ES_TDR_AF_081901 1119 — Page 6 of 6
DO NOT STAPLE
Signature — YOU MUST SIGN BELOW
• I certify that I have read and understand, consent, and agree to all the terms and conditions of the TD Ameritrade 529 College Savings
Plan Program Disclosure Statement and Participation Agreement as they relate to adding, deleting, or changing nancial features.
• By signing below, I authorize the Program Manager or its designee to add, delete, or change nancial features according to the
• If I have added or changed banking information in Section 4, I certify that I have authority to transact on the bank account so
indicated or that the account owners of such bank account have authorized me to institute this AIP and/or EFT service from their
account on their behalf.
• If the Account is owned by an entity or trust, I certify that I am authorized to act on its behalf in making this request. If the Account
is a minor-owned Account or is funded with UGMA/UTMA assets, I further certify that I am the parent/guardian/custodian of the
Account identied in Section 1.
• I certify that the information provided herein is true and complete in all respects. I understand that all changes made on this form
supersede all my previous designations.
• If I have chosen the AIP or EFT option, I authorize the Program Manager and its designees, upon telephone or online request, to
pay amounts representing redemptions made by me or to secure payment of amounts invested by me, by initiating credit or debit
entries to my account at the bank named in Section 4. I authorize the bank to accept any such credits or debits to my account
without responsibility to their correctness. I acknowledge that the origination of ACH transactions involving my bank account must
comply with U.S. law. I further agree that neither the Nebraska Educational Savings Plan Trust, the TD Ameritrade 529 College
Savings Plan, the State of Nebraska, the Nebraska State Treasurer, nor the Program Manager or its authorized agents or any of
their afliates, or TD Ameritrade, TD Ameritrade Investment Management, LLC or their authorized agents or afliates will not incur
any loss, liability, cost, or expense for acting upon my telephone or online request. I understand that this authorization may be
terminated by me at any time by notifying the Program Manager and the bank by telephone or in writing, and that the termination
request will be effective as soon as the Program Manager and the bank have had a reasonable amount of time to act upon it. I
certify that I have authority to transact on the bank account identied by me in Section 4.
Signature of Account Owner Date (mm/dd/yyyy)
Securities Products: Not FDIC Insured - No Bank Guarantee - May Lose Value
Nebraska Educational Savings Plan Trust, Issuer. First National Capital Markets, Inc.,
Distributor, Member FINRA, SIPC. TD Ameritrade, Inc., sub-administrator. TD Ameritrade
Investment Management, LLC, portfolio consultant. First National Capital Markets and
First National Bank of Omaha are afliates.
TD Ameritrade, Inc. renders certain marketing and administrative services to the TD
Ameritrade 529 College Savings Plan. TD Ameritrade Investment Management, LLC
renders portfolio consulting services to First National Bank of Omaha and the Nebraska
Investment Council. TD Ameritrade is a trademark jointly owned by TD Ameritrade IP
Company, Inc. and the Toronto-Dominion Bank. All rights reserved. Used with Permission.