EFTA01252229.pdf

Account Transfer Form 1D Ameritrade Mail or Fax to: PO Box 2760 • Omaha, NE 68103-2760 Fax: 886-468-8268 Receiving Firm DTC Clearing Number PM 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 1D Ameritrade Attn: TD Ameritrade, PO Box 2760, Omaha, NE 68103-2760 or fax to 866468.6268. 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. "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 TO Ameritrade accounts, please use the Internal transfer form. Please note you cannot use this form to transfer from a standard checking account and /or savings account from a bankfaedit union. For IRAs, and Beneficiary IRAs where the original owner was 70M years or older at death, please attach a copy of your end of year statement to enable us fo calculate the required minimum distribution for the account. 1. ACCOUNT INFORMATION 2. PLEASE PROVIDE INFORMATION ABOUT THE DELIVERING ACCOUNT Your TO Amoritrade Account (The registration of the account being transferred should match your (As directed in Section 1both registration and Tax IDs for the TO Amerittade account and the Tax ID for both the TO Ameritrade TO Arnentrade account and account being transferred should match.) account and account being transferred.) Account Number (Required): Account Number (Required): one perform) 867-730320 (On17 One per (0m) N4G-0238O4 Account Resestradorifhtle: Account Registration/rat SOUTHERN FINANCIAL LLC SOUTHERN FINANCIAL LLC Social Security/Tax ID Number Social Secuntyfrax ID Number Serial Securtty/Tax ID Number: Social Secunty/Tax ID Number. (Secondary If applicable) (Secondary, d apgatable) ContraVellvedng Firm Name (Required): Account Type (select one) DEUTSCHE BANK PRIVATE WEALTH MANAGMENT hint Trust — (Non IRA) 0 Traditional or Rollover IRA ❑ Roth IRA ❑ Beneficiary IRA ControlDervering rem Address: 345 PARK AVE 26TH FLOOR NY,NY10154 Cent t n Firm Phone umber Requited): 0CorprBusIness ❑ Beneficiary Roth IRA ❑UGMANTMA ❑ Qualified Plan (401k, 4038, PSP, etc.) Contra/Deliering rum Email: ❑Estate ❑ SIMPLE IRA ❑ SEP IRA Account Type (select one) ❑Other: — (Non IRA) ❑ Traditional or Rollover IRA ❑Joint ❑ Roth IRA ❑Trust ❑ Beneficiary IRA SCOrp/BuSiness ❑ Beneficiary Roth IRA OUGMA/UTMA ❑ Qualified Plan (401k, 4038, PSP, etc.) ❑Estate ❑ SIMPLE IRA ❑ SEP IRA ❑Other: If the registrations do not match, you may either establish a new account online at ovewtdameritrade.com or you must supply additional documentation and an delivering account owners must sign section 4. For unlike title/registration transfec press* call the transfer department at 888-723-8504, option 4 for additional requirements. Please note if there are any Issues with processing your transfec we will communicate that to you via your secure message center when you log In to your account. IIIIIIIIIIuiiVIII III Page I of 3 TDA 190 F 03118 EFTA01252229  TO Ameritrade Acct It 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 and 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 shares cannot be transferred. Please contact the delivering firm regarding your options. Asset Description (CUSIP or. Quantity Asset Description (CUSIP or symbol) Quantity (Partial Transfers Only) (Indicate • of whole Satan (Partial Transfers Only) endecala I drib* shares or ALL7 or 1. 539439AG4 1,903,000 5. 2. AAPL 180,000 6. 3. APO 263,157 7. 4. 8. 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. °Total Transfer (Transfer entire account) ❑ Wire !foes may apply) °Partial Transfer (Transfer part of account) Portion to transfer $ El 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 21 days prior to maturity. Please advise your bank not to 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 have a renewal deadline, maturity date. surrender charge period window, etc., paperwork must be received by TO Amerilrade 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 are being held. Annuity Transfer °Transfer my Annuity °Full °Partial • ❑Wire I have an annuity policy that I wish to transfer. Please redeem and terminate on my behalf. (fees may edgy) l am aware of, and acknowledge, that I am responsible for any penalties that I may Incur