📄 Extracted Text (391 words)
Account Transfer Form
I. RECEIVING FIRM INFORMATION (Only one per form)
RECEIVING FIRM CLEARING NUMBER O443
ACCOUNT NUMBER:
or TAXPAYER
SOCIAL SECURITY IDENTIFICATION
NUMBER NUMBER:
SECONDARY SOCIAL r or TAXPAYER
SECURITY NUMBER. T 1- IDENTIFICATION
NUMBER:
1
ACCOUNT TYPE: (Enter the two character code) 11
Nonretiremeni: SN—ISinglei JT—I.loint) TR —(Trustl CT —Manumit.) CO —(Corporate) CU —(Custodiaril ES —(Estate)
BC- (Bank Custody) AG-Mgancy)
Retirement: IR — (Traditional IRAI RI—IFloth IRA) DR —(Direct Rollover) BI—(Beneficiary) BR —(Beneficiary Roth IRA)
4K —(40Ik) El —(Education Savings Account) SI —(SIMPLE IRA) QP—(Qualdied Plan) 4B —(403b)
7B—(457 Plan) HS—(Heallh Savings Account) 5P-(525 Plan)
Other: OT—iOther)
II. DELIVERING ACCOUNT INFORMATION
CLEARING NUMBER:
ACCOUNT NUMBER: µ'470K4006 DELIVERING FIRM CONTACT INFORMATION
(MANDATORY WHEN CLEARING NUMBER IS NOT PROVIDED)
FIRM NAME: JP Morgan
CONTACT NAME'
ACCOUNT TITLE (As it appears on your statement)
FIRM ADDRESS: (No PO Box)
he I kis 1;tat
- - - CITY' STATE: ZIP:
TELEPHONE NUMBER:
NOTE It statement is necessary to process this form.
III. TRANSFER TYPE (Choose only o
A. ACCOUNT TRANSFER
O FULL (Check one below)
O TRANSFER ALL ASSETS IN KIND (Skip to Sedan VI)
O LIQUIDATE ALL ASSE I S LISTED IN SECTION IV (Liquidations are not lor brokerage accounts)
O TRANSFER AU. ASSETS IN KIND EXCEPT FOR THE ASSETS USIED IN SECTION N. WHICH REQUIRE LIQUIDATION
0 PARTIAL (Complete Section M
B. DRS/DRIP
U FULL (Check one below)
O SELL FRACTIONS AND CLOSE ACCOUNT
O TRANSFER ALL FULL SHARES ONLY
O PARTIAL (List assets m Section N)
NOTE: For transfer agents. electronically send positions or issue a certificate for whole shares and redeem tractional shares.
C. DIRECT MUTUAL FUND
LI TRANSFER MUTUAL FUNDS FROM THE ACCOUNT HELD DIRECTLY AT THE FUND COMPANY ISee Est in Section IV for exact
instructions)
NOTE: Only one fund family per form.
D. BANK RETIREMENT PLAN ACCOUNTS (Select only one)
O UOUIDATE IMMEDIATELY AND TRANSFER CASH I am aware of and acknowledge any penalty I will incur from an earty withdrawal.
O UOUIDATE AT MATURITY AND TRANSFER CASH Specify maturity date 'submit two to three weeks before maturity date).
NOTE: Liquidations involving bank CDs. checking accounts. or savings accounts can only be processed from retirement accounts.
1
SIGNATURE DATE I ir
- II,
SIGNATURE DATE RPE)-150 ACAT
COW )J-0G97 Pant 2 ot 3
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0104944
CONFIDENTIAL SDNY_GM_00251128
EFTA01449506
ℹ️ Document Details
SHA-256
2629a6cfe4da0afcc8bdd2bd0a650d8edf71e291b84812b3d60b221774d6e3d3
Bates Number
EFTA01449506
Dataset
DataSet-10
Document Type
document
Pages
1
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