ES_NYA_BC_1208120 — Page 1 of 4
• Complete this form if you are transferring to a new Beneciary all or part of the balance in the Account of your current Beneciary.
Type in your information and print out the completed form, or print clearly, preferably in capital letters and black ink.
If establishing an Account for a new Beneficiary, the initial investment must be at least: $25 per month or $75 per quarter by Recurring
Contribution; $25 per month by Payroll Direct Deposit; or $1,000 transferred from the existing Beneficiary’s Account.
Important: To avoid adverse tax consequences on the Account transfer, the new Beneciary must be a “Member of the Family” of the former
Beneciary, as dened in the New York’s 529 Advisor-Guided College Savings Program
(the “Advisor-Guided Plan” or the “Plan”) Disclosure Booklet
Tuition Savings Agreement (“Disclosure Booklet”). If the new Beneciary is not an eligible family member, the change will be considered a non-qualied
withdrawal, which means that it may be subject to both New York state and federal income tax and a 10% federal penalty tax on anyearnings.
Forms can be downloaded from our website at or you can call us to order any form - or request assistance in completing this
form - at 1.800.774.2108 any business day from 8 a.m. to 7 p.m. Eastern time.
Current Account information (All information is required.)
Account Number Telephone Number (In case we have a question about your Account.)
Name of Account Owner (rst, middle initial, last)
Name of Existing Beneciary (rst, middle initial, last)
Existing Beneciary Social Security Number or Taxpayer Identication Number
New Beneciary information (All information is required.)
Name of New Beneciary (rst, middle initial, last)
Social Security Number or Taxpayer Identication Number Birth Date (mm/dd/yyyy)
BIN Number (if applicable to the nancial professional rm)
Citizenship (Required)
Resident Alien (Non-Resident Aliens are not eligible)
Country of Citizenship (If not a U.S. Citizen)
Check if new Beneciary’s address is the same as Account Owner, otherwise complete the following:
Mailing Address
City State Zip Code
Return this form and any other required documents to:
New York’s 529 Advisor-Guided College Savings Program
P.O. Box 55498
Boston, MA 02205-5498
For overnight delivery or registered mail, send to:
New York’s 529 Advisor-Guided College Savings Program
95 Wells Avenue, Suite 155
Newton, MA 02459
* N Y A D V B E N E C H G *
New York’s 529 Advisor-Guided College Savings Program
Beneciary Change Form
ES_NYA_BC_1208120 — Page 2 of 4
Transfer amount (Check and complete Section 3A or 3B.)
A. Entire balance. The Advisor-Guided Plan will move the entire balance of the Account listed in Section 1 into the new
Beneciary’s existing Account, or will establish a new Account for the transfer. Once the transfer is completed, the old
Account will be closed.
Do you already have an Account for the new Beneciary? (Check one.)
Yes. Go to Section 3C.
Account Number
No. Go to Section 4.
B. Partial balance. The Advisor-Guided Plan will keep the Account open for the current Beneciary. The dollar amount you
specify below will be transferred to the new Beneciary’s Account.
Dollar amount OR Total balance
Name of Investment Option (For partial amounts.) (Check if applicable.)
, .
, .
, .
Do you already have an Account for the new Beneciary? (Check one.)
Yes. Go to Section 3C.
Account Number
No. Go to Section 4.
Note: If the amount you want transferred exceeds the Maximum Account Balance, the excess will remain in the existing Account
for your current Beneciary.
C. Existing Account transfers. Complete this section if you have selected “Yes” in Section 3A or 3B. If an option is not
selected below, the transfer amount will be allocated according to the new Beneciarys existing Portfolio allocation election.
Check one.
I want to transfer the assets in-kind.* (An “in-kind” transfer is moving the Units from the current Beneciarys Account to
the new Beneciarys Account without selling or buying Portfolios.) Go to Section 5.
I want to transfer and allocate the assets according to the new Beneciary’s current Investment Options.* (By selecting
this option, the current investments will be liquidated, and the funds will be deposited into the new Beneciary’s Account
according to the future allocation instructions on the new Beneciarys Account.) Go to Section 5.
I want to transfer the assets into the new Investment Option(s) selected in Section 4.* (This will not change the future
contribution allocation of the new Beneciary’s Account.) Go to Section 4.
* Assets transferred from one Account to another Account for a different Beneciary will be used to purchase the same class of
Portfolio Units as those being surrendered in connection with the transfer, regardless of the Portfolio that the Account Owner
selects to invest in with the transferred funds. To the extent available, the new Portfolio Units will retain the same holding-period
characteristics as the previously held Portfolio Units for purposes of calculating any applicable CDSC which may apply.
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Investment Option selection (Check only one box.)
Before choosing your Investment Options, see the Disclosure Booklet (available at for complete
information about the Investment Options offered.
• The assets will remain in the Portfolios you select until you exchange them into a new Investment Option.
• You must allocate at least 1% of your contributions to each Investment Option you choose. Use whole percentages only.
• Your investment percentages must total 100%.
• These Investment Options are designed to help you save for post-secondary higher education expenses.
A. I want to keep the same Investment Option as my existing Beneciary for my new Beneciary. For Age-Based investments,
the Age-Based portfolio will correspond to the new Beneciary’s age.
B. I want to establish a new Investment Option as listed below. Current Unit Class will be maintained upon transfer. If you
would like to invest in a different Unit Class or Portfolio for future purchases, please notify us.
