EFTA Document EFTA01344422

Account Transfer Form I. RECEIVING FIRM INFORMATION (Only one per form) RECEIVING FIRM CLEARING NUMBER 0443 ACCOUNT NUMBER: SOCIAL SECURITY NUMBER SECONDARY SOCIAL r SECURITY NUMBER. T 1- ACCOUNT TYPE: (Enter the two character code) 11 or TAXPAYER IDENTIFICATION NUMBER: or TAXPAYER IDENTIFICATION NUMBER: Nonretiremeni: SN-ISinglei -I.loint) TR -(Trustl CT -Manumit.) CO-(Corporate) CU-(Custodian) ES -(Estate) BC- (Bank Custody) AG-Mooney) Retirement: IR - (Traditional IRAI RI