Account # IV. PARTIAL TRANSFERS. DIRECT MUTUAL FUNDS AND LIQUIDATIONS (If there are more than eight assets, attach a signed list to this form) QUANTITY ASSET DESCRiPTON CUSir/SYMSOL FUND ACCOUNT NUMBER TRANSFER iNSTRUCTIONS• DIVIDEND OPTION" CAPITAL GAIN OPTION ESTIMATED S VALUE O Transfer in Kind 0 Liquidate 0 Cash 0 Reinvest J Cash 0 Reinvest CI Transfer in Kind 0 Liquidate 0 Cash 0 Reinvest J Cash LI Reinvest O Transfer in lend 0 Liquidate 0 Cash 0 Newest U Cash 0 Reinvest 0 Transfer in Kind 0 Liquidate 0 Cash 0 Reinvest J Cash LI Reinvest O Transfer in lend 0 Liquidate 0 Cash 0 Reinvest U Cash 0 Reinvest 0 Transfer in *rid 0 Liquidate 0 Cash 0 Reinvest J Cash U Reinvest O Transfer in lend 0 Liquidate 0 Cash 0 Reinvest U Cash 0 Reinvest 0 Transfer in *rid 0 Liquidate 0 Cash 0 Reinvest j Cash LI Reinvest II you have requested a awidation, your market price is not gusanteed. Yee will receive the current merket price after your transfer request is received. reviewed, and determined to be In good order by the delivering firm. Pershing is not responsible for market fluctuations or delays in the review process. DRS items cannot be !podded. 2 it this is a mutual fund transfer and there is no dividend or capital gain option checked in the section above. Pershing wilt PrOCOS$ this request as reinvest (FOR OFFICE USE ONLY: All transfers must be added to Pershing's transfer systems) V. RETIREMENT PLAN RESTRICTIONS AND CERTIFICATIONS is Age 70' - restrictions. It you are at he age of 70 this year and you are transferring or rolling over assets from an IRA. qualified plan or 4030d account. you may be required to take a minimum dstribuhon (HMCo) from your qualified plan or 40310) account before rolling over your assets. It Rollover Certification of Employee: I understand the lutes and conditions and I have met the requirements for making a rollover. Due to the important tax consequences of rolling over lunds or property. I have been advised to