from °Check any early withdrawal. Select only one: Liquidate annuity in full or partial liquidation. If partial is selected, amount for partial must be included. TD Amentrade is not responsible for the timing or execution of liquidations processed by the delivering Arm. MUTUAL FUND COMPANY TRANSFER Chock box for In-kind er Liquidation Transfer. Please list the Symbol or CUSIP for the Mutual Fund s) you wish to move. Unless otherwise Indicated. TD Ameritrade will transfer shares in-kind. This section pertains only to shares of Mutual Funds held tiredly 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 Handling Gains &Dividends Fund Name or Symbol Mutual Fund Account # (kdkale ft of shares or WV) (Check one) (Check ow if/a-lamb OIn-Kind M Reinvest °Liquidate MI Cash E n•IGrod • Reinvest • Liquidate • Cash • n•Kind MI Reinvest • Liquidate • Cash If you are transferring more funds man will fit above, please include an attached list for the complete list of funds. CIWIre •A statement MUST be included to ensure proper handing arid processing of your Mutual Fund transfer. (fees may apply) • Unless otherwise indicated, I authorize the Transferor to liquidate any non-transferable proprietary money market °Cheek and mutual fund assets that are pan 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 initial here) authorize the Transferor to liquidate and transfer as cash. Page 2 of 3 T0A 190 F 03;18 EFTA01252230  TD Ameritrade Asset t/ 867-730320 4. REGISTRATION DIFFERENCES AND DELIVERY ACCOUNT OWNERS' SIGNATURES (IF APPLICABLE) Registration Difference For unlike tilled or type transfers. such as Individual to Joint, I authorize the transfer from atollInt to at. All parties on the delivering account must sign below. All TD Ameritrade parties must sign in section 6 for transfer authorization. Client Signature: X Date: X Client Signature: Dale: X Client Signature: 5. ONE AND THE SAME LETTER (IF APPLICABLE) Date: If you are transferring an arrant, and the name(s) at TO Ameritrade do not exactly match but are still one and the same person, please complete Ws 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, slate 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 delivering firm account. (Please specify account types, such as Individual to Joint) Please sign name BOTH ways. X Signature: 6. TD AMERITRADE CLIENT AUTHORIZATION (REQUIRED) 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 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 certificates or other instruments in my account are In your physical possession, I instruct Transferor to transfer them in good deliverable form, including afroing any necessary lax wavers, 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 full account transfer, Transferor will freeze my account and cancel all open orders. I also understand that no new orders may/wil be taken. I affrm that I have destroyed or returned to the Transferor all crediVdebit cards and/or unused checks issued to me in connection with my account. If this TD Amortisede 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. (Mettation Signature Guarantee - For TD Amentrade Use Only) X Client Signature: Date: X Co-Owner's Signature: Dale: X CoOwner's Signature: Co-Ormers Date: Date: Sla g"' 7. LETTER OF ACCEPTANCE (FOR OFFICE USE ONLY) The undersign • organizationagrees to serve as successor custodian for the account of the above-named individual, and as custodian, we agree to accept the as Is being transferred. (Medallion Signature Guarantee - For TD Arrentrade Use Only) X Represen ive Signals? Representative Prt≥ItaQ N Date: -25- 20/9 For TD Ameritrade Caring, . use only Please be advised that TO IfillEhde Clearing, Inc. is an 'Approved 403(b)(7) Vendor and/or has ent into an lriormation Sharing Agreement with the Employer for the above-captioned 403(b)(7) account. The Employer/Agent Signature above hereby authorizes TD Amentrade 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 FINRNSIPC. TO Ameritrade is a trademark jointly owned by TD Ameritrade IP Company, Inc. and The Toronto-Dominion Bank. 0 2018 TD Ameritrade. Page 3 ot3 TDA 190 F 03118 EFTA01252231