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efta-01268360DOJ Data Set 10Other

EFTA01268360

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DOJ Data Set 10
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efta-01268360
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
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. Date: Date: Date: 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: Date: (Medallion Signature Guarantee - For TO Amentrade Use Oily) X Represen alive Signature'. Representative RIAtettlarnir_.---' Date: -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)

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Email addresses, URLs, phone numbers, and other technical indicators extracted from this document.

Domainwww.tdameritrade.com
FaxFax: 866-468-6268
Phone866-468-6268
Phone866-468.6268
Phone888-723-8504
SWIFT/BICDEUTSCHE
SWIFT/BICINFORMATION
SWIFT/BICOUGMAILITMA
SWIFT/BICSECTIONS
SWIFT/BICSOUTHERN
Tail #N4G
Wire RefTRANSFER Transfer
Wire RefTRANSFER INSTRUCTIONS
Wire RefTransfer OTransfer
Wire RefTransfer Please
Wire RefTransfer entire
Wire RefTransfer section
Wire Reftransfer Please
Wire Reftransfer authorization
Wire Reftransfer department
Wire Reftransfer entire
Wire Reftransfer instruction
Wire Reftransfer request
Wire Reftransfer shares

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