(Page 1 of 31 Signature SUarenteirSterripr-- Arraartritvaefic Mail or Fax to: PO Box 2760 • Omaha, NE 68103-2760 Fax: 866-46B-6268 Transfer Out - Depository Trust and Clearing (DTC) Transfer Form For use when requesting a Charitable Gift or Outbound partial transfer to another financial institution. tii bRAI K Charitable Gift For tax purposes, please contact redolent of coming donation. Consult with a tax professional on any tax issues. Please review the guidelines below to make sure your transfer can be processed. - For aU gift transfers. the date of ollt is the dale the transfer Is completed. If a charitable contribution, I certify that It Is bona tide. TD Ameritrade Clearing, Inc. may release my name to the receiving charitable organization unless I Indicate otherwise by initialing hero clij Partial Transfer Other than charitable contributions, If transfers are not between like-titled accounts, the third party information below must be completed. Periled account transfer-, between brokerages via an electronic system. Pursuant to the provisions of the USA Patriot Act of 2001, TD Amerilrade needs specific information from our clients regarding certain transactions. including Third Party Transfers. For this reason, we do ask for a specific purpose for Third Party Transfers. Please Note: Not all Third Party Transfer requests can be facilitated as the request may be outside TO AmerikaIts scope of business. Reason alt:TTA Party Transfer to to 40 .149Qve haAnhip Receiving Rim Name: I~v4em hive &o1& /LC. Receiving Accountrffie: F ComaivY (2-^-t• • aW4 :1, Only whole shares can be requested, as fractional shares cannot be processed. I understand that any trading could delay the processing of Oils request. SvmbotlCUSIP # of Shares SymboliCUSIP # of Shares Symbel/CUSIP # of Share! ""An4ied Qeui Cana/ , Aooq oo o Plea: list additional shams from tratillfor on m sepenle piece of paper .If wet would like to set et a specific lot