EFTA Document EFTA01449473

IME Accoun IV. PARTIAL TRANSFERS. DIRECT MUTUAL FUNDS AND LIQUIDATIONS (If there are more than eight assets, attach a signed list to this form) auArray ASSET DESCRIPTION CUSIPOSYMBOt FUND ACCOUNT TRANSFER INSTRUCTIONS' CAPITAL GAIN DIVIDEND CRTIOOPTION' AWR OPTION ESTIMATED S VALUE 2,200 US Dollar OUSDPRAA7 el Transfer in Kind 0 Liquidate 0 Cash 0 Reinvest J Cash 0 Reinvest 96,un.117 -1 -19 I US Dollar 0USDPRAA7 S Transfer in Kind 0 Liquidate 0 Cash 0 Reeves! J Cash U Reinvest PS LIS Gold Put 74347W9D1 El Transfer in lend CI Liquidate 0 Cash 0 Newest j Cash 0 Reinvest PS US Gold Put 74347W9DI S Transfer in Kind 0 Liquidate 0 Cash 0 Reinvest J Cash U Reinvest O Transfer in Kind 0 Liquidate 0 Cash 0 Reinvest U Cash 0 Reinvest 0 Transfer in Kind 0 Liquidate 0 Cash 0 Reinvest J Cash U Reinvest O Transfer in lend 0 Liquidate 0 Cash 0 Reinvest U Cash 0 Reinvest 0 Transfer in Kind 0 Liquidate 0 Cash 0 Reinvest j Cash Ll Reinvest II you have requested a iquidatIon, your market price is not gusianteed. YOu cos receive the current market price of ter your transfer request is received. reviewed, and determined to be In good order by the delivering fem. Pershing is not responsible for market fluctuations or delays in the review process. DRS 'terns cannot be liquidated. 2 It this is a mutual fund transfer and there is no dividend or capital gain option checked in the section above. Pershing will PrO0Oss thus request as reinvest (FOR OFFICE USE ONLY: All transfers must be added to Pershing's transfer systems) V. RETIREMENT PLAN RESTRICTIONS AND CERTIFICATIONS ul Age 7D - restrictions. It you are at leas, me age of 70 this year and you are transferring or rolling over assets from an IRA. qualilied plan or 4030s) account. you may be required to take a minimum distribution (FIMDI from your qualified plan or 40303) account before rolling over your assets. It Rollover Certification of Employee: I understand the lutes and conditions and I have met the requirements for making a rollover. Due to the important tax consequences of rolling over lunds or property. I have been advised to see a tax prolessional. All information provided by me is true and correct and may be raked 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 property as a transfer or rollover contribution. TO THE PRIOR TRUSTEE: U Pershing LLC accepts appointment as successor custodian. U Please be advised that does hereby accept appointment as successor custodian 0111.111FirmNanw) SUCCESSOR CUSTODIAN'S SIGNATURE: PA1 E VI . PARTICIPANT SIGNATURE AND CERTIFICATION To the Delivering rum Named Also... the trustee liSled Above. Unless otnerr e :fine.'er 411 .n ri.4:.<.a. .. :0 re:rinp, may be transferred within the time frames required by NYSt Rule 412 or smear rule of the NASD or other deognated exerrening authority. Unless otherwise indicated in the instructions above, I authorize yeti to liquidate any nontransferable propnelary money market fund assets that we part of my account and transfer the retailing credo balance to the succusscr custodian I authorize you to deduct any ouislandng 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 10 liquidate the assets ri my account to the extent necessary IO saltily that Obligation. II certificates o other instruments n my account are in wit physical possession. I instruct you to hands them in good deliverable form, induchng affixing any necessary tax wavers, to enable the successor comedian to transfer thern in es name to the purpose of the sale, when. and as directed to me. I understand that upon /Saving a copy of this transfer inforMalson, you ail 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 me In Connection With my brokerage eCCOwit I understand that yOU will contact n* Wag 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 process this account transfer INVESTMENT PROFESSIONAL'S NAME: INVESTMENT PROFESSIONAL'S PHONE NUMBER: CUSIP' belongs to its respective owner 09 I.WPA 059/ I IOW) Pas 3 of 3 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0104907 CONFIDENTIAL SDNY_GM_00251091 EFTA01449473