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mpanies require Original Client Signature. Please mail the Original form to complete the transfer request. IRA Savings Accounts—Typically held with Bank/Credit Union. El total Transfer ( transfer entire account) ['Partial Transfer (Transfer part of account) Portion to transfer O Wire (fees troy OPPlY) O Chec
med individual, and as custodian, we agree to accept the assets being transferred. Dale./ Date: Dale: Uate: (Medallion Signature Guarantee — For TD Amentrade Use Only) X Representative Signature: Reptesentati.ie Printed Na-ne. Date: For TO Ameritrodo Clearing, Ina. use only Please be advised that TO Am
mpanies require Original Client Signature. Please mall the Original form to complete the transfer request. IRA Savings Accounts—Typically held with Bank/Credit Union. OTotal Transfer (Transfer entire account) OPartia I Transfer (Transfer pert of account) Portion to transfer O Wire (fees may apply) O Check C
registration must sign this section. Unless otherwise indicated in the Instructions above, please transfer, Irk kind. an 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 bo transferr
e mail the Original form to complete the transfer request. 'Each section will hove additional Information. IRA Savings Accounts—Typically held with Bank/Credit Union. K Total Transfer (Transfer entire account) 0 Partial Transfer (Transfer part of account) Portion to transfer $ DWIre (lees may apply) 0 Chock
company to determine whether surrender forms are required before submitting the transfer form to TO Ameritrade. Attach surrender form if applicable. TD Amentrade is not responsible for the arcing or execution of liquidations processed by the delivering firm. 0 Wire gem may amply) 0 Chock D. TRANSFER AGENT
Entities connected to both Bank/Credit Union and TD Amentrade

Omaha
LOCATION
TD Ameritrade
ORGANIZATIONTrust Companies
ORGANIZATIONthe Tax ID
ORGANIZATIONThe Toronto-Dominion Bank
ORGANIZATIONLiquidation Transfer
ORGANIZATIONIndividual to Joint
ORGANIZATIONNo Bank Guarantee '
ORGANIZATIONTD Ameritrade Attn
ORGANIZATIONTD AMERITRADE CLIENT
ORGANIZATIONTD Ameritrade Clearing, Inc.
ORGANIZATIONMedallion Signature Guarantee
ORGANIZATIONORedeem
PERSONOWire
ORGANIZATIONEl Roth
ORGANIZATIONAmeritrade Attn
ORGANIZATIONthe Mutual Fund s
ORGANIZATIONIntel Mac OS
ORGANIZATION