Case File
efta-01268360DOJ Data Set 10OtherEFTA01268360
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Unknown
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DOJ Data Set 10
Reference
efta-01268360
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3
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0
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10 Ameritrade
Mail or Fax to:
PO Box 2760 . Omaha, NE 68103-2760
Fax: 866-468-6268
Account Transfer Form
Receiving Firm DTC Clearing Number: 0188
Please use the Direct Registration System (DRS) Transfer Form T0A 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 Ameritrado Attn:
TD AmerIkeda, PO Box 2760, Omaha, NE 68103-2760 or fax to 866-468.6268. 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.
yeti 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 Ameritrade accounts, please use the Infernal transfer form. Please note you cannot use this form
fo transfer from a standard checking account and/or savings account from a bank/credit union. For IRAs, and Beneficiary IRAs where the
original owner was 7034 years or older at death, please attach a copy of your end of year statement to enable us to calculate the required
rninimum distribution kr the account.
1. ACCOUNT INFORMATION
Your TO Ameritrado Account
(The registration of the account being transferred should match your
TD Amedtrade account and the Tax ID for both the TO Amer/trade
account and account being transferred.)
Account Number (Required):
(O* one per form
Account Reciatrati
i
SOUTHERN FINANCIAL LLC
SoriN Socutay/Tax ID Number:
66-0799192
Social Security/Tax ID Number
(Seceerrafx M applicable)
Account Type (select one)
❑Individual — (Non IRA)
Rohl
Trust
0CorpfBusiness
OUGMA/UTMA
DEState
OTraditional or Rollover IRA
K Roth IRA
K Beneficiary IRA
O Beneficiary Roth IRA
O Qualified Plan (401k, 4038, PSR etc)
O SIMPLE IRA
O SEP IRA
pother:
2. PLEASE PROVIDE INFORMATION ABOUT THE
DELIVERING ACCOUNT
(As deeded in Section 1 both registration and Tax Os for the
TO Ameritrade account and &gownt being transferred should match.)
Account Number (Required):
(O* one Perform) N4G•023804
Account Recielrationfrate:
SOUTHERN FINANCIAL LLC
Social S
/Tax ID Number.
4.
0
ax ID Number.
(Secondary, a appricalse)
Contracmilivenng Farm Name (Required):
DEUTSCHE BANK PRIVATE WEALTH MANAGMENT
CceararDerwaing Fkm Adams:
345 PARK AVE 26TH FLOOR NY,NY10154
ContrwDefwnn Firm Phone Number (Required):
Contra/Delivesing Firm Email:
Account Type (select one)
OIndividual - (Non IRA)
OJoint
ElTrust
aCorp/Business
OUGMAILITMA
OEstate
O Traditional or Rollover IRA
O Roth IRA
O Beneficiary IRA
O Beneficiary Roth IRA
O Qualified Plan (401k, 4038, PSP, etc.)
O SIMPLE IRA
K SEP IRA
00ther
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 all delivering account owners must sign section 4. For unlike title/registration transfer, please call the transfer department
at 888-723-8504, option 4 for additional requirements. 'Please note if there are any issues with processing your transfer, wo will communicate
that to you via your secure message center when you log in to your account
IIIIII
III II III MI CONFIDENTIAL
S0NY_GM_00O2BISS wits
EFTA_00122913
EFTA01268360
TD Ameritrade Acct a 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 arid 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 shams cannot be transferred. Please contact the delivering firm regarding your options.
Asset Description (CUSIP or symbol)
(Partial Transfers Only)
Quantity
(Indicate Sof whole shams
WALL)
Asset Description (CUSIP or symbol)
(Partial Transfers Only)
Quantity
findcata 0 of whole shares
orALL 7
1. 539439AG4
1,903,O00
5.
2. AAPL
180600
6.
3. APO
263,157
7.
4.
8.
B. BANK/CREDIT UNION 8 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 fonn to complete the transfer request.
IRA Savings Accounts—Typicallyheld with Bank/Credit Union.
['Total Transfer (Transfer entire account)
O Partial Transfer (Transfer part of account) Portion to transfer S
O Wire
(fees may *PAW
K Check
Certificates of Deposit (CDs).
['Redeem my CD immediately.
I am aware of, and acknowledge, that lam responsible for any penalties that 1 may incur from any early withdrawal.
['Redeem my CD at maturity. Maturity Date:
Submit request at least 21 days prior to matting( Please advise your bank not b 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 haw a renown)
deadline, maturity dela surrender charge period/window, etc., paperwork must be received by TD Ameritrade 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 em being held.
