Case File
efta-01268366DOJ Data Set 10OtherEFTA01268366
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Unknown
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DOJ Data Set 10
Reference
efta-01268366
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3
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0
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1D Ameritrade
Mall or Fax to:
PO Box 2760 • Omaha, NE 68103-2760
Fax: 866-468-6268
Account Transfer Form
Receiving Firm DTC Clearing Number.
Please use the Direct Registration System (DRS) Transfer Form TOA 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 Ameritrade, 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.
*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 Amedtrade 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 bank/credit union. For IRAs, and Beneficiary IRAs where the
original owner was 70% years or older at death, please attach a copy of your end of year statement fo enable us to calculate the required
minimum distribution for the account.
1. ACCOUNTLINFORMATION
Your TO Ameritrade Account
(The registration of the account being transferred should match your
TO Ammitrade account and the Tax ID for both the TO Ameritrade
account and account being transferred.)
2. PLEASE PROVIDE INFORMATION ABOUT THE
DELIVERING ACCOUNT
(As directed in Section I both registration and Tax (Os for the
TO Ameritrade account and account being transferred should match.)
Account Number (R ul
(Only one perform)
:
Account Number (R ul
:
(Dayon@ perform)
Account ReeistraUcoMat
SOUTHERN FINANCIAL LLC
Account Registration/Mr
SOUTHERN FINANCIAL LLC
Social Seooty/Tax ID Number.
Sochi Securlty/Tax ID Number:
Social Secunty/Tax ID Number:
(Secondary. If appacaele)
Sods
Number.
(Secondary if appricable)
Account Type (select one)
Contra/D•liutrIng Rim Name (Required):
DEUTSCHE BANK PRIVATE WEALTH MANAGMENT
— (Non IRA)
OTraditional or Rollover IRA
ContraiDetivertne Fm Address:
alcent
DTrust
O Roth IRA
08enenclary IRA
345 PARK AVE 26TH FLOOR NY,NY10154
COM e
no
cooked).
ElCorptBusIness
O Beneficiary Roth IRA
OUGMAAJTMA
O Qualified Plan (401k. 4038. PSP. etc.)
Contra/Detwering Firm Emait
['Estate
❑SIMPLE IRA
O SEP IRA
Account Type (select one)
00ther.
- (Non IRA)
El Traditional or Rollover IRA
aloint
O Roth IRA
IDTrust
O Beneficiary IRA
0
Corp/Business
O Beneficiary Roth IRA
OUGMAIUTMA
O Qualified Plan (401k, 4038, PSR etc.)
DEstale
O SIMPLE IRA
O SEP IRA
DOlher
If the registrations do not match, you may either establish a now account online at www.tdomeritrado.com or you must supply additional
documentation and all delivering account owners must sign section 4. For unlike tillefrogistration transfer; please call the transfer department
at 888-723-8504, option 4 for additional requirements. 'Please note it there aro any issues with processing your transfer, wo will communicate
that to you via your secure message center when you log In to your account.
11111111 CONFIDENTIAL
SDNY_GMAQtIIpCBIU
EFTA_00122921
EFTA01268366
TD AmonCredo Acct it 867-730320
A. BROKERAGE FIRM TRANSFER (Unless otherwise indicated, TO ATOtiffede will transfer in Fulg
OFull Transfer—To transfer entire account, check here and skip to Section 4.
aPartial Transfer—List specific security andfor cash amount below. If bonds are being transferred, please supply the CUSIP
Only whole shams can be requested as fractional shares cannot be transferred. Please contact the delivering firm regarding your options.
Asset Description (CUSIP or symbol)
(Partial Transfers Only)
Quantity
(indicate trot whoa snares
or -ALL7
Asset Description (CUSIP or symbol)
(Panial Transfers Only)
Quantity
(Indicate a ofwholesheres
or *AU?)
1. 539439AG4
1,903,000
5.
2. AAPL
180,000
6.
3. APO
263,157
7.
G.
8
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 mall the Original form to complete the transfer request.
IRA Savings Accounts-Typically held with Bank/Creche Union.
OTotal Transfer (Transfer entire account)
O Partial Transfer (Transfer part of account) Portion to transfer
O Wire
(feestnay wry)
K Chock
Certificates of Deposit (CDs).
°Redeem my CD immediately.
am aware of, and acknowledge, that lam responsible for any penalties that I may Incur from any early withdrawal.
ORedeem my CD at maturity. Maturity Date:
Submit request at least 21days 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
deadfine, maturity date, surrender charge period/window, etc., paperwork must be received by TO Amerifrade in good order three weeks
prior to the firm deadline to allow for proper processing times. To liquidate a CO held in a non-retirement account, contact the bank or
credit union at which the assets are being held.
Annuity Transfer
OTransfer my Annuity
OFUll ❑Partial
OVVire
have an annuity policy that l wish to transfer. Please redeem and terminate on my behalf.
