EFTA01268461.pdf

Account Transfer Form
1D Anievrrikvade
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 T0A 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 Ameritrado, PO Box 2760, Omaha, NE 68103.2760 or fax to 866-468.6268. 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 ate 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 this form
to transfer from a standard checking account and/or savings account from a banklcredit union. For IRAs, and Beneficiary IRAs where the
original owner was 70)4 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
DELIVERING ACCOUNT
Your TD Ameritrade Account
(The registration of the account being transferred should match your (As *acted in Section 1b oth registration end Tax IDs for the
TO Ameritrade account and account behg transferred should match)
TO Ameritrade account and the Tax ID for both the TD Ameritrade
account and account being transferred.)
Account Number (Required): Account Number (Required):
(ONn ne Ferir ) 867-730320 (0nty one per form) N46-023804
Account Regletradorade: Account RegstrationTee:
SOUTHERN FINANCIAL LLC SOUTHERN FINANCIAL LLC
Social Security/4x ID Number Social Scour/10-ex ID Number:
66-0799192 66-0799192
Social Security/Tax ID Number: Social Security/Tax ID Number
(Secondary if applicable) (Secondary If applicable)
ConiraiDelkedng Firm Name Mews*
Account Type (select one)
DEUTSCHE BANK PRIVATE WEALTH MANAGMENT
Individual — (Non IRA) El Traditional or Rollover IRA Contra/Delivering Ram Address:
El Roth IRA 345 PARK AVE 26TH FLOOR NY,NY10154
OTruSt q Beneficiary IRA Confracelivering Arm Phone Number (Required):
OCOrp/SUSIneSS q Beneficiary Roth IRA ZZ LIfftt- 0'153
D0GMAUM%
q Qualified Plan (401k. 4038, PSP. etc.) ContraiDetivering Firm Ernalt
ElEstate q SIMPLE IRA
q SEP IRA
Account Type (select one)
DOther:
0
Olndividual — (Non IRA) Traditional or Rollover IRA
E1Rolh
O.1oint IRA
0
OTrust Beneficiary IRA
I:Corp/Business q Beneficiary Roth IRA
0
OUGmAiuTmA Qualified Plan (401k. 4036, PSR etc.)
DEstate 0 SIMPLE IRA
OSEP IRA
00lher
If the registrations do not match, you may either establish a new account online at virww.tdameritrado.com or you must supply additional
documentation and all delivering account owners must sign section 4. For unlike tideiregistration transfec please call the transfer department
at 888-7234504, option 4 for additional requirements. Please note if there are any issues with processing your transfer, we will communicate
that to you via your secure message center when you log in to your account.
1111111111111111111111111111111111111111
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EFTA01268461

TO Amorittado Acct # 867.730320
A. BROKERAGE FIRM TRANSFER (Unless otherwise indicated. TO Amerind° will transfer in Full)
['Full 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 CUSP
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 symbol) Quantity
(Partial Transfers any) (Indicate a of whole snares (Peal Transfers Only) (Indicate ll of stole shares
or ALI or'AU.7
1. 539439AG4 1,903,000 5.
2. AAPL 180,000 6.
3. APO 263,157 7.
4. 8.
B. 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 mall the Original form to complete the transfer request.
IRA Savings Accounts—Typically held with BanklCredit Union,
OTotal Transfer (Transfer entire account) 0 Wire
pees mar sorAW
OPertial Transfer (Transfer part of account) Portion to transfer D Cheek
Certificates of Deposit (CDs).
ORedeem my CD Immediately
l am aware of, and acknowledge, that I am responsible for any penalties that I may incur from any early withdrawal.
ORedeem my CD at maturity. Maturity Date:
Submit request at least 21 days 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 have a renewal
deadline, maturity date, surrender charge petiodlwindow, etc., paperwork must be received by TO Ameritrade in good order three weeks
prior to the firm deadline to allow for proper processing limes. 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 $ 0 Wire
I have an annuity policy that I wish to transfer. Please redeem and terminate on my beh alt gees may apply)
l am aware of, and acknowledge, that lam responsible for any penalties that I may incur from 0 Chock
any early withdrawal.
Select only one: Liquidate annuity in full or partial liquidation. If partial is selected, amount for partial must be included.
TD Ameritrade is not responsible for the timing or execution of liquidations processed by the delivering firm.
C. MUTUAL FUND COMPANY TRANSFER
Cheek 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 Ameritrade will transfer shares in-kind. This section pertains only to shares of Mutual Funds held direcUy
with the fund company, for brokerage accounts containing Mutual Funds and/or Stocks please complete the Brokerage Firm Transfer sedlon
(Seetbn 3A, above).
Proprietary Mutual Funds and alln o4oad Money Market funds cannot be transferred in-kind end must be liquidated.
Quantity Handling Gains 8 Dividends
Fund Name or Symbol Mutual Fund Account #
(kid/cage It ofs hares or ''ALL7 (Check one) (Check me GM-kind)
OlmKinci ORelmest
['Liquidate III Cash
Oln•Kind OReinvest
NI Liquidate OCtlall
In n-Kind UlI Reinvest
M Liquidate OICash
If you are transferring more funds Than will fit above, please include an attached list for the complete list of funds. OWlre
A statement MUST be included to ensure proper handling and processing of your Mutual Fund transfer. (tees may apply)
• Unless otherwise Indicated, I authorize the Transferor to liquidate any non4ransferablo proprietary money market 0 Chock
and mutual fund assets that are pan of my account and to transfer the resulting credit balance to my account with
TO Amerttrade. If the fund is unable to be held by TO Amerind°, I (please initial here) authorize the Transferor
to liquidate and transfer as cash.
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EFTA01268462

