EFTA01381399.pdf

TD Ameritrade Acct 4. REGISTRATION DIFFERENCES AND DELIVERY ACCOUNT OWNERS' SIGNATURES ifF APPLICABLE) 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 delivenng account must sign below. All TO Ameritrade parties must sign in section 6 for transfer authorization. X Chent Signature: Date X Client Signature: Date: X Client Signature' 5. ONE AND THE SAME LETTER (IF APPLICABLE) Date If you are transferring an account, and the name(s) at TO Ameritrade do not exactly match but are still 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, Sr, etc. If last name difference, must supply legal documentation: that is, stale issued driver's 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 delivenng firm account. (Please specify account types, such as Individual to Joint) Please sign name BOTH ways. X Signature: 6. TD AMERITRADE CLIENT AUTHORIZATION (REQUIRED) Signatere' All TO Amerltrade 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 TD Ameritrade. I understand that the extent any assets in my account are not read!y transferable. with or 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 Transfercr to deduct any outstanding lees 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, fa a full account transfer. Transferor will freeze my account and cancel all open orders. I also understand that no new orders mayhvill be taken. I affirm that I have destroyed or returned to the Transferor all credilldebit 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 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 Ameranade Use Only) )(Gent Signature: Date: X CoOrmers Signature: )(Co -Owners Signature Date: Date: X Co.Oeners Signature 7. LETTER OF ACCEPTANCE (FOR OFFICE USE ONLY) Date The undersigned organization agrees to serve as successor custodian for the account of the above named indrvidual, and as custodian, we agree to accept the assets being transferred. (Modallisri D Aim )( Representative Signature: Date Representative Printed Name: For TO Amerltrade Clearing, Inc. use only Please be advised that TO Ameritrade Clearing. Inc. is an 'Approved 403(b)(7) Vendor' and/or has entered into an Information Sharing Agreement with the Employer for the above-captioned 403(b)(7) arrant. The Employer/Agent Signature above hereby authorizes TD Ameritrade Clearing. Inc. to accept this exchange Invesancrt Prccuc:s Not FDIC Insured ' No Byt G.arantce ' May Lose Ve.Jel TD Ameritrade. Inc. and TD Ameritrade Clearing, Inc., members FINRNSIPC. TD Ameritrade is a trademark jointly owneri by TO Amentrade IP Company, Inc and The Toronto-Dominion Bank.* 2018 TO Ameritrade. NY 3 o13 DA liter @3"6 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0080345 CONFIDENTIAL SDNY_GM_00226529 EFTA01381399