(fees may apply)
I am aware of, and acknowledge, that lam responsible for any penalties that I may Incur from
K 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 Ameritrade is not responsible for the timing or execution of iquidations processed by the delivering firm.
C.
MUTUAL FUND COMPANY TRANSFER
Chock box for in-kind or Liquidation Transfer. Please list the Symbdor 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 direct y
with the fund company. for brokerage accounts containing Mutual Funds andfor 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 Account if
Quantity
(Indicate a of shares or ALL7
Handling
(Check one)
Gains & Dividends
(Check one t I In-lohd)
Din-Kind
°Liquidate
M
•
Reinvest
Cash
Olnaind
O Liquidate
°Reinvest
°Cash
OIn-Kind
°Liquidate
M Reinvest
OCash
if you are transferring more funds than will fit above, please include on attached list for the comp! le list of funds
A statement MUST be included to ensure proper handfing and processing of your Mutual Fund transfer
• Unless otherwise indicated, I authorize the Transferor to liquidate any non-transferable proprietary money marker
and mutual fund assets that are part of my account and to transfer the resulting credit bane.; to my account with
TO Ameritrade. If the fund is unable to be held by TD Amentrade, l (please initial here)
authorize the Transferor
to liquidate and transfer as cash.
COMPIDENTIAL
OWire
(foes may amp?)
O Check
so194.119ficlittii2272
EFFA_00122922
EFTA01268367
TO Ameritrade Acct i 867-730320
Registration Difference
For unlike titled or type transfers, such as Individual to Jolt I authorize the transfer from
account to
Al parties on the delivering account must sign below. All TD Ameritrade parties must sign in section 6 for transfer authorization.
X
Gent Signature:
X
Client Signature:
X
Client Signature:
5. ONE AND THESAME,LETITERPEAPPL(CABLE)..
aCO0unt.
If you we transferring an account, and the name(s) at TD Amoritrade do not exactly match but are still one and the same person, please complete
this scalar). This section should be utilized if your name has changed due to one or more of the folimidng: 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 driver's license,
passport, or government ID. (Please specity account types, such as Individual to Joint)
I
(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.
)( Sirens.:
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 incicated in the instructions above, please transfer, in-kind, all assets into my account with TD 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 credo balance, or If the credit balance In the account
Ls inSufficicmt to satisfy any outstanding fees. If certificates or other instruments in my account are in your physical possession, [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 sate, when and as directed by me. I understand that upon receiving a copy of this transfer instruction, rarebit account transfer,
Transferor will 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 crocR/debit cards and/or unused checks issued to me in connection with my account.
If this TD Nitwit:ado account' a qualified retirement account, I have amended the applicable plan to designate the successor custodian.
Alternatively, this TD Amedtra
account is an Individual Retirement Account (IRA),
I have adopted an IRA plan so I
t it names the successor custodian.
X
Client Signature:
X
Co-Owners Signature:
X
Co-Owner's Signakart„...Z
X
Co-Owes Signs
€7k5/201 r
Date
Dale:
(Medaition Signature Guarantee— For TO Amentrade Use Only)
The undersign • organizationcifigrees to serve as successor custodian for the account of the above-named Individual. and as custodian. we agree to
cc
aept the as els being trans erred.
X
Roprosen five Signature:
Representative Print
Ne
2-25-2olf
For TD Ameritrade C Laing, I (use only
Please be advised lh t M
'rade Clearing, Inc. is an Approved 403(b)(7)
Vendor anctior hes eriIwe into an Information Sharing Agreement with the Et netuyer
for the above-captioned 403(b)(7) account. The Employer/Agent Signature above
hereby authorizes TO Ameritrade Clearing. Inc. to accept this exchange.
(dedaion Signature Guarantee — Fee TD Arne:it/ado Use Oray)
Investment Products: Not FDIC Insured • No Bank Guarantee • May Lose Value
TD Ameritrade, Inc. and TD Arne:tirade Clearing, Inc., members FINRA/SIPC. TD Ameritrade is a trademark jointly owned by
TO Ameritrade IP Company, Inc. and The Toronto-Oomlnlon Bahr, CI 2018 TD Ameritrade.
SDNY_DaktiSp(tn3
CONFIDENTIAL
EFTA_00122923
EFTA01268368
Technical Artifacts (17)
View in Artifacts BrowserEmail addresses, URLs, phone numbers, and other technical indicators extracted from this document.
Domain
www.tdomeritrado.comFax
Fax: 866-468-6268Phone
866-468-6268Phone
888-723-8504SWIFT/BIC
DEUTSCHESWIFT/BIC
INFORMATIONSWIFT/BIC
SOUTHERNWire Ref
TRANSFER
TransferWire Ref
Transfer
OTransferWire Ref
Transfer entireWire Ref
Transfer sectionWire Ref
transfer authorizationWire Ref
transfer departmentWire Ref
transfer entireWire Ref
transfer instructionWire Ref
transfer requestWire Ref
transfer sharesForum Discussions
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