EFTA01268464.pdf

Account Transfer Form
TO Ameritrade
Mall 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 866-468-6268. 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.
•11 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 TO 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 70,4 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 directed in Section! both registration end Tax los for the
TO Arne/Made account and the Tax ID for both the TO Ameritrade ICI Amentrade account and account being transferred should match.)
account and account being transferred.)
Account Number (Required): Account Number (Required):
(Only one per lone) (Onlyone per form)
Account ReaistraUcerfrett Account Registration/Me:
SOUTHERN FINANCIAL LLC SOUTHERN FINANCIAL LLC
Soda/ Secuntyrax ID Number. Sods SecurIty/Tex ID Number:
Sodel Securityrrax ID Number. Sods Securtly/Tax ID Number.
(Secondary If appitatim (Secondary If apt:table)
ContrarDeliverIng Fern Name (amitkad):
Account Type (select one) DEUTSCHE BANK PRIVATE WEALTH MANAGMENT
Olndividual — (Non IRA) OTraditional or ROOM IRA ContraiDeliverina Firm Address:
Can
DJoint O ROth IRA 345 PARK AVE 26TH FLOOR NY.NY10154
DTrust O Beneficiary IRA
['Com/Business O Beneficiary Roth IRA
O UGMAAJTMA O Qualified Plan (401k. 403B. PSP. etc.) Ccara/Delivaing Rrm Email
DEstate O SIMPLE IRA
O SEP IRA
Account Type (select one)
DOther.
O Incrrviduai — (Non IRA) El Traditional or Rollover IRA
O Joint O Roth IRA
OTrust O Beneficiary IRA
OcOrp/Buslness O Beneficiary Roth IRA
OUGMA/UTMA O Qualified Plan (401k, 4038, PSR etc)
['Estate O SIMPLE IRA
O SEP IRA
00ther
if the registrations do not match, you may either establish a now account online at www.tdemeritrado.com or you must supply additional
documentation and all delivering account owners must sign section 4. For unlike title/registration transfer; please call the transfer department
at 888-723-8504, option 4 for additional requirements. Wean note if there aro any issues with processing your transfer, wo will communicate
that to you via your secure message center when you log in to your account.
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CONFIDENTIAL S0NY_Ofdketitta a
EFTA_00123065
EFTA01268464

TD Anent/ado Ma It
A. BROKERAGE FIRM TRANSFER (Unless otherwise indicated, TO Ameritrade will transfer in Ful0
ORA
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 [he CUSP
Only whole sham 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 &keg Onocate is of %nab snares (Penal Transfers Only) (Indicate teofl whole shoes
or ALAI or *AU')
1. 539439AG4 1,903,000 5.
2. AAPL 180,000 B.
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 Swings Accounts-Typically held with BankiCreclit Union.
0
OTotal Transfer (Transfer entire account) IMre
(fees may apply)
0 P artial Transfer (Transfer part of account) Portion to transfer O Check
Certificates of Deposit (CDs).
°Redeem my CD Immediately.
t am aware of, and acknowledge, that l am responsible for any penalties that I may incur from any early withdrawal.
ORedeem my CD at maturity. Maturity Date:
Submit request at least 21days prior to maturity. Please advise your bank not to roil 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 perlocilmndow, etc., paperwork must be received by TO Ameritrade in good order three weeks
prior to the frim deadline to allow for proper processing times. To liquidate a CO held in a non-retirement account, contact the bank or
credit union at which the assets are being held.
Annuity Transfer
OTransfer my Annuity
0
OFUII Partial S
I have an annuity policy that! wish to transfer. Please redeem and terminate on my behalf. (fenI nayallety)
am aware of, and acknowledge, that lam responsible for any penalties that! may Incur from q Check
any early withdrawal.
Select only one: Liquidate annuity in full or partial liquidation. If partiali s selected, amount for partial must De included.
TD Ameritrade is not responsible for the timing or execution of fiquidations processed by the delivering firm.
C. MUTUAL FUND COMPANY TRANSFER
Chock 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, TO Ameritrade will transfer shares in-kind. This section pertains only to shares of Mutual Funds held directly
with the fund company, for brokerage accounts containing Mutual Funds andlor Stocks please complete the Brokerage Firm Transfer section
(Section 3A, above).
'Proprietary Mutual Funds and all no-load Money Market funds cannot bo transferred in-kind and must be liquidated.
Quantity Handling Gains & Dividends
Fund Name or Symbol Mutual Fund Account if
(Indicate a of shares or ALL7 (Check one) (Check one tun-lend)
Oln-Kind M Reinvest
°Liquidate • Cash
9ln•Kind
°Reinvest
Liquidate °leash
Oln.Kind • Reinvest
all Liquidate OCash
if you are transferring more funds than will fit above, please include on attached list for the complete list of funds. 0 Wire
A statement MUST be included to ensure proper nandfing and processing of your Mutual Fund transfer frees nr•X WA)
0
• Unless otherwise Mooted, I authorize the Transferor to liquidate any non-transferable proprietary money market Check
and mutual fund assets that are part of my account and to transfer the resulting credit betence to my account with
Ti) Ameritrade. If the fund is unable to be held by TO Ameritrade, I (please initial here) authorize the Transferor
to liquidate and transfer as cash.
scReact412422
COMIDENTIAL
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EFTA01268465

