Authorization To Accept Distribution From Trust/estate Account Form

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Authorization to Accept Distribution
From Trust/Estate Account
Scottrade Account Information
Account Title
Account Number
Account Holder's Name
Social Security Number
Joint Account Holder's name
Social Security Number
Delivering Firm Information
Name
Address
City
State
ZIP
The account holder(s) listed above have an established
account at Scottrade.
(Account Type)
Please transfer any assets the account holder is entitled to from the trust/estate distribution into this account. Delivery
instructions are attached. If there are any mutual funds being delivered Scottrade will need to know the cusip numbers and
share amounts being delivered so that bins can be set up to receive these shares. The distribution of the assets from the
trust/estate account is the responsibility of the client and the delivering firm. Scottrade will not perform any follow-up to settle
this transfer.
Account Holder Signature(s):
By signing below I/we are giving Scottrade permission to assist with the delivery of assets by providing the delivering firm
with delivery instructions and bin numbers. I/we authorize the transfer of my/our portion of this distribution to the Scottrade
account referenced above.
X
Account Holder's Signature
Date
X
Account Holder's Signature
Date
Medallion Signature Guarantee (For Scottrade Use Only)
*CCSF4002*
CCSF4002/7-14

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