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sd-10-EFTA01344417Dept. of JusticeOther

EFTA Document EFTA01344417

Account # N4G-024943 IV. PARTIAL TRANSFERS. DIRECT MUTUAL FUNDS AND LIQUIDATIONS (If there are more than eight assets, attach a signed list to this form) QUANTITY ASSET OESCRiTTON CUSII9/SYMBOL FUND ACCWNT NUMBER lat4141 hot p.n. swap "ban on, I ,IPM Rem-SRL foga Sit% Ernbeep teat Osrpfkawa73111/1 PM TR Ines enr nM Ft FuNd E POMMY lee pl bet. Mn If YiF Pal Cane& Co 7.9% PEG BOFA Corp 81/8% Modred Ileanbeare fee 3 lie TRANSFER iNSTRUCTIONS• ONIDEND OPTION' CAPITAL GAIN OPTIOST 1

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Dept. of Justice
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sd-10-EFTA01344417
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Account # N4G-024943 IV. PARTIAL TRANSFERS. DIRECT MUTUAL FUNDS AND LIQUIDATIONS (If there are more than eight assets, attach a signed list to this form) QUANTITY ASSET OESCRiTTON CUSII9/SYMBOL FUND ACCWNT NUMBER lat4141 hot p.n. swap "ban on, I ,IPM Rem-SRL foga Sit% Ernbeep teat Osrpfkawa73111/1 PM TR Ines enr nM Ft FuNd E POMMY lee pl bet. Mn If YiF Pal Cane& Co 7.9% PEG BOFA Corp 81/8% Modred Ileanbeare fee 3 lie TRANSFER iNSTRUCTIONS• ONIDEND OPTION' CAPITAL GAIN OPTIOST 1

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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
Account # N4G-024943 IV. PARTIAL TRANSFERS. DIRECT MUTUAL FUNDS AND LIQUIDATIONS (If there are more than eight assets, attach a signed list to this form) QUANTITY ASSET OESCRiTTON CUSII9/SYMBOL FUND ACCWNT NUMBER lat4141 hot p.n. swap "ban on, I ,IPM Rem-SRL foga Sit% Ernbeep teat Osrpfkawa73111/1 PM TR Ines enr nM Ft FuNd E POMMY lee pl bet. Mn If YiF Pal Cane& Co 7.9% PEG BOFA Corp 81/8% Modred Ileanbeare fee 3 lie TRANSFER iNSTRUCTIONS• ONIDEND OPTION' CAPITAL GAIN OPTIOST 1.5titas--EO yALVE S Transfer in Kind 0 Liquidate 0 Cash 0 Reinvest J Cash 0 Reinvest 5001766.64 S Transfer in Kind 0 Liquidate 0 Cash 0 Reinvest J Cash Li Reinvest 2704385.15 S Transfer in 14nd 0 Liquidate 0 Cash 0 Reinvest J Cash 0 Reinvest 1363500 S Transfer in Kind 0 Liquidate 0 Cash 0 Reinvest J Cash Li Reinvest 2057601.37 S Transfer in Kind 0 Liquidate 0 Cash 0 Reinvest J Cash 0 Reinvest 445001) II Transfer in Kind 0 Liquidate 0 Cash 0 Reinvest J Cash 0 Reinvest 3337958.33 8 Transfer in Kind 0 Liquidate 0 Cash 0 Reinvest J Cash 0 Reinvest 3389620.83 la Transfer in Kind 0 Liquidate 0 Cash 0 Reinvest cl Cash K Reinvest 996250 1 1I you have requested a liquidation, your market price Is not guaranteed. YOu will receive the current market puce after your transfer request is received. reviewed, and determined to be In good order by the delivering form. Pershing is not responsible for market fluctuations or delays in the review process. DRS items cannot be liquidated. 2 II this is a mutual fund transfer and there is no dividend or capital gain option checked in the section above. Pershing wig process 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. II you are at :aril the age of 70 this year and you are transferring or rolling over assets from an IRA. qualified plan or 40303) account. you may be required to take a minimum distribution (HMCo) from your qualified plan or 40303) account before rolling over your assets. II Rollover Certification of Employee: I understand the tube 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 see a tax proton:Onel. All information provided by ins is true and correct and may be read on by Pershing LLC. I assume full responsibility for this transaction and will not hold Pershing LLC liable for any adverse consequences the may result I hereby irrevocably designate this contribution in funds or other property as a transfer or rollover contribution. TO THE PRIOR TRUSTEE: -I Pershing LLC accepts appointment as successor custodian. -1 Please be advised that does hereby accept appointment as successor custodian OMIT Firm None) SUCCESSOR CUSTODIAN'S SIGNATURE: DATE VI PARTICIPANT SIGNATURE AND CERTIFICATION To the Delivering Firm Named Aboas the trustee listed above. Unless otners :5 nn:: er 4:1 ASif.:2-. .n nit .1C.COnn: .O irn ,rinp, may be transferred within the time Irames required by NYSt Rule 412 or smiler rule of the NASD or other deugnated examining authority. Unless otherwise indicated in the instructions above, I /willows yeti to liquidate any nontransferable propnelary money market fund assets that we part of my account and transfer the retailing credo balance to the successct custodian I authorize you to deduct any outstanding lees due to you from the credit balance in my account. II my account does not contain a MOO balance. or if the credit balance in the account is insufficient to satisfy any outstanding lees due t0 you. I authorize you to liquidate the assets in my account to the extent necessary I0 satmly that Obligation. II certificates or other instruments n my account are in Wit physcal possession, I instruct you to transfer them in good deliverable lam, including affixing any necessary tax waivers, to enable the successor comedian to transfer them in es name nor the purpose of the sale, when, and as directed to me. I understand that upon meowing a copy of this 1r:titter information, you vita cancel all open orders for my account on your books. I affirm that I have destroyed or returned to you credit/de0it cards and/or unused checks issued tome n connection with my brokerage account I understand that sOu will Contact me with respect tO the disposition of any assets in my Inokerage account that are nontransletible. CLIENT'S SIGNATURE: DATE: JOINT CLIENT'S SIGNATURE: DATE. Please attach your most recent brokerage account statement to process this account transfer INVESTMENT PROFESSIONAL'S NAME: INVESTMENT PROFESSIONAL'S PHONE NUMBER: SIGNATURE GUARAN1EED BY: CUSIP belongs to its repartee owner 09 NINA 059/ I IO.'09) Paps 3 of 3 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0029835 CONFIDENTIAL SDNY_GM_00 176019 EFTA01344417

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Email addresses, URLs, phone numbers, and other technical indicators extracted from this document.

Phone2704385
Phone3337958
Phone3389620
Phone5001766
Tail #N4G
Wire RefTRANSFER iNSTRUCTIONS
Wire Reftransfer INVESTMENT
Wire Reftransfer request
Wire Reftransfer systems

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