10 Ameritrade Mail or Fax to: PO Box 2760 • Omaha, NE 68103.2760 Fax: 866.468.6268 Account Transfer Form Receiving Firm DTC Clearing Number: 0188 Instructions: Attach a complete copy of your most recent statement, of the account you are requesting 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. —If you are requesting to transfer from your Qualified Retirement Plan. please contact your plan administrator: this form may not be required. If you are transferring between two TD Ameritrade accounts. please use the Internal transfer form. Please note you cannot use this form to transfer from a standard checking account and for savings account from a banklcredit union. For IRAs. and Beneficiary IRAs where the original owner was 70% years or older at death. please attach a copy of your end of year statement to enable us to calculate the required minimum distribution for the account. 1. ACCOUNT INFORMATION Your TD Ameritrade Account (The registration of the account being transferred should match your TO Ameritrade account and the Tax ID for both the TO Ameritrade account and account being transferred.) Account Number (Required): (Only one per form) Account Registration/Title. Social SecuntytTax ID Number: Social Secuntyfriuc ID Number: (Secondary If applicable) Account Type (select one) Individual - (Non IRA) DJoint OTrust [' Corp/Business UGMA/UTMA 0403B 0Other: ['SIMPLE IRA ['SEP IRA O Traditional or Rollover IRA O Roth IRA O Beneficiary IRA O Beneficiary Roth IRA O Estate OQualified Plan ('See above) 2. PLEASE PROVIDE INFORMATION ABOUT THE ACCOUNT TO BE TRANSFERRED (As directed in Section 7 both registration and Tax IDs for the TO Ameritrade account and account being transferred should match.) Account Number (Required): (Only one per form) Account Registration/Ti