EFTA Document EFTA01449438

Account # 46-023812 IV. PARTIAL TRANSFERS. DIRECT MUTUAL FUNDS AND LIQUIDATIONS (If there are more than eight assets, attach a signed list to this form) CluAFETITY ASSET DESCRIPTION CUSIPISYMBOT FUND ACCOUNT Nt eaBER TRANSFER INSTRUCTIONS' CAPITA_ GAIN DIVIDEND CeTION' OPTOhe ESTimATED S VALVE 2,200 US Dollar OUSDPRAA7 al Transfer in Kind 0 Liquidate CI Cash D Reinvest J Cash LI Reinvest HtLeRS.S7 -1 -19 I US Dollar 0USDPRAA7 S Transfer in Kind D Liquidate CI Cash Ll Reeves! ..I Cash U Reinvest PS LIS Gold Put 74347%119Di El Transfer in lend CI Liquidate 0 Cash 0 Renew, j Cash LI Reinvest PS US Gold Put 74347W9DI S Transfer in Kind D Liquidate CI Cash CI Reinvest J Cash U Reinvest O Transfer in Kind D Liquidate 0 Cash 0 Reinvest U Cash LI Reinvest 0 Transfer in Kind 0 Liquidate CI Cash CI Reinvest J Cash U Reinvest O Transfer in lend 0 Liquidate 0 Cash 0 Reinvest U Cash LI Reinvest 0 Transfer in Kind 0 Liquidate 0 Cash 0 Reinvest LI Cash J Reinvest II you have requested a legs0on, your market price is not gusanteest. You will receive the current market puce 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 there is no dividend or capital gain option checked in the section above. Pershing will PrOCAlS$ thus request as reinvest (FOR OFFICE USE ONLY: All transfers must be added to Pershing's transfer systems) V. RETIREMENT PLAN RESTRICTIONS AND CERTIFICATIONS ui Age 70" restrictions. II you are at areal the age of 70 this year and you are transferring or rolling over assets from an IRA. qualilied plan or 40300 account. you may be required to take a minimum dstributi.on (HMCo) from your qualified plan or 40310) account before rolling over your assets. II Rollover Certification of Employee: I understand the lutes and conditions and I have met the requirements for making a rollover. Due t0 the important tax consequences ol rolling over lunds or property. I have been advised to see a tax proton:out. All information provided by me is true and correct and may be relied on by Pershing LLC. I assume lull responsibility 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 properly as a transfer or rollover contribution. TO THE PRIOR TRUSTEE: J Pershing LLC accepts appointment as successor custodian. J Please be advised that does hereby accept appointment as successor custodian (Insert Firm Name) SUCCESSOR CUSTODIAN'S SIGNATURE: DAT E VI . PARTICIPANT SIGNATURE AND CERTIFICATION To the Delivering Firm Named Aboer the trustee listed Above. Unless 0tneoz re 411 .n ri. .1:.<.(tn: :0 re:F.Inp, may be transferred within the time frames required by NYSt Hub 412 or smear rule of the NASD or other deegnated exernming authority. Unless otherwise indicated in the instructions above, I authorize you to liquidate any nontransferable proprietary money market fund assets that we part ol my account and transfer the malting credit balance to the successor custodian I authorize you to deduct any ouistandng lees due to you from the credit balance in my account. II my account does not contain a credit Delence. or if the credit balance in the account is insufficient to satisfy any outstanding lees due to you. I authorize you to liquidate the assets ri my account to the extent necessary to sately that obligation. II cerelicates or other instruments n my account are in Wit physic-al possession, I instruct you to trends: them in good deliverable Men including affixing any necessary tax wavers, to enable the successor custodian to transfer them in es name for Be purpose of the sale, when. and as directed torus. I understand that upon receiving a copy of ths kanslor information, you val 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 to men connection with my brokerage aCCOtan I understand Mel you well CallaCt Me with respect to the disposition of any assets in my brokerage account that are nontransferable. SIGNATURE GUARANTEED BY: CLIENT'S SIGNATURE: DATE: JOINT CLIENT'S SIGNATURE: DATE. Please attach your most recent btokerage account statement to piocess this account transfer INVESTMENT PROFESSIONAL'S NAME: INVESTMENT PROFESSIONAL'S PHONE NUMBER: CUSIP' belongs to its respective owner CO PVIM 059/ I IOW) Rigor 3 ol 3 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0104869 CONFIDENTIAL SDNY_GM_00251053 EFTA01449438