha Fmpinynr for the above-captioned 403(b)(7) account. The Employer/Agent Signature above hereby authorizes TO Ameritrade Clearing. Inc. to accept this exchange. Investment Products: Not FDIC Insured ' No Bank Guarantee ' May Lose Value) TD Ameritrade, Inc. and TD Ameritrade Clearing, Inc., members fINRNOInC. TD Ameritrade Is a trademark jointly owned by TD Ameritrade IP Company, Inc. and The Toronto-Dominion Bank. 2018 TO Ameritrade. SDNY_GM_00elleftfit 03(16 CONFIDENTIAL EFTA_00122802 EFTA01268278