3
Shared Docs
3
Same-Page
3 / 3
Mentions
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 866468.6268. "if you are requesting to transfer from your Qualified Retirement Plan, please contact you
siness EIUGAUVUTMA O 403B O 0ther: ['SIMPLE IRA ['SEP IRA ['Traditional or Rollover IRA ['Roth IRA O Beneficiary IRA O Beneficiary Roth IRA DEstate DOualified Plan ("See above) 2. PLEASE PROVIDE INFORMATION ABOUT THE ACCOUNT TO BE TRANSFERRED (As directed in Section 1 both registration and Ta
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-
ZZ LIfftt- 0'153 ContraiDetivering Firm Ernalt Account Type (select one) Olndividual — (Non IRA) O.1oint OTrust I:Corp/Business OUGmAiuTmA DEstate 0 Traditional or Rollover IRA E1Rolh IRA 0 Beneficiary IRA K Beneficiary Roth IRA 0 Qualified Plan (401k. 4036, PSR etc.) 0 SIMPLE IRA OSEP IR
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 Cen
OM IRA DJoint O ROth IRA DTrust O Beneficiary IRA ['Com/Business O Beneficiary Roth IRA O UGMAAJTMA O Qualified Plan (401k. 403B. PSP. etc.) DEstate O SIMPLE IRA O SEP IRA DOther. 2. PLEASE PROVIDE INFORMATION ABOUT THE DELIVERING ACCOUNT (As directed in Section! both registration end Tax lo
Entities connected to both TD Ameritrade and DEstate

Omaha
LOCATIONThe Toronto-Dominion Bank
ORGANIZATIONTrust Companies
ORGANIZATIONLiquidation Transfer
ORGANIZATIONthe Tax ID
ORGANIZATIONTD Ameritrade Attn
ORGANIZATIONIndividual to Joint
ORGANIZATIONORedeem
PERSONAmeritrade IP Company, Inc.
ORGANIZATIONPartial Transfers
ORGANIZATIONOlndividual
PERSON