EFTA01268279.pdf

(Page 1 of 4) Account Transfer Form ID Ameritrade Mall or Fax to: ■ Omaha, NE 68103-2760 Fax: 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 Amer/trade, PO Rox 2780, Omaha, NF 6R103-7760 or fax to 886-4613-878/3. To submit tha compIntml 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. If you are transferring between two TD Amerluade accounts, please use the Internal transfer form. Please note you cannot use tills form to transfer from a standard checking account and /Or savings account from a banklcredit union. For IRAs, and Beneficiary IRAs where the original owner was 7014 years or older at death, please) attach a copy of your end of year statement to enable ut to calculate the required minimum distribution for the account. 1. ACCOUNT INFORMATION 2. PLEASE PROVIDE INFORMATION ABOUT THE Your TD Ameritrade Account DELIVERING ACCOUNT (The registration of the account being transferred should match your (As directed in Section loom registration and tax IDS tor the TD Ameritrade account and the Tax ID for both the TO Amentrade TO Amerifrade account and account being transferred shouldmatch.) account and account being transferred.) Account Number (Required): Account Number (Reoulredl: (Only one perform) (Only ono perform) Account Reputation/Tide: Account Resestrationclitle: SOUTHERN FINANCIAL LLC SOUTHERN FINANCIAL LLC Social Secunly/Tax ID Number: Social Security/Tax ID Number. Social Security/Tax II) Number- Social Security/Tax ID Number: (Secondsy II applicable) (Secondary If applicable) ConfrodOelkedng arm Nome (Rogukoco. Account Type (select one) DEUTSCHE BANK PRIVATE WEALTH MANAGMENT Eilndividi pal — (Non IRA) O Traditional or Rollover IRA Corterulaelneering firm Addro,a: IDJoint El Roth IRA NY,N Y10154 EITrust OBeneficiary IRA v er (:cow/ad) ECorp/Business o Beneficiary Roth IRA Ducwvvrtm LI Qualified Nan (401k, 4038, PER ate.) Cvntiathrliveiiny Fi; lit Et 'toil DEstate El SIMPLE IRA ❑ 3EP IRA Account Type (select one) EIOther: OInclividual (Non IRA) O Traditional or Rollover IRA EJoint ❑ Roth IRA OTrust O 0eneficiary IRA EJCorp/Business O Beneficiary Roth IRA DUG:AAA/7MA 0 Qualified Plan (401k, 4038. P3P, etc.) EIESIalb ❑SIMPLE IRA O SEP IRA ['Other: 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 ell delivering account owners must sign section 4. For unlike tifielreglatretion transfer; please eon the transfer department at n8423-8504, 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 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII CONFlOENTIAL SDNY_GM_00001452, owe EFTA_00122803 EFTA01268279 (Page 2 of 4/ TD Ametibetha AW P 867-730320 3. TRANSFER INSTRUCTIONS-PLEASE COMPLETE ONLY ONE OF THE FOLLOWING SECTIONS (A.6, OR C) A. BROKERAGE FIRM TRANSFER (Unless otherwise indicated, TD 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 bakes If bonds aro being transferred, please supply the CUSIP. Only whole shams can ba requested as fractional shares cannot be transferred. Please contact the delivering firm regarding your options. Asset Description (CUSIP or symbol) Quantity Asset Description (CUSIP or symbol) Quantity (Porno/ Translort Only) (Indkolo ll al whoa shams (Psival rilloStolO Only) hkuttiota Al °lank, Atka/lit or "ALL") or -ALL) 1. CASH 5,000,000 S. AMZN 1,000 2. GOOG 3,000 6. BABA 5,000 3. CVNA 25.000 7. BIIB 2.095 4. UTX 15,000 8. KPTI 25,000 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 mail the Original form to complete the transfer request. IRA Savings Accounts—Typically held with Bank/Credit Union. El total Transfer ( transfer entire account) O Wire (fees troy OPPlY) ['Partial Transfer (Transfer part of account) Portion to transfer O Check Certificates of Deposit (CDs). ['Redeem my CD immediately. I am aware of, and acknowledge, that lam responsible for any penalties that I may incur from any early withdrawal. ['Redeem my CD at 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 °action whether you wish to liquidate the CD immediately or at maturity For any investment instruments that have a renewal deadline, maturity dare. surrender charge periodlvdndow. etc., paperwork must be received by TO Ameritrade in good order three weeks prior to the firm deadline to allow for proper processing times. To liquidate a CD held kit non-retirement account, contact the bank or credit union at which the assets are being held. Annuity Transfer ['Transfer my Annuity 0 Full O Partial $ Wire I have an annuity policy that I wish to transfer. Please redeem and terminate on my behalf. ❑ (fees may apply) lam aware of. acknowledge. that lam responsible for any penalties that I may incur from ri 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 Amenlrade is not responsible for the timing 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 with the fund company, for brokerage accounts containing Mutual Funds and/or