EFTA01268363.pdf

10 Account Transfer Form
Ameritrade
Mail or Fax to:
PO Box 2760 . Omaha, NE 68103-2760
Fax 866-468-6268 Receiving Firm DTC Clearing Number: 0188
Please use the Direct Registration System (DRS) Transfer Form TDA 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:
TD Ameritrade, PO Box 2760, Omaha, NE 68103-2760 or fax to 866-466-6268. 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 TD Ameritrade accounts, please use the Internal transfer form. Please note you cannot use tins form
to transfer from a standard checking account end or savings account from a bank/credit union. For IRAs, and Beneficiary IRAs where the
original owner was 70:1 years or eider at death, please attach a copy of your end of year statement to enable us to calculate the mgefired
minimum distribution for the account.
1. ACCOUNT INFORMATION 2. PLEASE PROVIDE INFORMATION ABOUT THE
DELIVERING ACCOUNT
Your TD Amoritrado Account
(The registration of the account being transferred should match your (As directed in Section 1b oth registration and Tax !Ds for the
TO Ameritrade account and the Tex ID kr both the TO Ameritrade TO Amenbade account and account being transferred should match.)
account and account being transferred.)
Account Number (Required): Account Number (Required):
(Orly one perform) 867-730320 (Onrone Perform) N4G-0238O4
Account RegIstrolionTee: Account Registration/ride:
SOUTHERN FINANCIAL LLC SOUTHERN FINANCIAL LLC
Social Security/Tax ID Number: Social SocurItyffax ID Number:
66-0799192 66-0799192
Social Security/Tax 10 Number: SodalSecuatyffax ID Number
(Seconderx epfflicerble) (Seconder% Ir applicable)
ContrarDeavoling rum Name (Required):
Account Type (select one)
DEUTSCHE BANK PRIVATE WEALTH MANAGMENT
El Individual — (Non IRA) O Traditional or Roamer IRA CorensOelkiodng Firm Address:
❑Joint
O Roth IRA 345 PARK AVE 26TH FLOOR NY,NY10154
q Trust O Beneficiary IRA C°M7lacing Firm Phone Number (Reps* 9:
ECorp/BusIness
q Beneficiary Roth IRA 1.2"15-41- 0 116_3
❑UGMM)TMA q Galati:led Plan (401k, 4038, PSB etc.) ContraDegvering Firm Ernst•
q Estate O SIMPLE IRA
O SEP IRA
Account Typo (select one)
❑Other:
q Individual - (Non IRA) q Tracktional or Relies IRA
q Roth IRA
❑Trust q q Beneficiary IRA
0Corp/Buelness Beneficiary Roth IRA
q UGMAfUTMA q Qualified Plan (401k. 4038. PSR etc.)
❑Estate q SIMPLE IRA
EISEPIRA
q Omer.
If the registrations do not match, you may either establish a now account online at www.tdamerltrade.com or you must supply additional
documentation and all delivering account owners must sign section 1. For unlike tittelregistration transfer; please call the transfer department
et 888-723-8501, option 4 for additional requirements. Please note if there are any issues with processing your transfer; we will communicate
that fo you via your secure message center when you log in to your account.
IIIIIIIIIIIIIIIIII II1 1111111 11
III
CONFIDENTIAL S0NY_Gbte)letaggitlit
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To Arnenitede *cc' is 867.730320
A. BROKERAGE FIRM TRANSFER (Unless otherwise indicated, TO Amentrade will transfer in Fut°
pFull Transfer—To transfer entire account, check here and 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 shams can be requested as fractional shares cannot be transferred. Please contact the delivering firm regarding your options.
Asset Description (CUSIP or symbol) Quantity Asset Description (CUSIP or symbo9 Quantity
(Partial Transfers Only) (Mckcate a of tvlide shares (Pubs! Transfers Only) (Indic:gee armhole snares
*1'1*LO or ALL)
1. 04821XAK4 2,000,000 5. 30162RAA9 3,000,000
2. 172967JZ5 3,000,000 8.361860208 80,000
3. 172987341 79,000 7. A29866AB5 2,000,000
4. 17453BAW1 1,000,000 8. 46625HHA1 5,760,000
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 mall the Original form to complete the transfer request.
IRA Savings Accounts—Typically held with Bank/Credit Union.
Ej
['Total Transfer (Transfer entire account) Wire
(lees may apply)
DPartial Transfer (Transfer part of account) Portion to transfer S 0 Clunk
Certificates of Deposit (CDs).
0Redeem my CD immediately.
I am aware of; and acknowledge, that I am responsible for any penalties that I may incur from any early withdrawal.
0Rodoem 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 with to liquidate the CD immediately or at maturity For any investment instruments that haven renewal
deadline. maturity date, surrender charge perfothvindow, etc., paperwork must be received by TD Am.:brede 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 are being held.
