EFTA01268360.pdf

Account Transfer Form 10 Ameritrade Mail or Fax to: PO Box 2760 . Omaha, NE 68103-2760 Fax: 866-468-6268 Receiving Firm DTC Clearing Number: 0188 Please use the Direct Registration System (DRS) Transfer Form T0A 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 AmerIkeda, 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. yeti are requesting to transfer from your Qualified Retirement Plan, please contact your plan administrator; this form may not be required If you are transferring between two TD Ameritrade accounts, please use the Infernal 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, and Beneficiary IRAs where the original owner was 7034 years or older at death, please attach a copy of your end of year statement to enable us to calculate the required rninimum distribution kr the account. 1. ACCOUNT INFORMATION 2. PLEASE PROVIDE INFORMATION ABOUT THE DELIVERING ACCOUNT Your TO Ameritrado Account (The registration of the account being transferred should match your (As deeded in Section 1 both registration and Tax Os for the TD Amedtrade account and the Tax ID for both the TO Amer/trade TO Ameritrade account and &gownt being transferred should match.) account and account being transferred.) Account Number (Required): Account Number (Required): (O* one per form (O* one Perform) N4G•023804 Account Reciatrati i Account Recielrationfrate: SOUTHERN FINANCIAL LLC SOUTHERN FINANCIAL LLC SoriN Socutay/Tax ID Number: 4. Social0S /Tax ID Number. 66-0799192 Social Security/Tax ID Number ax ID Number. (Seceerrafx M applicable) (Secondary, a appricalse) Contracmilivenng Farm Name (Required): Account Type (select one) DEUTSCHE BANK PRIVATE WEALTH MANAGMENT ❑Individual — (Non IRA) OTraditional or Rollover IRA CceararDerwaing Fkm Adams: Rohl ❑ Roth IRA 345 PARK AVE 26TH FLOOR NY,NY10154 Trust ❑ Beneficiary IRA ContrwDefwnn Firm Phone Number (Required): 0CorpfBusiness O Beneficiary Roth IRA OUGMA/UTMA O Qualified Plan (401k, 4038, PSR etc) Contra/Delivesing Firm Email: DEState O SIMPLE IRA O SEP IRA Account Type (select one) pother: OIndividual - (Non IRA) O Traditional or Rollover IRA OJoint O Roth IRA ElTrust O Beneficiary IRA aCorp/Business O Beneficiary Roth IRA OUGMAILITMA O Qualified Plan (401k, 4038, PSP, etc.) OEstate O SIMPLE IRA ❑ 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 title/registration transfer, 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, wo will communicate that to you via your secure message center when you log in to your account IIIIII III II III MI CONFIDENTIAL S0NY_GM_00O2BISS wits EFTA_00122913 EFTA01268360  TD Ameritrade Acct 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 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 shams cannot be transferred. Please contact the delivering firm regarding your options. Asset Description (CUSIP or symbol) Quantity Asset Description (CUSIP or symbol) Quantity (Partial Transfers Only) (Indicate Sof whole shams (Partial Transfers Only) findcata 0 of whole shares WALL) orALL 7 1. 539439AG4 1,903,O00 5. 2. AAPL 180600 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 fonn to complete the transfer request. IRA Savings Accounts—Typicallyheld with Bank/Credit Union. ['Total Transfer (Transfer entire account) O Wire (fees may *PAW O Partial Transfer (Transfer part of account) Portion to transfer S ❑ Check Certificates of Deposit (CDs). ['Redeem my CD immediately. I am aware of, and acknowledge, that lam responsible for any penalties that 1may incur from any early withdrawal. ['Redeem my CD at maturity. Maturity Date: Submit request at least 21 days prior to matting( Please advise your bank not b 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 Investment instruments that haw a renown) deadline, maturity dela 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 em being held. Annuity Transfer OTransfer my Annuity ❑Full D Partial $ El Wks I have an annuity policy that I wish to transfer Please redeem and terminate on my behalf. him may app,') l am aware of, and acknowledge, that I am responsible for any penalties that I may incur from O 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 timing or execution of liquidations processed by the delivering firm. C. MUTUAL FUND COMPANY TRANSFER Cheek 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 with the fund company. for brokerage accounts containing Mutual Funds and/or Stocks please comple e the Brokerage Firm Transfer section (Section 3A, above). Proprietary MutualFunds and alI no-bad Money Market funds cannot be transferred in-kind and must be liquidated. Quantity Handling Gains & Dividends Fund Name or Symbol Mutual Fund Account 0 (Indicate Not shares or -ALL) (Check one) (Check one if ln-kind) • In-Kind • Reinvest • Liquidate • Cash Oln-Kind O Reimest OLiquidaM III Cash B M-Kind Liquidate • Ftelmest oCash If you are transferring more funds than will fit above, please include an attached list for the cowrie e list of funds. ID Wire *A statement MUST be included to ensure proper handling and processing of your MutualFund transfer. (fees may apply) • Unless otherwise indicated, I authorize the Transferor to liquidate any non-transferable proprietary money market O Check and mutual fund assets that are part of my account and to transfer the resulting credit balance to my account with TO Amentrade. If the fund is unable to be held by TO Ameritrade. I (please initialhere) authorize the Transferor fo liquidate and transfer as cash. soNY_Obtigebt$394 C0 ENTIAL EFTA_00122914 EFTA01268361  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 TD 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_OOltgaggS ortng CONFIDENTIAL EFTA_001229 I 5 EFTA01268362