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tribution for the account. 1. ACCOUNT INFORMATION Your TD Ameritrade Account (The registration of the account being transferred should match your TD Ameritrade account and the Tax ID for both the TO Amentrade account and account being transferred.) Account Number (Required): (Only one perform) Account Re
icable) Account Type (select one) Eilndividi pal — (Non IRA) IDJoint EI Trust ECorp/Business Ducwvvrtm DEstate O Traditional or Rollover IRA El Roth IRA OBeneficiary IRA o Beneficiary Roth IRA LI Qualified Nan (401k, 4038, PER ate.) El SIMPLE IRA K 3EP IRA EI Other: 2. PLEASE PROVIDE INFORM
y 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-
ondary if applicable) Account Type (select one) Individual — (Non IRA) OTruSt OCOrp/SUSIneSS D0GMAUM% ElEstate El Traditional or Rollover IRA El Roth IRA K Beneficiary IRA K Beneficiary Roth IRA K Qualified Plan (401k. 4038, PSP. etc.) K SIMPLE IRA K SEP IRA DOther: 2. PLEASE PROVIDE INFORMA
esting 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 Cent
il: Account Type (select one) O Indiyidual (Non IRA) point Trust ElOorpfElusiness OUGMNUTMA ['Estate O 0ther El Traditional or Rollover IRA El Roth IRA O Beneficiary IRA O Beneficiary Roth IRA K Qualified Plan (401k, 403B, PSP, etc.) OSIMPLE IRA O SEP IRA If the registrations do not match,
Entities connected to both TD Ameritrade and El Roth

Omaha
LOCATIONThe Toronto-Dominion Bank
ORGANIZATIONTrust Companies
ORGANIZATIONthe Tax ID
ORGANIZATIONLiquidation Transfer
ORGANIZATIONIndividual to Joint
ORGANIZATIONTD Ameritrade Attn
ORGANIZATIONNo Bank Guarantee '
ORGANIZATIONTD Amentrade
PERSONMedallion Signature Guarantee
ORGANIZATIONORedeem
PERSONSocial Security/Tax
ORGANIZATIONBank/Credit Union
ORGANIZATIONthe Mutual Fund s
ORGANIZATIONIntel Mac OS
ORGANIZATIONB. BANK/CREDIT UNION & ANNUITY
ORGANIZATION