EFTA01268434.pdf

Account Transfer Form
TO Ameritrade
Mail or Fax to:
PO Box 2760 • Omaha. NE 68103-2760
Fax: Receiving Firm DTC Clearing Number: 0188
Please use the Direct Registration System (DRS) Transfer Form TDA100557 for transfer from a transfer agent.
Instructions: Attach a complete copy of your most recent statement, of the account you aro requesting tho transfer from,
(dated within 90 days) In order for the transfer to be process. It the completed form to TD Ameritrade Attn:
TD Ameritrade, PO Box 2760, Omaha, NE 68103-2760 or fax to 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 fw o 70 Ameritrade 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 to enable us to calculate the required
minimum distribution for the account.
1. ACCOUNT INFORMATION 2. PLEASE PROVIDE INFORMATION ABOUT THE
Your TD Amoritrade Account DELIVERING ACCOUNT
(The registration of the account being transferred should match your (As directed in Section I both registration and Tax las for the
TO Amen:rade account and the Tax ID for both the TO Ameritrade TO Ameritrade account and account being transferred should match.)
account and account being transferred)
Account Number - Account Number (Required):
(Only one perform (Only one per tom)
Account Roggstrati . Account RoCustrationfritle
SOUTHERN FINANCIAL LLC SOUTHERN FINANCIAL LLC
Social Secant /Tax 10 Number: Social Smugly/Tax ID Number:
nty ax ID Number UMW ID Number:
(Seconders tf applicable) (Seoandary d apper-able)
Contratoliverino Few Nano (RectuireC).
Account Toe (select one)
DEUTSCHE BANK PRIVATE WEALTH MANAGMENT
— (Non IRA) ❑Traditional a Rollover IRA Contratefivedrig Armada:est
❑Joint q Roth IRA 345 PARK AVE 26M FLOOR NY,NY10154
['Beneficiary
❑trust IRA ContraiDeuvedng Fern FAcno Number (Required).
q3 Corp/Business q Beneficiary Roth IRA
q
❑UGMA(UTMA Qualified Plan (401k. 4036. PSR etc.) Contra/DellwrIng Fern
❑Estate q SIMPLE IRA
El
SEP IRA
00ther Account Type (select one)
—(Non IRA) q Traditional or Rollover IRA
❑Joint q Roth IRA
p Trust q Beneficiary IRA
q3 Cap/Business q Beneficiary Roth IRA
q
q UGMA/UTMA Qualified Plan (401k, 4038. PSP etc.)
q
❑Estate SIMPLE IRA
q SEP IRA
q Other:
If the registrations do not match, you may either establish a now account online at www.tdameritrade.com or you must supply additional
documentation and alt delivering account owners must sign section 4. For unlike litlelrogistration transfer please call the transfer department
at 888-7234504, option 4 for additional requirements. •Please note if there aro any issues with processing your transfer; we will communicate
that to you via your secure message center when you log in to your account
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TO emcee-ado s
A. BROKERAGE FIRM TRANSFER (Unless otherwise indicated, TO Amoritrado will transfer in Full)
0Full Transfer—To transfer entire account, check here and skip to Section 4.
OPartial Transfer—List specific security and/or cash amount below. If bands are being transferred. please supply the CUSIP.
Only whole shares 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 (CUSP or symbol) Quantity
(ParXi Transfers Only) (indicate lot whole shares (Partial Transfers OraY) (Ineicate# of aticre Mans
or 'ALL') or 'Air)
1. CASH 5,000,000 5. AMZN 1,000
2. GOOG 3,000 6. BABA 5,000
3. CVNA 25,000 T. BII B 2,095
4. UTX 15,000 8. KPTI 25,000
8. 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 mail the Original form to complete the transfer request.
IRA Savings Accounts—Typically held with BanklCrectit Union.
0Total Transfer (Transfer entire account) q Wire
(foes may apply)
0 Partial Transfer (Transfer part of account) Portion to transfer S 0 Chock
Certificates of Deposit (CDs).
0Redeam my CD immediately.
am aware of, and acknowledge, that lam responsible for any penalties that may Incur from any early withdrawal.
°Redeem 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 hove a renewal
deadline, maturity date, surrender charge periodw indow, etc., paperwork must be received by TO Amentrado in good order throe 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
°Transfer my Annuity
0 Full 0 Partial S 0 Wiro
have an annuity policy that! wish to transfer. Please redeem and terminate on my behalf. (fees may apply)
I am aware of, and acknowledge, that I am responsible for any penalties that! may incur from 0 Cheek
any early withdrawal.
Select only ono: Liquidate annuity in full or partial liquidation. If partial is selected, amount for partial must be included.