Annuity Transfer
OTransfer my Annuity
❑Full D Partial $
El Wks
I have an annuity policy that I wish to transfer Please redeem and terminate on my behalf.
him may app,')
l am aware of, and acknowledge, that I am responsible for any penalties that I may incur from
O 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 Ameritrade is not responsible for the timing or execution of liquidations processed by the delivering firm.
C.
MUTUAL FUND COMPANY TRANSFER
Cheek 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 comple e the Brokerage Firm Transfer section
(Section 3A, above).
Proprietary Mutual Funds and al I no-bad Money Market funds cannot be transferred in-kind and must be liquidated.
Fund Name or Symbol
Mutual Fund Account 0
Quantity
(Indicate Not shares or -ALL)
Handling
(Check one)
Gains & Dividends
(Check one if ln-kind)
•
•
In-Kind
Liquidate
•
•
Reinvest
Cash
Oln-Kind
OLiquidaM
O Reimest
III Cash
B
M-Kind
Liquidate
• Ftelmest
oCash
If you are transferring more funds than will fit above, please include an attached list for the cowrie e list of funds.
*A statement MUST be included to ensure proper handling and processing of your Mutual Fund transfer.
• Unless otherwise indicated, I authorize the Transferor to liquidate any non-transferable proprietary money market
and mutual fund assets that are part 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
fo liquidate and transfer as cash.
C 0
E N T I AL
ID Wire
(fees may apply)
O Check
soNY_Obtigebt$394
EFTA_00122914
EFTA01268361
TO Amcritrade Acct rs 867-730320
Registration Difference
For unlike titled or type transfers, such as Individual to Joint. I authorize the transfer from
account to
AN parties on the delivering 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:
5. ONE AND THE SAME LETTER (IF APPLICABLE)
account.
If you are trans:ening an account, and the name(s) at TD Ameritrade do not exactly match but are sill one and the same person, please complete
this 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.. Sc. etc. If last name difference. must supply legal documentation: that is, state issued drivers 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 Inn account. Please speciy account type.% such as Individual to Joint)
Please sign name BOTH ways.
X
Signature:
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 via 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 affixing any necessary tax waivers, 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 fug account transfer.
Transferor wilt freeze my account and cancel all open orders. I also understand that no new orders may/will be taken. I affirm that I have destroyed or
returned to the Transferor all credit/debit cards and/or unused checks issued to me in connection with my account.
If this TD Ameritrade account is a qualified retirement account. I have amended the applicable plan to designate the successor custodian.
Alternatively, if this TO Ameritrodo account is an Individual Retirement Account (IRA),
I have adopted an IRA plan so that it names the successor custodian.
4,1(' Caere Signature:
X
Co-Owner's Signature:
X
Co-Owner's Signature-
X Coawners
7. LETTER OF ACCEPTANCE (FOR OFFICE USE ONL
The undersign
cu
organization
roes to serve as successor
successor
stodian for the account of the above-named individual, and as custodian. we agree to
it ag
accept the as
s being trans
red.
Dale:
Dale:
Dale:
(Medallion Signature Guarantee - For TO Amentrade Use Oily)
•
X
Represen alive Signature'.
Representative RIAtettlarnir_.---'
-7.5- 209
For TD Ameritrade Caring,
use only
Please be advised t t TD
eritrade Clearing, Inc. is an Approved 403(b)(7)
Vendor' andlor has
into an Information Sharing Agreement with the Employer
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 TO Ameriviale Use Only)
Investment Products: Not FDIC Insured • No Bank Guarantee ' May Lose Value
TD Ameritrade, Inc. and TD Ameritrade Clearing, Inc., members FINFtA/SIPC. TD Ameritrade is a trademark jointly owned by
TD Ameritrade IP Company, Inc. and The Toronto-Dominion Bank.
2018 TD Ameritrade.
CONFIDENTIAL
SONY_GM_OOltgaggS ortng
EFTA_001229 I 5
EFTA01268362
Technical Artifacts (24)
View in Artifacts BrowserEmail addresses, URLs, phone numbers, and other technical indicators extracted from this document.
Domain
www.tdameritrade.comFax
Fax: 866-468-6268Phone
866-468-6268Phone
866-468.6268Phone
888-723-8504SWIFT/BIC
DEUTSCHESWIFT/BIC
INFORMATIONSWIFT/BIC
OUGMAILITMASWIFT/BIC
SECTIONSSWIFT/BIC
SOUTHERNTail #
N4GWire Ref
TRANSFER
TransferWire Ref
TRANSFER INSTRUCTIONSWire Ref
Transfer
OTransferWire Ref
Transfer PleaseWire Ref
Transfer entireWire Ref
Transfer sectionWire Ref
transfer PleaseWire Ref
transfer authorizationWire Ref
transfer departmentWire Ref
transfer entireWire Ref
transfer instructionWire Ref
transfer requestWire Ref
transfer sharesForum Discussions
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