Annuity Transfer
0Transfer my Annuity
0 Full 0 Partial S 0 Wire
I have an annuity policy that I wish to transfer. Please redeem and terminate on my behalf pees may apply)
I am aware of, and acknowledge, that lam responsible for any penalties that! may Incur from 0 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 Amentrade Is not responsible for the timing or execution of liquidations processed by the delivering firm.
C. MUTUAL FUND COMPANY TRANSFER
Check 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, TD Amentrade wit transfer shares in-kind. This section per tains only to shares of Mutual Funds held directly
with the fund company, for brokerage accounts containing Mutual Funds and/or Stocks please complete the Brokerage Firm Transfer section
(Section 3A, above).
'Propnefery Mutual Funds and all no-load Money Market funds cannot be transferred gated and must be liquidated.
Quantity Handling Gains a Dividends
Fund Name or Symbol Mutual Fund Account N
gnokere SI °raven Of ALL, rehearing (C.bedrone tabling
0
In•Kind OReinvest
0 Oquidate OCash
BlrelOnd all Reinvest
Liquidate al l Cash
IN InKnd ['Reinvest
• Liquidate E Cash
ill you are transferring more kinds than will fit above, please include an attached list for the complete list of funds. 0 Wire
A statement MUST be Included to ensure proper handling and processing of your Mutual Fund transfer. Pees mai/Apply)
• Unless otherwise Indicated, I authorize the Transferor to !gradate anynon-transferable proprietary money Menet 0Check
and mutual fund assets that are part of myMON/Mend to transfer the resoling credit balance to my account with
TO Arneritrade. If the fund is unable to be held by TO Amentrade, I (please initial here) authorize the Transferor
to liquidate end transfer as cash.
CONFIDENTIAL SOtegfigdggiell12268
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TD Ameritrade Acct iv 867-730320
Registration Difference
For unlike titled or type transfers, such as Individual to Jcint. I authorize the transfer from account to account.
All parties on the delivering account must sign below. AI TO Ameritrade parties must sign in section 6 for transfer auMorization.
Xcent Signature: Date:
XCite Signature: Date:
Xdent Signature: Date:
5. ONE AND THE SAME LETTER (IF APPLICABLE)..
If you are transferring an account, and the name(s) at TO Ameritrade do not exactly match but are still one and the same person, please compete
this section. This section should be utilized if your name has changed due to one or more of the foilovring: Marriage. Dhorce, Name Spelling Err%
or any type of Name Change including Jz, Sr., etc. If last name difference, must supply legal documentation: that is, stale issued drivels IICenSe,
passport, or government ID. (Please specify account types, such as Indwidual to Jokl)
(please print name), am One and the Same as
(please pant name) as shown on the delivering firm account. (Please specity account types, such as Individual to Joint)
Please sign name BOTH ways.
4X Signature XSignature:
All TD Ameritrado 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-lend. 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 wthin the time
frames required by appicable regulations. I understand I will bo contacted by the carrying and/or receiving firm with regard to any assets that aro 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 aro 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 full 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 Transf all credit/debit cards amPor unused checks issued to me in correction with my account.
If this TD rade accou t is a qualified retirement account, I have amended the app5cable plan to designate the successor custodian.
Mama if this TO Arne trade account is an Individual Retirement Account (IRA),
I have opted an IRA pa so That it names the successor custodian. (Medallion Signature Guarantee — For TO Ameritrade Use Only)
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X 71.islekit
co-omieff Dale
X Co-Owners SIgiial Dam:
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XCo.Owners Signature: Date:
The can, ned organiza • agrees to serve as successor custodian for the account of the above-named individual, and as custodian. we agree to
accept e assets being Wan erred.
XRiokroKseniaUve Signatwi LMW (sedate% Signature Guarantee- For TDArneritrade Use Only)
.7.125/20m
Representative Minted-Nang!'
For TO Ameritrade CI fling, tE. use only
Please be advised the TD uade Clearing, Inc. Is an 'Approved 403(b)(7)
Vendor and/or has ent d into an Information Sharing Agreement with the Employer
for the above.capdoned 403(b)(7) account. The Employer/Agent Signature above
hereby authorizes TD Arneritrade Clearing, Inc. to accept this exchange.
Investment Products: Not FDIC Insured ' No Bank Guarantee ' May Lose Value
TO Ameritrade, Inc. and TD Ameritrade Clearing. Inc., members FINRA/SIPC. TD Ameritrade is a trademark jointly owned by
TO Ameritrade IP Company, Inc. and The Toronto-Dominion Bank. 0 2018 TO Ameritrade.
COf IDENTIAL SONY_G/IMOOVII0S9
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EFTA01268365