EFTA Document EFTA01268291

(Page 1 of 4 ) TO Ameritrade Mail or Fax tot PO Box 2760 . Omaha, NE 68103-2760 Far 866-4684268 Account Transfer Form Receiving Firm DTC Clearing Number: 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 TO Ameritrade Attn: TO Amentrade, PO Box 2760, Omaha, NE 68103.2760 or fax to 866.468-6268. "If you are request