ES_TDR_BC_081901 1119 — Page 5 of 5
DO NOT STAPLE
SIGNATURE — YOU MUST SIGN BELOW
• By signing below, I hereby acknowledge that I have received, read and agree to the terms and conditions of the Program Disclosure
Statement which governs all aspects of this Account and is incorporated herein by reference. I will retain a copy for my records.
• I certify that all of the information I have provided on this form is accurate and complete and that I am bound by the terms, rights and
responsibilities stated in the Program Disclosure Statement and by any and all statutory, administrative and operating procedures
that govern the TD Ameritrade 529 College Savings Plan. Except as set forth below, I understand that the Program Disclosure
Statement and Enrollment Form constitute the entire agreement between me and the Nebraska Educational Savings Plan Trust
(Trust). No person is authorized to make an oral modication to this agreement.
• I understand investments in the TD Ameritrade 529 College Savings Plan are not guaranteed or insured by the FDIC or any other
government agency, and are not deposits or other obligations of any depository institution. Investments are not guaranteed or insured
by the State of Nebraska, the Nebraska State Treasurer, the Nebraska Investment Council, First National Bank of Omaha or TD
Ameritrade, TD Ameritrade Investment Management, LLC or their authorized agents or afliates, and are subject to investment risks,
including loss of the principal amount invested.
• I understand that participation in the TD Ameritrade 529 College Savings Plan does not guarantee that contributions and the
investment return on contributions, if any, will be adequate to cover tuition and other higher education expenses or that a
Beneciary will be admitted to or permitted to continue to attend an Eligible Educational Institution.
• I intend to use my Account solely to pay the qualied higher education expenses of the Beneciary.
• 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 8F of my original Enrollment Form. 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 the TD Ameritrade 529 College Savings Plan, the Trust, the State
of Nebraska, the Nebraska State Treasurer, the Nebraska Investment Council, or any of their authorized agents or afliates, the
Program Manager or its authorized agents or any of their afliates, 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
8F of my original Enrollment Form 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.
• To the best of my knowledge, each contribution to my Account, when added to the value of all other accounts established for the same
Beneciary in 529 plans issued by the Trust will not cause the aggregate balances in such accounts to exceed the Maximum Contribution
Limit then in effect or the cost in current dollars of qualied higher education expenses that I reasonably anticipate the Beneciary will incur.
• If the Account is minor-owned or is funded with UGMA/UTMA assets, I certify that I am of legal age in my state of residence,
I am the parent/guardian/custodian of the Account, and that I am authorized to open the Account.
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 and that I am
authorized to open an Account for the Beneciary named in Section 2. I agree to promptly inform the Program Manager in the event that
any of the foregoing certications becomes untrue. I understand and acknowledge that the Program Manager has the right to terminate
the entity’s participation in the Program if it has reasonable grounds to believe that any of the foregoing certications is untrue.
• I certify that the new Beneciary is a “Member of the Family” of the current Beneciary listed in Section 1. I understand that
transfers not meeting this condition may result in the earnings portion of the transfer being considered a Non-Qualied Withdrawal
subject to both state and federal income tax as well as an additional 10% federal tax.
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.