Fillable Account Transfer Form - Scottrade (Page 2 of 3) in pdf

LETTER OF AUTHORIZATION TO TRANSFER (If Applicable)

REQUIRED if the account name and/or title you are transferring does not match your Scottrade account title. I/we hereby authorize the

transfer of my/our account being held at the firm listed on page 1 of this form and registered as:

Account Title as it appears on your most recent statement

_________________________________________

____________________

LOA Signatures:

ACCOUNT HOLDER SIGNATURE

DATE

(Account holder(s)

X _________________________________________

_____________________

must also sign below)

JOINT ACCOUNT HOLDER SIGNATURE

DATE

_________________________________________

_____________________

JOINT ACCOUNT HOLDER SIGNATURE

DATE

To Delivering Firm: Unless otherwise indicated above, please transfer all assets in my account to Scottrade, Inc. (“Scottrade”). I understand that to the extent any assets in my account

are not readily transferable, with or without penalties, such assets may not be transferred within the time frames required by New York Stock Exchange Rule 412 or similar rule of FINRA

or other designated examining authority. Unless otherwise indicated above, I authorize you to liquidate any nontransferable proprietary money market fund assets that are part of my

account, and transfer the resulting credit balance to the successor custodian. I understand that you will contact me with respect to the disposition of any other assets in my securities

account that are nontransferable or which cannot be held at Scottrade. I authorize you to deduct any outstanding fees due you from the credit balance in my account. If my account

does not contain a credit balance, or if the credit balance in the account is insufficient to satisfy any outstanding fees due you, I authorize you to liquidate the assets in my account to the

extent necessary to satisfy that obligation. If certificates or other instruments in my account are in your physical possession, I instruct you to transfer them in good deliverable form,

including affixing any necessary tax waivers, to enable the successor custodian to transfer them in its name for the purpose of sale, when and as directed by me. I understand that upon

receiving a copy of this transfer instruction, you will cancel all open orders for my account on your books. I affirm that I have destroyed or returned to you all credit/debit cards and/or

unused checks issued to me in connection with my securities account. I understand that by transferring my mutual funds to Scottrade, all future correspondence concerning my mutual

fund positions must be directed to Scottrade. Furthermore, I acknowledge that while my fund positions are being held in street name with Scottrade, I will not be able to have direct

communication with the fund company concerning my account. Therefore, I authorize you to release any information relevant to this transfer to Scottrade.

For Retirement Accounts: If this transfer is for a qualified retirement account, I have amended the applicable plan so that it names Scottrade as successor custodian. Alternatively, if

this transfer is for an Individual Retirement Account (IRA), I have adopted an IRA plan so that it names the successor custodian. If I am transferring an IRA and the IRA type indicated

on my statement is different from the IRA I currently maintain at Scottrade (e.g., Traditional IRA vs. Rollover IRA), I hereby authorize Scottrade to commingle my IRA assets.

Fees: If the assets I am transferring are considered nonstandard assets at Scottrade, I understand that I will be charged set-up and maintenance fees. I understand that fractional

shares of stock are nontransferable, and I agree that any fractional shares will be liquidated by the delivering firm upon the transfer of the whole shares. The delivering firm may or may

not charge a fee for this liquidation. I understand that the delivering firm may or may not assess account fees for the transfer and/or termination of my account with them.

Mutual Fund Dividends and Capital Gains: I understand that my delivering broker may provide Scottrade with mutual fund dividends and capital gains distribution instructions for each

mutual fund position so that Scottrade may implement these instructions. In the event that the instructions are not provided by the delivering broker or the dividend and/or capital gains

distribution option requested is not available at Scottrade, the instructions will default to reinvest (unless reinvestment isn't available, in which case dividends and capital gains will be

paid in cash).

I hereby attest that the information submitted to Scottrade is true and accurate.

BRANCH OFFICE * WITH A COPY OF YOUR

SIGN THIS COMPLETED FORM AND RETURN IT TO YOUR LOCAL SCOTTRADE

MOST RECENT ACCOUNT STATEMENT.

If you are working with an independent registered investment advisor, please contact your advisor for further assistance.

_________________________________________

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ACCOUNT HOLDER SIGNATURE

DATE

X _________________________________________

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