EFTA Document EFTA01427893

Account Transfer Form Mail or Fax to: PO Box 2760 ti Omaha, NE 68103-2760 Fax: 866-468-6268 Receiving Firm DTC Clearing Number: 0188 Please use the Direct Registration System (DRS) Transfer Form TDA 100557 for transfer from a transfer agent. 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 TD Ameritrade Attn: TD A