EFTA01449441.pdf

Account JIM IV. PARTIAL TRANSFERS. DIRECT MUTUAL FUNDS AND LIQUIDATIONS (If there are more than eight assets, attach a signed list to this form) eukprire ASSET DESCRiPTON frelACCOUNT CUSIP./SYMBOLFUND TRANSFER CAPOAL CAIN ESTIMATED tABER TRANSFERiNSTRUCTIONS• DIVIDEND OPTION" OPTIOhF VALUE 57,000 Ally pfd 02005N308 0 Transfer in Kind 0 Liquidate 0 Cash U Ramer J Cash 0 Reinvest 1.525mm CI Transfer in Kind 0 Liquidate 0 Cash 0 Renvest ..I Cash U Reinvest O Transfer in 14nd 0 Liquidate 0 Cash 0 Reinter U Cash 0 Reinvest 0 Transfer in Kind 0 Liquidate 0 Cash 0 Reinvest J Cash U Reinvest 0 Transfer in 14nd 0 Liquidate 0 Cash 0 Reinvest U Cash 0 Reinvest 0 Transfer in Kind 0 Liquidate 0 Cash 0 Reinvest J Cash U Reinvest O Transfer in Igrid 0 tiquidem 0 Cash 0 Reinvest U Cash 0 Reinvest 0 Transfer in Kind 0 Liquidate 0 Cash 0 Reinvest j Cash U Reinvest 1 II you have requested a rqulatIon, your market price is not gee/awed. YOu will receive the current Market price after your transfer request is received. reviewed, and determined to be In good order by the delivering firm. Pershing is not responsible for market fluctuations or delays in the review process. DRS ibbrilS cannot be liquidated. 2 II this is a mutual fund transfer and there is no dividend or capital gain option checked in the section above. Pershing will PrOCOS$ this request as reinvest (FOR OFFICE USE ONLY: All transfers must be added to Pershing's transfer systems) V. RETIREMENT PLAN RESTRICTIONS AND CERTIFICATIONS Hi Age 70' - restrictions. It you are at least me age of 70 this year and you are transferring or rolling over assets from an IRA. qualilied plan or 40300 account. you may be required to lake a minimum diasibuti.on (RMO) from your qualified plan or 40310) account before rolling over your assets. It Rollover Certification of Employee: I understand the rules and conditions and I have met the requirements for making a rollover. Due to the important tax consequences of rolling over lunds or property. I have been advised to see a tax prolevuonal. All information provided by me is true and correct and may be relied on by Pershing LLC. I assume full responsibility for this transaCtion and will not hold Pershing LLC liable for any adverse consequences that may result I hereby irrevocably designate this contribution in funds or other property as a transfer or rollover contribution. TO THE PRIOR TRUSTEE: U Pershing LLC accepts appointment as successor custodian. U Please be advised that does hereby accept appointment as successor custodian (how Firm Name) SUCCESSOR CUSTODIAN'S SIGNATURE: DAT E VI PARTICIPANT SIGNATURE AND CERTIFICATION To the Delivering f urn Named Aboso the trustee listed above. unless Oleo oz re pif,f, :5in er 411 L:! .:n ri,4:.<.c. .: :0 re:F.Inp, may be transferred within the time frames required by NYSL Rule 412 or smiler rule of the NASD or other deugnated exorening authority. Unless otherwise indicated in the instructions above, I /willowe you to liquidate any nontransferable propnelary money market fund assets that we pert of my account and transfer the retailing credo balance to the SUCCUSWI Custodian I authorize you to deduct any outstanding lees due to you from the credit balance in my account. II my account does not contain a Credit balance. or if the credit balance in the account is insufficient to satisfy any outstanding lees due to you. I authorize you 10 liquidate the assets in my account to the extent necessary to satisfy that Obligation. II ceiblicales or other instruments n my account are in wit physical possession. I instruct you to transfer Maim in good deliverable fonn, including affixing any necessary tax waivers, to enable the successor custodian to transfer them in its name nor the purpose of the sale, when. and as defeated to me. I understand that upon meowing a copy of this IL:writer inforMaIxon, you will cancel all open orders for my account on your books. I affirm that I have destroyed or returned to you credit/debit cards and/or unused checks issued tome n connection with my brokerage OCCOtra I understand that you will contact me vnth respect to the disposition of any assets in my brokerage account that are nontransferable. SIGNATURE GUARANTEED BY: CLIENT'S SIGNATURE: DATE: JOINT CLIENT'S SIGNATURE: DATE- Please attach your most recent brokerage account statement to process this account transfer INVESTMENT PROFESSIONAL'S NAME: INVESTMENT PROFESSIONAL'S PHONE NUMBER: CUSIP' belongs to its respective owner 09 I.WPA 059/ I IO/C0) Paw, 3 of 3 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0104872 CONFIDENTIAL SDNY_GM_00251056 EFTA01449441