Case File
efta-01268279DOJ Data Set 10OtherEFTA01268279
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01268279
Pages
4
Persons
0
Integrity
Extracted Text (OCR)
Text extracted via OCR from the original document. May contain errors from the scanning process.
(Page 1 of
4 )
ID Ameritrade
Mall or Fax to:
■ Omaha, NE 68103-2760
Fax:
Account Transfer Form
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
Your TD Ameritrade Account
(The registration of the account being transferred should match your
TD Ameritrade account and the Tax ID for both the TO Amentrade
account and account being transferred.)
Account Number (Required):
(Only one perform)
Account Reputation/Tide:
SOUTHERN FINANCIAL LLC
Social Secunly/Tax ID Number:
Social Security/Tax II) Number-
(Secondsy II applicable)
Account Type (select one)
Eilndividi pal — (Non IRA)
IDJoint
EI Trust
ECorp/Business
Ducwvvrtm
DEstate
O Traditional or Rollover IRA
El Roth IRA
OBeneficiary IRA
o Beneficiary Roth IRA
LI Qualified Nan (401k, 4038, PER ate.)
El SIMPLE IRA
K 3EP IRA
EI Other:
2. PLEASE PROVIDE INFORMATION ABOUT THE
DELIVERING ACCOUNT
(As directed in Section loom registration and tax IDS tor the
TO Amerifrade account and account being transferred should match.)
Account Number (Reoulredl:
(Only ono perform)
Account Resestrationclitle:
SOUTHERN FINANCIAL LLC
Social Security/Tax ID Number.
Social Security/Tax ID Number:
(Secondary If applicable)
ConfrodOelkedng arm Nome (Rogukoco.
DEUTSCHE BANK PRIVATE WEALTH MANAGMENT
Corterulaelneering firm Addro,a:
NY,N Y10154
v
er (:cow/ad)
Cvntiathrliveiiny Fi; lit Et 'toil
Account Type (select one)
OInclividual (Non IRA) O Traditional or Rollover IRA
EJoint
K 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
CON FlOENTIAL
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(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)
(Porno/ Translort Only)
Quantity
(Indkolo ll al whoa shams
or "ALL")
Asset Description (CUSIP or symbol)
(Psival rilloStolO Only)
Quantity
hkuttiota Al °lank, Atka/lit
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)
['Partial Transfer (Transfer part of account) Portion to transfer
O Wire
(fees troy OPPlY)
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 21 days 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.
K (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.
Fund Name or Symbol
Mutual Fund Accounts
Quantity
(Indicate e o f shares or ACC)
H wiling
(Chock ono)
Gains &Dividends
(Clock ono if halm;
OIn-Kind
OLiquidate
M Reinvest
OCash
• InKind
M Liquidate
■
■
Reinvest
Cash
O IwKind
M Liquidate
0
•
Reinvest
Cash
if you are transferring more funds than will fit above, please include en attached list for the complete list of funds
A statement MUST be included to ensure proper handling and processing of your Mutual Fund transfer
Unless oMenvise indicated, 1 autnonze are transferor to liquidate any nontransferable propnetary money market
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 fund is unoblo to be hold by TDAmeritnadc, I (plcoac initial hare)
authorize the Transferor
to liquidate and transfer as cash.
CONFIDENTIAL
ID Wire
(tees may apply)
K Check
SDNY_Gtge06801,368
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
All parties on the dekvering account must sign below All TD Ameritrade parties must sign In section 6 for transfer authorization.
X
Client Signature:
X
Client Signature.
X
Client Signature.
6. ONE AND THE SAME LETTER OF APPLICABL E)
account.
Date.
Dale.
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.
X
Signature:
6. TD AMERITRADE CLIENT AUTHORIZATION (REQUIRED)
)(/ 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 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)55115SILII I. 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.
(....
X
Client Signalize:
------- -
X
Co-Caner% Signature.
.........„....,..---
...
4X
Co-Owner's Signalize.
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.
Dale./
Dale:
Uate:
(Medallion Signature Guarantee — For TD Amentrade Use Only)
X
Representative Signature:
Reptesentati.ie Printed Na-ne.
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.
(Medallion Signature Guarantee — For TD Ameritrade Use Only)
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.
CONFIDENTIAL
SDNY_GM_000WISOF 03,18
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(Page 1
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1)
Page 1
From:
"KOFAX PROD PROCESS"
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
CONFIDENTIAL
SONY_GM_00012155
EFTA_00122806
EFTA01268282
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View in Artifacts BrowserEmail addresses, URLs, phone numbers, and other technical indicators extracted from this document.
Domain
invcatemcritradc.comDomain
www.tdameritrade.comPhone
3373452Phone
423-8504Phone
7917391Phone
886-4613SWIFT/BIC
DEUTSCHESWIFT/BIC
ENVIRONMENTSWIFT/BIC
INFORMATIONSWIFT/BIC
SECTIONSSWIFT/BIC
SOUTHERNWire Ref
TRANSFER
TransferWire Ref
TRANSFER INSTRUCTIONSWire Ref
Transfer sectionWire Ref
Transfer statusWire Ref
transfer
UnlessWire Ref
transfer authorizationWire Ref
transfer departmentWire Ref
transfer entireWire Ref
transfer requestWire Ref
transfer sharesForum Discussions
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