Age-Based Investment Option:
JPMorgan 529 Age-Based Portfolio
(Your investment will be allocated to the appropriate Age-Based Portfolio for your Beneciary’s age.)
Asset Allocation Portfolio Investment Options:
JPMorgan 529 Aggressive Portfolio
JPMorgan 529 Moderate Growth Portfolio
JPMorgan 529 Moderate Portfolio
JPMorgan 529 Conservative Growth Portfolio
JPMorgan 529 Conservative Portfolio
JPMorgan 529 College Portfolio
Single Fund Portfolio Investment Options:
SSGA 529 Portfolio S&P 1500 Composite Stock Market ETF Portfolio
JPMorgan 529 Equity Income Portfolio
JPMorgan 529 Large Cap Growth Portfolio
JPMorgan 529 Mid Cap Value Portfolio
JPMorgan 529 Growth Advantage Portfolio
SSGA 529 S&P 600 Small Cap ETF Portfolio
JPMorgan 529 Small Cap Equity Portfolio
JPMorgan 529 Realty Income Portfolio
SSGA 529 Portfolio Developed World ex-US ETF Portfolio
JPMorgan 529 International Equity Portfolio
SSGA 529 MSCI ACWI ex-US ETF Portfolio
JPMorgan 529 Core Bond Portfolio
JPMorgan 529 Core Plus Bond Portfolio
SSGA 529 Portfolio Aggregate Bond ETF Portfolio
JPMorgan 529 Short Duration Bond Portfolio
JPMorgan 529 Ination Managed Bond Portfolio
JPMorgan 529 U.S. Government Money Market Portfolio
Note: Only complete
this section if you do not
have an existing Account
for the new Beneciary
or elected to transfer to
new Investment Option(s)
in 3C. For new Accounts,
this will also be the future
contributions allocation.
ES_NYA_BC_1208120 — Page 4 of 4
Successor Account Owner information
• The Successor Account Owner will take over control of the Account in the event of your death.
• You may revoke or change the Successor Account Owner at any time. See the Disclosure Booklet for more information.
I want to have the same Successor Account Owner for the new Beneciary.
I want to establish a new Successor Account Owner for the new Beneciary, provided below.
Name (rst, middle initial, last)
Birth Date (mm/dd/yyyy)
Recurring Contributions (Optional)
Through Recurring Contributions, you can have funds transferred electronically on a regular basis from your bank, savings and
loan, or credit union account to your Plan Account. Your contribution will be credited to your Plan Account on the same business day it
is debited from your bank account. You may download a Recurring Contributions/Electronic Bank Transfer Form to add, change,
or delete bank information, or change the investment amount and frequency at any time by logging on to your Account at or by calling 1.800.774.2108.
I would like to continue my existing Recurring Contributions for the new Beneciary.
By signing below, I hereby certify that:
I have received the Disclosure Booklet and Tuition Savings Agreement of New York’s 529 Advisor-Guided College Savings Program
(“Disclosure Booklet”). I understand that by signing this form, I am agreeing to be bound by the terms and conditions of the
Disclosure Booklet. I understand that the New York’s 529 Advisor-Guided College Savings Program
(“Plan”) may from time to time
amend the Disclosure Booklet, and I agree I will be subject to the terms of those amendments. I understand that the Disclosure
Booklet and this form shall be construed, governed, and interpreted in accordance with the laws of the State of New York.
I understand that the Disclosure Booklet and the Plan forms signed by me constitute the entire agreement between the Account
Owner and the Plan. No person is authorized to make an oral modication to this agreement.
I understand that I may incur federal, state or local income and penalty taxes as a consequence of certain activities, including
without limitation non-qualied withdrawals, terminating my Account, or changing my Beneciary to an ineligible person. Account
Owners should seek advice from a qualied tax professional.
I understand that contributions to the Plan are not insured and that the investment returns are not guaranteed by the Federal Deposit
Insurance Corporation, the State of New York, its agencies, or any other government or government agency, Ascensus Broker Dealer
Services, Inc., and its afliates, JP Morgan Distribution Services, Inc., or the investment managers for the underlying funds in the
Plan. There is no assurance that the Accounts under the Plan will generate any specic rate of return; and there is no assurance that
the Account will not decrease in value. I understand that I could lose money.
I understand that the Investment Options offered by the Plan have been designed to save for post-secondary higher education expenses
and that for New York State tax purposes, the earnings on a withdrawal used to pay K-12 Expenses, Apprenticeship Program
Expenses, or Qualied Education Loan Expenses will be considered a nonqualied withdrawal and will require the recapture of any
New York State tax benets that have accrued on contributions.
I understand that contributions that cause the total balance of this Account and any other Accounts established in the Plan and in
any other Qualied Tuition Program offered by the State of New York on behalf of the Beneciary to exceed the Maximum Account
Balance set forth in the Disclosure Booklet are not permitted. I understand that if a contribution is made to my Account that exceeds
the Maximum Account Balance, all or a portion of the contribution amount will be returned to me or the contributor.
all the information that I provided on this form is true and accurate in all material respects, that Ascensus and its afliates are
entitled to rely on the information provided herein and the instructions provided on this form, and that I am bound by any and all
statutory, administrative, and operating procedures that govern the Plan.
Signature of Account Owner Date (mm/dd/yyyy)