TO Ameritrade Acct
Registration Difference
For unlke lilted or type transfers, such as Individual to Jolt I authorize the transfer from account to account.
Al parties on the delivering account must sign below. All TD Arnentrade parties must sign in section 6 for transfer authorization.
XClient Signaiwo: Date:
XClient Signature: Date:
Client Signature: Data:
5. ONE AND THE SAME,LETITER.0E.A PRL1CABLE). •
If you we transferring an account, and the name(s) at TD Amoritrade do not exactly match but are still one and the same person, please complete
this scalar). This section should be utifaed if your name has changed due to one or more of the (alloying: Marriage, Divorce, Name Sparing 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 One 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.
41( Signature: 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 incicated in the instructions above, please transfer, in-kind, all assets into my account with TD 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 within the time
frames required by amicable regulations. I understand I will be contacted by the carrying andkir receMng 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. II 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 them In its name
for the purpose of sa!e, when and as directed by me. I understand that upon receiving a copy of this transfer instruction. fertilise 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 Transferor all crodtrdebit cards and/or unused checks issued to me in connection with my account.
If this TD Amentradoaccant a qualified retirement account, 1 have amended the applicable plan to designate the successor custodial.
Alternatively, phis TO Ameritra account is an Individual Retirement Account (IRA),
I have adopted an IRA plan so I t it names the successor custodian. (Medallion Signature Guarantee- For TO Amentrade Use OnN)
XClient Signature: Dale:
€7k5/201
/Co -Owner's Signature: Date:
XC-oOwner's Signaturt......,/ Date
X CGOWIlleS Signa Date:
The undersign organization,J sgrees to serve as successor custodian for the account of the abovanamed indivklual and as custodian. we agree to
acecpt the as els being trans erred.
XRoprosen Signature: Date: gdedalon Signature Guarantee - For TD Arneritrade Uso Only)
2-2.5-20f
Representative RAI Na i ex,/
For TD Ameritrade C Ling, I (use only
Please be advised th t M 'trade Clearing, Inc. is an 'Approved 403(b)(7)
Venda' andror hes eryere into an Information Sharing Agreement with the Einott.ryer
for the above-captioned 403(b)(7) account. The Employer/Agent Signature above
hereby authorizes TO Ameritrade 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 Amentrade Is a trademark jointly owned by
TO Ameritrade IP Company, Inc. and The Toronto-Dominion Bank. 0 2018 TD Amerltrade.
CONFIDENTIAL SDNY_Getittiall,(Negag
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