TO Ameritrade Acct 0 867-730320
Registration Difference
For unlike tilled or type transfers, such as Individual to Joint, I authorize the transfer from account to accost.
All parties on the delivering account must sign below. All TD Ameritrade parties must sign In section 6 for transfer authorization.
XClient Signature: Date:
Ar Client Signature: Date:
XClient Signature: Date:
5. ONE AND THE SAME LETTER (IF APREICABITE).. .
If you are transferring an account, and the name(s) at TD Ameritrade do not exactly match but are still one and the same person, please complete
this section. This section should be utilized if your name has changed due to one or more of the following: Marriage, Divorce, Name Spelling Error.
or any type of Name Change including Jr.. Sr., 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 Individual to Joint)
(please print name), am Ono and the Same as
(please print name) as shown on the delivering firm account. (Please specify account types, such as Individual to Joint)
Please sign name BOTH ways.
XSignature: XSignature:
6. TO AMERITRADE CLIENTAUTRORIZATION (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 TO Ameritrode. 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 applicable regulations. I understand I will be contacted by the carrying and/or receiving firm with regard to any assets that are 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 are In your physical possession, I instruct Transferor to
transfer them in good deliverable form, including affreng any necessary lax 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 affrm that I have destroyed or
returned to the Transferor all credit/debit cards and/or unused checks issued to me in connection with my account.
II this TO AmeritradeeccoDn a qualified retirement account, 1 have amended the applicable plan to designate the successor custodian.
Alternatively, iphis-TD Arneriln account is an Individual Retirement Account (IRA),
I have adopted an IRA plan so t it names the successor custodian. (Medallion Signature Guarantee — For TO Arnentrade Use Only)
XCl int Signature: Date:
2/2.,72019
/y . Coavners Signature: Date:
XCo-Owners Signalut,,,,,/" Date:
XCo-Owners Signe Date:
The undersign • organization frees to serve as successor custodian for the account of the above-named Individual, and as custodian. we agree to
accept the a ens being trans ed.
XRepress rive Signe Date: (Medallion Signature Guarantee — For TD Ameritrade Use Only)
2-25-209
Representative PA% d Na
For TD Ameritradei .Cit Faring,,] E. only
Please be advised I t TDishentrade Clearing, Inc. is an 'Approved 403(b)(7)
Vendor' and/orhese eree into an InformatiOn Sharing Agreement we' the Employer
for the above-captioned 403(b)(7) account. The EmpioyertAgent Signature above
hereby authorizes TD Amerilrade Clearing, Inc. to accept this exchange.
Investment Products: Nol FDIC Insured ' No Bank Guarantee ' May Lose Value
TO Ameritrade, Inc. and TO Amerilrade Clearing, Inc., members FINRNSIPC. 'ID Ameritrade is a trademark jointly owned by
TD Ameritrade IP Company, Inc. and The Toronto-Dominion Bank. O 2018 TD Ameritrade.
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