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Ally Bank
PO Box 951
Horsham, PA 19044
Fax
Subject Line: Operations
Fax Number: 866-699-2969
TRUST CONVERSION REQUEST FORM
Use this form to:
Convert a personal Ally Bank account to an account titled in the name of a trust.
Provide us the documents below:
• Completed Trust Conversion Request Form
• A copy of the pages in the Trust Agreement describing the trust. This includes the formal name of the trust, the grantor(s), & trustee(s) as well as the
signature and notary pages of the Trust Agreement and trustee powers.
• A copy of Death Certicate(s), if anyone named in the trust title and/or a trustee(s) is/are deceased
• A copy of court orders associated with the creation or modication of the trust (if applicable)
Current Account Holder Information and Authorization
CURRENT ACCOUNT HOLDER NAME ACCOUNT NUMBER(S)
CURRENT ACCOUNT HOLDER NAME ACCOUNT NUMBER(S)
In order for a personal account to be eligible for conversion to the name of a trust, ALL current account owners must sign below. You acknowledge
that the accounts listed above will be re-titled in the name of a trust. Since the account(s) will convert to an entity, you acknowledge that if you are not
designated as a trustee in the Trust Agreement you will no longer have access to the account and you are giving up direct ownership of the funds as
they become property of the trust listed above. You also acknowledge that any person/entity currently designated as a “Payable on Death” (POD)
payee or “In Trust For” (ITF) beneciary on the accounts listed above will be removed as the Trust Agreement will designate the distribution of assets
within the trust.
SIGNATURE OF CURRENT ACCOUNT HOLDER SIGNATURE OF CURRENT ACCOUNT HOLDER
Trust Information
Choose One:
Revocable Trust Revocable Trust (Grantor is not a Trustee) Irrevocable Trust
NAME OF TRUST (AS IT APPEARS ON THE TRUST AGREEMENT) TAX IDENTIFICATION NUMBER FOR TRUST
Ally Bank Member FDIC
QUESTIONS? CALL 1-877-247-2559 OR VISIT ALLY.COM
UPDATED 09/2019
1
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TRUST CONVERSION REQUEST FORM
Additional Trustee(s)
To help the United States government ght terrorism and money laundering, federal law requires us to obtain, verify, and record information that identies
each person who opens an account. What this means for you: when you open an account, we will ask for your name, a street address, date of birth, and
an identication number, such as a Social Security number. We may also ask to see your driver’s license or other identifying documents that will allow us
to identify you.
We only open accounts for legal U.S. residents. By signing and submitting this application, you are acknowledging that you are a U.S. citizen or resident
alien of the U.S.
If you have a freeze on your credit as a feature of credit security monitoring, we may contact you to lift the freeze temporarily to verify your identity.
You authorize us to contact you by using any telephone number you provide to us, including a mobile or cell phone number that you are authorized to
use. In addition to manual calling, we may use text messages, prerecorded or articial voice messages, or automatic dialing systems. We will not charge
you for any contact, but your mobile phone service provider may.
To be completed if any trustee named in the trust is not currently on any of the accounts listed above. For additional trustees, copy this form and
submit for each trustee.
Grantor/Primary Trustee Information
I am an existing Ally Bank account owner and would like to use my information already on le.
(Please complete only Name, Social Security Number, and Date of Birth information below.)
FIRST NAME M.I. LAST NAME / SUFFIX SOCIAL SECURITY NUMBER
DATE OF BIRTH
EMAIL ADDRESS HOME PHONE
BUSINESS PHONE (OPTIONAL) MOBILE PHONE (OPTIONAL)
RESIDENTIAL STREET ADDRESS (NO PO BOXES)
RESIDENTIAL ADDRESS LINE 2 (OPTIONAL)
RESIDENTIAL CITY STATE ZIP
MAILING STREET ADDRESS (IF DIFFERENT THAN RESIDENTIAL)
MAILING ADDRESS LINE 2 (OPTIONAL)
MAILING CITY STATE ZIP
RESIDENTIAL STREET ADDRESS (NO PO BOXES) RESIDENTIAL CITY STATE ZIP
Security Information: Provide a security question with answer and mother’s maiden name that may be used to identify you when contacting us.
SECURITY QUESTION SECURITY ANSWER MOTHER’S MAIDEN NAME
Ally Bank Member FDIC
QUESTIONS? CALL 1-877-247-2559 OR VISIT ALLY.COM
UPDATED 09/2019
2
Provide a prior residential address if the applicant has been at the above address for less than 5 years. In addition, provide a copy of one of the
following for address verication: Driver’s License, state issued ID card or utility bill (not greater than 60 days).
OCCUPATION EMPLOYER
CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER
Account Agreement
(TO BE SIGNED BY A TRUSTEE WHO IS NOT A CURRENT ALLY BANK CUSTOMER)
Acceptance of Terms and Conditions
By signing below and agreeing to become a trustee on the account, you agree to the terms of the Ally Bank Deposit Agreement that will be sent to you
within 10 days of being added to the account(s). You as trustee, authorize us to obtain a consumer report from a consumer reporting agency to verify
information provided in this application or for any legitimate business purpose in connection with the Ally Bank account.
SIGNATURE DATE
Certication Of Taxpayer Identication Number
Complete and sign the Certication of Taxpayer Identication Number form if you currently have no existing accounts at Ally.
A Certication of Taxpayer Identication Number form is required for each account owner.
Complete with the trust SSN/TIN and trustee’s signature
FORM W9 TAXPAYER IDENTIFICATION NUMBER (TIN) CERTIFICATION (Not applicable for Non-Resident Aliens)
(For individuals, the TIN is your Social Security Number or Individual Tax Identication Number (ITIN) which should match the rst name listed on
the account and will be used for tax reporting purposes. For other entities, it is your Employer Identication Number.)
SOCIAL SECURITY NUMBER OR EMPLOYER IDENTIFICATION NUMBER:
A.
B. Certication - Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identication number (or I am waiting for a number to be issued to me), and
2. I am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notied by the Internal
Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has
notied me that I am no longer subject to backup withholding, and
3. I am a U.S. citizen or other U.S. person (including a U.S. Resident Alien), and
4. I am exempt from Foreign Account Tax Compliance Act Reporting.
Backup Withholding Instructions
You must check off this box if you have been notied by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return.
The Internal Revenue Service does not require your consent to any provision of this document other than the certications required to
avoid backup withholding.
TRUSTEE SIGNATURE NAME OF TRUST DATE
CUSTOMER NUMBER
(INTERNAL USE ONLY)
Ally Bank Member FDIC
QUESTIONS? CALL 1-877-247-2559 OR VISIT ALLY.COM
UPDATED 09/2019
3
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FAX, MAIL, UPLOAD Return this form with any (Ally Bank)

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Completed 30 July 2020

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