Account Transfer Form I. RECEIVING FIRM INFORMATION (Only one per form) RECEIVING FIRM CLEARING NUMBER ACCOUNT NUMBER: SOCIAL SECURITY NUMBER SECONDARY SOCIAL SECURITY NUMBER: - FF1- ACCOUNT TYPE: (Enter the two character code) C 0 or TAXPAYER IDENTIFICATION NUMBER: or TAXPAYER IDENTIFICATION NUMBER: Nonratuemeni. JT-1-lornil TR —(Trustl CT—(Couustee) CO—(Corporate) CU—(Custodian) ES —(Estate) BC —(Bank Custody) AG—(Agency) Retirement. IR —I Iraditional IRA' RI—(Roth IRA, DR —(Direct Rollover) RI —IBeneliciary) BR —TEleneficiary Roth IRA) 4K —(401k) El—(Education Savings Account) SI —(SIMPLE IRA) QP—(Qualified Plan) 48—(403b) 78—(457 Plan) HS-114eallh Savings Account) 5P-(529 Plan) OT — !Other) Other. II. DELIVERING ACCOUNT INFORMATION CLEARING NUMBER: ACCOUNT NUMBER: FIRM NAME JPMergsn Chase Bank, N.A. ACCOUNT TITLE: (As it appears on your statement) Southern Trust Company, Inc NOTE: A complete copy of yet. DELIVERING FIRM CONTACT INFORMATION (MANDATORY WHEN CLEARING NUMBER IS NOT PROVIDED' CONTACT NAME: FIRM ADDRESS. (No PO Box) CITY: STATE: ZIP. TELEPHONE NUMBER: —It statement is necessary to process this form. III. TRANSFER TYPE (Choose only one) A ACCOUNT TRANSFER U FULL 'Check one below) K TRANSFER ALL ASSETS IN KIND (Skip to Seclion VII U LIQUIDAI E ALL ASSETS LISTED IN SECTION IV (Lquicielions are not for brokerage accounts) U TRANSFER ALL ASSE IS IN KIND EXCEPT FOR THE ASSETS USTED IN SECTION N. WHICH REQUIRE LIQUIDATION U PARTIAL (Complete Section M B. DRS/DRIP U FULL (Check one below) U SELL FRACTIONS AND CLOSE ACCOUNT 0 TRANSFER ALL FULL SHARES ONLY U PARI IAL (List assets in Section NI NOTE: For transler agents. electronically send positions o issue a certificate for whole shares and redeem Tractional shares. C. DIRECT MUTUAL FUND LI TRANSFER MUTUAL FUNDS FROM THE ACCOUNT HELD DIRECILY AI THE FUND COMPANY ISee list in Section IV for exact instructions) NOTE: Only one fund family per form.