Stocks please complete the Brokerage Firm Transfer section (Section 3A, above). Proprietary Mutual Funds and all no-load Money Market funds cannot be transferred in-kind and must be liquidated. Quantity H wiling Gains &Dividends Fund Name or Symbol Mutual Fund Accounts (Indicate e of shares or ACC) (Chock ono) (Clock ono ifhalm; OIn-Kind M Reinvest OLiquidate OCash • InKind ■ Reinvest M Liquidate ■ Cash O IwKind 0 Reinvest M Liquidate • Cash if you are transferring more funds than will fit above, please include en attached list for the complete list of funds ID Wire A statement MUST be included to ensure proper handling and processing of your Mutual Fund transfer (tees may apply) Unless oMenvise indicated, 1 autnonze are transferor to liquidate any nontransferable propnetary money market ❑ Check and mutual fund assets that are part of my account and to transfer the resulting credit balance to my account with TO Amoritrodu N tho fundis unoblo to be hold by TDAmeritnadc, I (plcoac initialhare) authorize the Transferor to liquidate and transfer as cash. SDNY_Gtge06801,368 CONFIDENTIAL EFTA 00/22804 EFTA01268280  To ornerier:ale OW U 867.730320 Registration Difference For unlike tilled or typo transfers, such as Individual to Joint, I authorize the transfer from account to account. All parties on the dekvering account must sign below All TD Ameritrade parties must sign In section 6 for transfer authorization. Client Signature: Date: X Client Signature. X Client Signature. Date. Dale. X 6. ONE AND THE SAME LETTER OF APPLICABL E) If you aro transferring an account, and the names) at TD 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 room of the following: Marriage, Diyuros, Name Suefing EI run, or any type of Name Change Including Jr, Sr., etc. If last name difference, must supply legal documentation: that is, state 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 delivering firm account. (Please specify account types, such as Individual to Joint) Please sign name BOTH ways. Signature: )(/ Signature: X 6. TD AMERITRADE CLIENT AUTHORIZATION (REQUIRED) 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 lime 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 cenmcates or other instruments In my account are in your physical IX)55115SILIII. I hisliu,d Toil brut VI 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. whenan a itected by me. I understand that upon receiving a cony of this !ranee, instruction. for a hill annonni transfer. Transferor will freeze my account and noel all open orders. I also understand that no new orders mayMS be taken. I affirm that I have destroyed or returned to the Tra eferor all crediUd cards and/or unused checks issued to me in connection with my account. If this TD Ameri de account is a lifted retirement account, I have amended the applicable plan to designate the successor custodian. Alternatively, if t is TD ArneritradOccount is an Individual Retirement Account (IRA), I have adopted IRA plan so I t it names the successor custodian. (Medallion Signature Guarantee — For TD Amentrade Use Only) X Client Signalize: ------- (....- Dale./ X 4X Co-Caner% Signature. Co-Owner's Signalize. ... .........„....,..--- Date: Dale: Uate: X Co-Owners Signature: 7. LETTER OF ACCEPTANCE (FOR OFFICE USE ONLY) The undersigned organization agrees to serve as successor custo Ian for the account of the above-named individual, and as custodian, we agree to accept the assets being transferred. (Medallion Signature Guarantee — For TD Ameritrade Use Only) X Representative Signature: Reptesentati.ie Printed Na-ne. Date: For TO Ameritrodo Clearing, Ina. use only Please be advised that TO Ameritrade Clearing. Inc. is an Approved 403(bX7) Vander' and/nr has antnran into an Information Sharing Agreement with tha Frnployer 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 riNnAtairc. TO Ameritrade is a trademark jointly owned by TO Ameritrade IP Company. Inc. and The Toronto-Dominion Bank. O 2G18 TD Ameritrade. SDNY_GM_000WISOF 03,18 CONFIDENTIAL EFTA_00122805 EFTA01268281 (Page 1 0! 1) Page 1 From: "KOFAX PROD PROCESS" Date: Wed, 6 Feb 2019 19:57:32 -0500 To: Subject: Transfer status //- messagelD=103373452 //- casel I: 57917391 Attachments: Attachment_20049579.zip From Address: Message ID: 103373452 Case ID: 57917391 Form Message FULL NAME: Chad ACCOUNT_TITLE: SOUTHERN FINANCIAL LLC USER1D ACCOUNT NUMBER: TRANShh.R._TYPE: External NANIEOFTRANSFEREEFI: Deutsche Bank ACCOUNT_TITLE_AT_TRANSFEREE_FI: Southern Financial LLC TRANSFER_SUBTYPE: Partial transfer User-Agent: Mozilla/5.0 (Macintosh; Intel Mac OS X 10.13; rv:65.0) Gecko/20100101 Firefox165.0 ENVIRONMENT: invcatemcritradc.com Account Tmrzfer form completed [ Attachment 1 Type: application/pdf Name: TD_Bank_ACAT_transfter_from_DB_2-6-2019.pdfl SONY_GM_00012155 CONFIDENTIAL EFTA_00122806 EFTA01268282