Ti) Amor-Made 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 Amerinade will transfer shares In-kind. This section pertains only to shares of Mutual Finds held directly
with the fund company, for brokerage accounts containing Mutual Funds and/or Stocks please compete the Brokerage Firm Transfer section
(Section 3A, above).
'Proprietary Mutual Funds and all no-ioad Money Market funds cannot be transferred it-kind and must be liquidated.
Quantity Handling Gains &Dividends
Fund Name or Symbol Mutual Fund Account ft
(Indicate It of shares or -ALL') (Check ono) (Checkone if ht.kinco
X In.Kind • Reinvest
• Liquidate • Cash
an-Kind X Reinvest
• Liquidate X Cash
• In-Kind 0 Reinvest
• Liquidate °Cash
'If you are transferring more funds than will fit above, please include an attached list for the compl to list of funds. OWire
A statement MUST be included to ensure proper handling and processing of your Mutual Fund transfer (fees may zippy)
'Unless otherwise indicated. I authorize the Transferor to liquidate any non-transferable proprietarymoney market 0 Cheek
and mutual fund assets that are part of my account and to transfer the resulting credit balance to my account with
TO Ameritrade. If the fund /s unable to be held by TD Ante/Riad% I (please inset here) authorize the Transferor
to liquidate and transfer as cash.
CONFFIDENTIAL SDNY_GMLIPMIttabb
EFTA_00 I 2303 I
EFTA01268435

TD Ameritrade Acct
Registration Difference
For unlike titled or type transfers, such as Individual to Joint, I authorize the transfer from account to account.
Al parties on the delivering account must sign below. All TD Amentrade parties must sign in section 6 for transfer authorization.
XClient Signalise: Date:
)( Client Signature: Dale:
XClient Signature:
5. ONE AND THE SAME LETTER (IF APPLICABLE)
If you are transferring an acoount, and the name(s) at TD Amentrade do not exactly match bid are still one and the same person, please complete
this section_ This section should be utifzed if your name has changed due to one or more of the following: Marriage. Divorce. Nacre Seeing Error.
or any type of Name Change inducing Jr., Sc. etc. If last name difference, must supply legal documentation: that is, state issued driver's license,
passport, or government ID. (Please specify account types, such as lndMdual to Joint)
(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 fo Join()
Please sign name BOTH ways.
XSignature: XSignature:
6. TD AMERITRADE CLIENT AUTHORIZATION (REQUIRED)
All TD Ameritrade 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-kind, all assets into my account with TD Amentrade. 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 apparable regulations. I understand I will be contacted by the carrying and/or receiving firm with regard to any assets that we not
transferable. I authorize the Transferor to deduct any outstanding fees due to transfer from the credit balance, or if the credit balance i the account
is insufficient to satisfy any outstanding fees. If certificates or other instruments in my account are 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 thorn in its name
for the purpose of sale, when a a ireeled by me. I understand that upon receiving a copy of this transfer instruction, for a full account transfer,
Transferor will freeze royaccount and I all open orders. I also understand that no new orders maylwill be taken. I affirm that I have destroyed or
returned to the Trarsferor all credt/d it cards and/or unused checks issued to me in connection with my account.
If this TD Amen! ado account is a gGalified retirement account, I have amended the applicable plan to designate the successor custodian.
Alternatively, if I is TD Arneritradehccount is an Individual Retirement Account (IRA),
I have adopted IRA plan so tht it names the successor custodian. (Medallion Signature Guarantee — For TD Artientrade Use Only)
XClient Signalise: PO/I
DeaN5
XCo-Owner's Signature Date:
XCo-Owner's Signature Date:
XCo-Oimers Signature: Dare:
7. LETTER OF ACCEPTANCE (FOR OFFICE USE ONLY)
The undersigned organization agrees to serve as successor custodian for the account of the above-named individual, and as custodian, we agree to
accept the assets being transferred.
XRepresentative Signalise: Date: (ailedellion Signature Guarantee - For TD Amenable Use Only)
Representative Printed Name:
For TD Ameritrade Clearing, Inc. use only
Please be advised that TD Ameritrade Clearing. Inc. is an Approved 403(6)(7)
Vendee and/or has entered nito an Information Sharing Agreement with the Employer
for the above-captioned 403(b)(7) account The Employer/Agent Signature above
hereby authorizes TO Amentrade Clearing, Inc. to accept this exchange.
Investment Products: Not FDIC Insured ' No Bank Guarantee ' Nay Lose Value
TD Ameritrade, Inc. and TD Ameritrade Clearing, Inc., members FINRAISIPC. TD Amentrade Is a trademark jointly owned by
TO Ameritrade IP Company Inc. and The Toronto-Dominion Bank. O 2018 TD Ameritrade.
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