EFTA01449464.pdf

Account # IV. PARTIAL TRANSFERS. DIRECT MUTUAL FUNDS AND LIQUIDATIONS (If there are more than eight assets, attach a signed list to this form) cokivrav ASSET DESCRiPTON falACCOUNT CUSH:P./SYMBOL FUND CAPiTAL CAIN ESTIMATED tABER TRANSFER INSTRUCTIONS' DIVIDEND OPTION" OPTION VALUE 57,000 Ally pfd 02005N308 o Transfer in Kind 0 Liquidate 0 Cash U Reinvest J Cash 0 Reinvest 1.525mm CI Transfer in Kind 0 Liquidate 0 Cash 0 Reeves! J Cash LI Reinvest O Transfer in lend 0 Liquidate 0 Cash 0 Newest U Cash 0 Reinvest 0 Transfer in OM 0 Liquidate 0 Cash 0 Reinvest J Cash LI Reinvest 0 Transfer in lend 0 Liquidate 0 Cash 0 Reinvest U Cash 0 Reinvest 0 Transfer in *nd 0 Liquidate 0 Cash 0 Reinvest J Cash U Reinvest O Transfer in lend 0 Liquidate 0 Cash 0 Reinvest U Cash 0 Reinvest 0 Transfer in Yard 0 Liquidate 0 Cash 0 Reinvest j Cash U Reinvest 1 II you have requested a awidellon, your market price is not pa/entitled 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 items Cannot be liquidated. 2 II this is a mutual fund transfer and theta is no dividend or capital gain option checked in the section above. Pershing will PrOCOSS this request as reinvest (FOR OFFICE USE ONLY: All transfers must be added to Pershing's transfer systems) V. RETIREMENT PLAN RESTRICTIONS AND CERTIFICATIONS is Age 70' - restrictions. It you are at Irras1 me age of 70 • this year and yea.; are transferring or rolling over assets from an IRA. qualified plan or 40300 account. you may be required to take a minimum distribution (FWD) from your qualified plan or 40310) account before rolling over your assets. It Rollover Certification of Employee: I understand the tuba 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 proton:0nel. All information provided by me is true and correct and may be relied on by Pershing LLC. I assume full responntathly 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: J Pershing LLC accepts appointment as successor custodian. —1 Please be advised that does hereby accept appointment as successor custodian (Input Firm Name) SUCCESSOR CUSTODIAN'S SIGNATURE: DAT E VI PARTICIPANT SIGNATURE AND CERTIFICATION To the Delivering Firm Named Atom.. the trustee listed above. Unless otnerii I': I :fine.'er 411 At.i!.2,:n 1:.<.(t.: :0 re:F.Inp, may be Irandeired within the time !renters required by NYSt Hub 412 or smear ruie of the NASD or other deugnated examining authority. Unless otherwise indicated in the instructions above, I authorise you to liquidate any nontransferable propnelary money market fund assets that we pan of my account and transfer the retailing credit balance to the successor custodian I authorize you to dedact any outstandng 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 !Cr you. I authorize you 10 liquidate the assets n my account to the extent necessary le satnly that Obligation. II ceiblicales or other instruments n my account are in wit physcal possession. I instruct you to transfer Mem in good deliverable tom induchng affixing any necessary tax wavers, to enable the successor custodian to transfer them in es name for the purpose of the sale, when. and as directed to me. I understand that upon meowing a copy of the transfer information, you nil 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 10 men connection with my brokerage aCCOint I understand that you will Contact me with respect to the disposition of any assets in my brokerage account that are nontranslerable. 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 10 its respective owner 09 I.WPA 059/ I Ken Page 3 of 3 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0104897 CONFIDENTIAL SDNY_GM_00251081 EFTA01449464