Fillable Charitable Gift Loa - Transfer Of Account Form printable pdf download

Charitable Gift Loa - Transfer Of Account Form

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CHARITABLE GIFT LOA

TRANSFER OF ACCOUNT

Date:

Title of Scottrade

Account:

(Please Print)

Your Scottrade

Account Number:

Relationship to Recipient:

Reason for This Request:

Internal

External

Transfer Type:

Please gift the following:

shares of

To (Account Title):

Social Security Number:

Address (including city, state and zip code):

Contact Person:

At (Firm):

DTC Number:

Account Number:

Cost Basis

If the securities you are transferring are part of a larger position that was purchased in multiple tax lots, the default method for determining which

shares to transfer is First-In, First-Out (FIFO), unless you have previously specified a different global tax strategy that will implement another method.

To specify the transfer of alternate shares, complete the section below.

Number of Shares

Acquired Date

Average Unit Cost

Number of Shares

Acquired Date

Average Unit Cost

I hereby agree to indemnify Scottrade, its affiliates, successors, assigns, officers, directors, agents, and employees, and hold them free and harmless

from, and to promptly pay Scottrade upon demand for, any and all losses, liabilities, claims, damages and costs (including reasonable attorney fees)

or financial obligations that may arise as a result of Scottrade’s reliance on the information provided in this document, and from acting upon

instructions believed by Scottrade to have originated with me. This indemnity is in addition to, and no way limits or restricts any rights or

responsibilities that have been made under any other agreement or agreements between me and Scottrade.

Account Holder's Signature

Date

Account Holder's Signature

*CC4201*

Signature Page

Signature Verification via

Application

Associate Initials